Summary of benefits

Some benefits are affected by Health Technology Clinical Committee (HTCC) decisions. UMP is required by law to follow these decisions.

How does this work?

Only certain services are listed in the table below. For those not listed, see the alphabetical list of covered benefits in your certificate of coverage.

Not all details, such as benefit limitations or exclusions, are included in the table. Also review:

If you have questions about your benefits, services that require preauthorization or plan notification, or services not covered by the plan, call UMP Customer Service at 1-888-849-3681 (TRS: 711).

If you would like more information about the benefits listed below, you can read your UMP Classic 2019 Certificate of Coverage, the Summaries of Benefits and Coverage, or the medical policies

Benefit/service

How will you pay?
(See descriptions of service types listed below)

Acupuncture

Standard

Ambulance

Special: Select link on left for benefit details.

Applied Behavior Analysis (ABA) Therapy

Standard

Breast health screening tests

See "Mammograms" below.

Chiropractic physician services See "Spinal and extremity manipulations" below.
Contraceptive services Preventive

Dental services

Special: Select link on left for benefit details.

Diabetes care supplies

Special: Select link on left for benefit details.

Diabetes Control Program Preventive

Diabetes Prevention Program

Preventive

Diagnostic tests, laboratory, and X-rays

Standard

Durable medical equipment, supplies, and prostheses

Standard

Emergency room

Standard, plus an ER copay of $75, medical deductible, and coinsurance.
You are usually billed separately for:

  • Facility charges
  • Professional (physician) services
  • Lab tests, x-rays, and other imaging tests 

End-of-life counseling

If received as part of hospice services: Paid at 100% after meeting medical deductible.
If received outside of hospice services: Standard.

Family planning services

Standard

Headaches, chronic migraines or tension Standard: Covered Botox injections for migraines.
All other specified treatments not covered.

Hearing aids
(Not subject to medical deductible)

Special: See benefit link at left for details.

Hearing exams, routine

Preventive
 

Home health care

Standard

Hospice care (Includes respite care and prescription drugs)

Special: See benefit link at left for details.

Hospital services (inpatient services)

Inpatient

Hospital services (outpatient services) Standard
Immunizations (vaccines) Preventive (usually)

Joint replacement, knees and hips-Centers of Excellence (COE) Program

Special: Select link on left for benefit details.

Mammograms (Diagnostic)

Standard

Mammograms (Screening) Preventive

Massage therapy

Standard

Mastectomy and breast reconstruction

Inpatient
(Standard for related outpatient visits)

Mental health treatment (Inpatient services)

Inpatient

Mental health treatment (Outpatient services) Standard

Naturopathic physician services

Standard

Obstetric and newborn care

Inpatient
(Standard for related outpatient visits)
Some breast pumps are covered as preventive.

Office visits

Standard

Physical, occupational, speech, and neurodevelopmental therapy

Standard
Charges for inpatient services are not included in the inpatient copay.

Prescription drugs

See What you pay for drugs

Preventive care 
(Includes vaccines, routine exams, some screening tests)

Preventive

Skilled nursing facility

Inpatient
Some services may be billed separately (such as physical therapy).

Spinal and extremity manipulations

Standard

Spine care—Centers of Excellence (COE) Program Special: Select link on left for benefit details.
Substance use disorder treatment (Inpatient services)  Inpatient
Substance use disorder treatment (Outpatient services) Standard
Surgery (Inpatient services) Inpatient
Surgery (Outpatient services) Standard

Telemedicine services

Standard
 

Tobacco cessation services

Preventive

Transgender health

Standard

Urgent care

Standard
You don’t pay the ER copay for urgent care services at urgent care facilities.

Vision care (diseases and disorders of the eye)

Standard

Vision exams (routine)

Preventive

Vision hardware (eyeglasses and contact lenses) (over  age 18)

Special: See benefit link at left for details.

Well-child visits Preventive

Contact

UMP Customer Service
Online: Your Regence account 
Phone: 1-888-849-3681
TRS: 711
Business hours: Monday through Friday 5 a.m. to 8 p.m. and Saturday 8 a.m. to 4:30 p.m. (Pacific)

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