What you pay for drugs

Now that you know how it works...

Find the cost for your drug

What you pay for prescription drugs under UMP CDHP

Until you meet your deductible, you will pay the entire cost of your prescription drugs.

Once you have met your deductible for the year, you pay 15 percent of the drug’s cost for covered prescription drugs.

You can get up to a 90-day supply for most drugs, except for specialty drugs. For drugs covered as preventive, you don’t pay the deductible or coinsurance when you use a network pharmacy.

If a prescription drug isn't covered by the plan, it does not count toward either your deductible or out-of-pocket limit.

Note: You may use your Health Savings Account (HSA) to pay for many drugs not covered by the plan.

Why you should use network pharmacies

When you use network pharmacies, retail or mail-order, you pay based on the drug’s allowed amount, a discounted price negotiated for the plan.

If you use a non-network pharmacy of any type, the pharmacy may charge more than the allowed amount. You will have to pay this amount, which doesn’t count toward your deductible or out-of-pocket limit and is not payable by the plan.

You also may need to submit your own prescription drug claim to Washington State Rx Services for reimbursement if you purchase drugs at a non-network pharmacy.

Find network pharmacies

Note: Prescriptions ordered through mail-order pharmacies located outside the U.S. are not covered, even if you send in a claim.

If a dependent has other medical coverage

If a dependent has primary coverage through another plan that covers prescription drugs, read the "How much will I pay for prescription drugs?" section of your certificate of coverage. This section explains possible limits and restrictions to prescription drug coverage, how to use a network pharmacy when UMP CDHP is secondary, and how to use a mail-order pharmacy when UMP CHDP is secondary.

Contact

Washington State Rx Services
Phone: 1-888-361-1611
TRS: 711
Business hours:  24 hours a day, 7 days a week