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Show your UMP member ID card each time you see a provider or fill a prescription. Pharmacies and providers need this information to charge you the right amount and bill your plan correctly.
Your UMP Plus medical deductible is $125 per person every calendar year (with a maximum of $375 for a family of three or more).
For most covered medical services, you pay toward the medical deductible before the plan begins to pay. Learn more, including how the medical deductible works for families, at UMP Plus: How does the medical deductible work?
You do not pay a deductible for prescription drugs, and prescription drug costs don’t count toward your medical deductible.
You don’t have to pay your medical deductible before the plan begins to pay for the following:
- Office visit charges by Primary Care Network providers.
- Preventive care and immunizations.
- Routine vision care (exams, glasses, and contacts).
- Routine hearing care (exams and hearing aids).
- Select contraceptive supplies and services.
- Certain products available from network pharmacies.
- Prescription drugs.
- Tobacco cessation services.
- Diabetes Prevention Program.
- Required second opinions.
The following out-of-pocket expenses do not count toward your deductible:
- Services you pay for that aren’t covered by the plan.
- Services exempt from the medical deductible, even if you had out-of-pocket costs. For example, preventive care received from a non-network or out-of-network provider.
- Charges for services exceeding benefit maximums. For example, the maximum for adult vision hardware is $150 every two calendar years. The charges over $150 do not count toward your medical deductible.
- Charges for services beyond benefit limits. For example, the annual benefit limit for acupuncture is 16 visits. Costs for more than 16 visits are not covered by the plan and do not count toward your medical deductible.
- Out-of-network provider charges that exceed the allowed amount.
- Your inpatient hospital copayment.
- Your emergency room copayment.
- Prescription drug costs.