The UMP website is moving. This website contains 2019 UMP information for PEBB members only (through the end of 2019). If you are a PEBB member and/or you will be a new School Employees Benefits Board (SEBB) member and you need 2020 UMP benefits information, visit our new UMP website.
Search the UMP Preferred Drug List
Use the UMP Preferred Drug List to find:
- If a drug is covered by the plan.
- How much you will pay for a drug based on the drug’s tier.
- If the drug must be preauthorized.
- If the drug must be purchased from the plan’s specialty pharmacy, Ardon Health.
- If there are any limits on a drug’s coverage.
- If there are less expensive alternatives.
Changes to the UMP Preferred Drug list are posted online at least once a month. However, not all drugs are listed on the UMP Preferred Drug List. Also, a drug may change tiers at any time, particularly when a generic equivalent becomes available. New brand-name drugs may not be covered during the first 180 days they are available.
For questions about your prescription drugs, or to check if a new drug is covered, call Washington State Rx Services at 1-888-361-1611 (TRS: 711).
Other prescription drug tools
Use the prescription price check if you want to know how much your drug will cost.
To get information specific to your account (for example, your prescription drug claims history), log in to your pharmacy account and use the prescription price check tool.
Who decides which drugs are preferred?
As a state-sponsored health plan, UMP must follow coverage decisions made by the Washington State Pharmacy & Therapeutics Committee (P&T Committee), which consists of Washington health care professionals, including physicians and pharmacists. The UMP Preferred Drug List includes these coverage recommendations.
Not all drug classes are reviewed by the Washington State P&T Committee. For these drugs, the Washington State Rx Services P&T Committee makes coverage recommendations for UMP's review and final determination of a drug's tier level.
For the plan to approve a drug for you, it must be medically necessary for your health condition. Your provider may prescribe a drug or drug dosage that does not meet the plan’s definition of medically necessary.
For more information on the P&T Committee, see the Prescription Drug Program's webpages.
Note: A drug may be designated as Tier 3 (nonpreferred) even if no generic equivalent is available. Visit What you pay for drugs to learn how you may request an exception to the Tier 3 cost share.