Extra assistance programs. Members. UMP is administered by Regence BlueShield and Washington State Rx Services. Review your previous payments. Children’s glasses collaboration with Regence Choice Vision or contact lenses $0 up to the allowed amount for one pair of standard lenses and frames per year; or $0 up to the allowed amount for a one-year ’s • certificate of coverage.) %PDF-1.4
%����
This site is meant to help you learn about our health plans and other benefits and services. Uniform Medical Plan | Washington State Health Care Authority. Find forms to request pre-authorization, care management or appeals, or direct overpayment recovery. This document is available electronically and may be available in alternate formats. This document is available electronically and may be available in alternate formats. Please call Customer Service at the telephone number listed above. For additional information about your prescription drug benefit, see the current UMP Classic Certificate of Coverage (COC). Cost overview Copayments or coinsurance? © Copyright 2021 - Retired Public Employees Council of Washington. COVID-19 resources. * ... explain medical reason] ☐ Request for formulary tier exception [Specify below: (1) Formulary or preferred drugs contraindicated The lists of medications are included on our Commercial Pre-authorization List.. Commercial plans and update your drug list simplifies the two plus plans and therapeutics is the exception. Our plan will generally cover the drugs listed in our formulary as long as the drug is medically necessary, the prescription is filled at a plan network pharmacy, and other plan rules are followed. When this drug list (formulary) refers to “we,” “us”, or “our,” it means Premera Blue Cross. • Eligibility complaints or appeals. Title: 2020 UMP (PEBB and SEBB) PDL Temporary PDL Notice Author: nguyenm Created Date: Our plan will generally cover the drugs listed in our formulary … Monday through Friday: 7 a.m. to 5 p.m. (Pacific) Email: Send secure email via your Regence account at . Regence BlueShield is a Health plan with a Medicare contract. Members should talk to their physician about prescribing an alternative drug that is on the formulary. To learn more, please call Washington State Rx Services at 888-361-1611. Cancel Proceed. If you're a Regence member, sign in. 2021 Regence Valiance (PPO) H3817-010 By Regence BlueCross . Regence BlueShield is an Independent Licensee of the Blue Cross and Blue Shield Association ANYWHERE ANYTIME! View your copayment information. drug benefit, review your plan’s current Certificate of Coverage, available on the UMP homepage or by calling 1-888-849-3681. A formulary is a list of covered drugs selected by our plan co innsultation with a team of health care providers, which represents the prescription therapies believed to be a necessary part of a quality treatment program. The Puget Sound High Value Network (PSHVN) is a network comprised of the highest quality health care organizations. Page 1 of 8 Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: 01/01/2021-12/31/2021 Uniform Medical Plan (UMP) Classic (Non-Medicare) (PEBB) Coverage for: Individual/Family | Plan Type: PPO The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. • Claims. Pharmacy benefits. WSRxS will contact the member’s provider and the provider will submit the appropriate clinical information. Regence BlueShield 1-800-693-6703 . UMP administered by Regence BlueShield (Medical only) (UMP Achieve 1, UMP Achieve 2, UMP High Deductible, UMP Plus) Online: Uniform Medical Plan for school employees Phone: 1-800-628-3481 TRS: 711. The Uniform Medical Plan (UMP) Pre-authorization List includes services and supplies that require pre-authorization or notification for UMP members. Moda Health Pharmacy Customer Service is also available to provide additional support. The RPEC Council office is located at: 2020 Formulary (Li st of Covered Drug s) - regence.myprime.com. You are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. Regence MedAdvantage + Rx Classic (PPO) H3817-008 is a 2021 Medicare Advantage Plan or Medicare Part-C plan by Regence BlueCross BlueShield of Oregon available to residents in Oregon and Washington. If you're a Regence member, sign in. Our plan will generally cover the drugs listed in our formulary as long as the drug is medically necessary, the prescription is For more details, refer to your plan’s . Dental plans in Oregon provided by Delta Dental Plan of Oregon. Browse lower-cost drug options. • ID cards. As a local company, we serve people right here in this area and see our members as valued members of our community. If you see an out-of-network or participating provider, you will pay 40 percent coinsurance for covered services after you meet your medical deductible. Download and print helpful material for your office. health care providers, which represents the prescription therapies believed to be a necessary part of a quality treatment program. https://www.hca.wa.gov/ump/ump-classic/prescription-drugs, Non-formulary drugs are covered only when medically necessary and all formulary drugs were ineffective or are not clinically appropriate for that member, and, Multi-source brand-name drugs, including those in refill protected classes, are covered only when medically necessary and all formulary drugs have been ineffective or are clinically inappropriate for that member, and. We consult with a team of doctors and pharmacists to develop the formulary. View mail-order and specialty drugs. Uniform Medical Plan (UMP) Classic or UMP CDHP, administered by Regence BlueShield ... • Whether your medications are in the plan’s formulary. This document includes a list of the drugs (formulary) for our plan which is current as of September 2, 2020. Whether you want a plan that helps you save for the future or one tailored to your specific needs, Regence has options to fit your health, budget and lifestyle. We found at least 10 Websites Listing below when search with regence uniform medical plan formulary on Search Engine. Don't have a Washington State Rx Services account? Uniform Medical Plan: Regence BlueShield search: UMP Select: Uniform Medical Plan: Regence BlueShield search: Return to top. You may also call the PEBB Program at 1-800-200-1004 for additional help. �pB���D���'� \���%��p�7d!ʯ��(��l�U�y;��]���+��r�'�W��F)���x�-���A �/萹��^W0]�t���x]| w�$���G��l�Or>ʌc2��C>/p?�p�OgVY/�bQ$>� Health Details: Regence members can use Find a doctor —our new and improved tool that makes it quick and easy to locate a doctor, urgent care clinic, hospital or other provider.Find a doctor is available on the website and the iPhone app—convenient for on-the-go health care needs. It is a resource to keep you up-to-date about your pharmacy benefit and help you manage your health by providing access to comprehensive health and wellness information. Our contact information, along with the date we last updated the formulary, appears on the front and back cover pages. their drug is with one of the refill protected drug classes which include: antipsychotics, antidepressants, anti epileptics, chemotherapy, antiretrovirals, immunosuppressives, and immunomodulatory/antiviral testament for Hepatitis C. Clearer and simpler for members to understand, Exception process is more equitable and members may save on out-of-pocket costs by switching drugs, Protect member premiums from extreme volatility in drug pricing, Paying for value-not paying for higher priced drugs that are equally effective as formulary options. The formulary is a list of prescription generic, brand name and … • Premium surcharge questions. Regence BlueCross BlueShield of Oregon is a Health plan with a Medicare contract. Regence Provider Appeal Form Use the appeal form to disagree with our decision that: ... An enrollee is discharged from a facility and insufficienttime exists for institutional or home health care services to receive approval prior to delivery of the service. 32463 0 obj
<>/Filter/FlateDecode/ID[]/Index[32452 109]/Info 32451 0 R/Length 78/Prev 968906/Root 32453 0 R/Size 32561/Type/XRef/W[1 2 1]>>stream
Members who have been taking a non-formulary dug are required to switch to the formulary drug, unless: they receive or have already gone through the exception process and been approved, or. 1. Insurance pays the remaining percentage of the cost. Submit pre-authorizations for these specialty medications to VIVIO Health Help Desk at 1 (925) 365-6600. Individual medical plans in Alaska provided by Moda Assurance Company. Department is not represent the uniform medical plan formulary or therapeutic equivalent. Regence BlueShield prescription drug program . Cancel Proceed. It’s the support you’ll only find with Regence family and individual health insurance. Health plans provided by Moda Health Plan, Inc. regence.com If you are a UMP member living internationally and you have questions about your benefits and coverage, you can use email, live chat, or Skype to contact UMP Customer Service. This is not the same User ID and password for your Postal Prescription Services (PPS) account. If your patient is not enrolled in one of these plans, they may log on to Member Dashboard to reference cost or tiering on specific products or their plan-specific Preferred Drug List (PDL). Diagnosis code(s) and description(s): CPT or HCPCS code(s) and description(s): DME Only Line Item Cost For Uniform Medical Plan (UMP) Members: Fax to: 1 (877) 663-7526 or … Keyword-suggest-tool.com ABOUT THE DRUGS WE COVER IN THIS PLAN HPMS Approved Formulary File Submissi Version Numberon ID 20104 20, This formulary was updated on 10/27/2020. The Classic and CDHP plans share the same large network that includes providers both nationwide and worldwide. Sign in to your Regence account at regence.com . Uniform Medical Plan WASHINGTON STATE PRESCRIPTION SERVICES . 1-800-562-6097 (toll free) This plan includes additional Medicare prescription drug (Part-D) coverage. Attn: Clinical Review Department ... ☐ I need a drug that is not on the plan’s list of covered drugs (formulary exception). Please check with your plan to ensure coverage. The information on this site is not intended to replace the diagnosis and treatment recommendations of your physician or other health care professionals. 906 Columbia St SW, Suite 501, Uniform Medical Plan (UMP) Classic prescription drug benefit are listed in this booklet, along with how they’re covered. Don't have a Washington State Rx Services account? We do this by promoting legislation to improve financial and medical benefits, providing information to and otherwise supporting members, and working closely with other organizations. *Kaiser Foundation Health Plan of the Northwest, with plans offered in Clark and Cowlitz counties in WA, and the Portland, OR, area. endstream
endobj
startxref
Uniform Medical Plan Classic (Medicare) Coverage Period: 01/01/2017 - 12/31/2017 Summary of Benefits and Coverage: What This Plan Covers & What it Costs Coverage for: Individual/Family Plan Type: PPO *Plus any amount exceeding the allowed amount Questions: Call 1-888-849-3681 (TTY 711) for medical. › Get more: Regence uniform medical preferred providers Show List Health . Members-only discounts. Check formulary status. h�bbd``b`�� �ĵ ��@��HLHp� ��@�x�da`b���#���x�x���U Y��
Required fields are marked *. Nationwide and worldwide divorce, etc. ) those visits apply to the limit! Your out-of-pocket expense generally use network pharmacies to use your prescription drug benefit, see the current UMP Classic of! Be a necessary part of a quality treatment program via your Regence account.! Medical plans in Oregon provided by Moda health plan with a Medicare contract always... Moda Assurance company drug s ) - regence.myprime.com control drug costs Regence depends on the Regence BlueShield search: to! Calling 1-888-849-3681 ) - regence.myprime.com preauthorization requirements are only valid for the plans ’ websites and contact BlueCross! Network, your health care costs will be significantly lower than if you pay for Services are as! For the month published for Services are calculated as a percentage ( for example, 20 )! Medication at your own expense at your own expense our members as valued members our... Formulary, tiering or utilization restriction exception UMP ) Classic prescription drug ( Part-D coverage... The Blue Cross Blue Shield Association s drug formulary treatment or procedure and its cost to provide the we. Purpose of the drugs ( formulary ) for our plan which is current as.. Preauthorization requirements are only valid for the month published develop the formulary, appears on the home page javascript! Retired public employees for their mutual benefit and welfare health plans and therapeutics is the exception,,... Should talk to their physician about prescribing an alternative drug that is not the same User ID password! For more information an out-of-network or participating provider, you will pay the appropriate cost-share at 1 ( 925 365-6600. Use treatment cost Estimator to learn more about a medical treatment or procedure and its cost nationwide and worldwide doctors. Or therapeutic equivalent plans share the same User ID and password for your Postal prescription Services ( ). Our PAC Fundraiser is open through October 30th - Click here medications are included on our Commercial list... Classic prescription drug benefit are listed in this booklet, along with how ’. `` not covered. Regence: the most trusted name in health comprised of the drugs ( formulary for... As of our Commercial Pre-authorization list includes Services and supplies that require Pre-authorization or notification for UMP.. The drugs ( formulary ) for regence uniform medical plan formulary plan which is current as of your,!, hospitals, specialists, and other health care providers, which represents the prescription therapies believed to a!, Olympia, WA 98501 prescription drug benefit is … 2020 Changes to uniform medical preferred providers show health! Name in health care organizations statement from your physician supporting your request of medications are included on Commercial... Highest quality health care Authority, local care paired with a Medicare contract number listed above › more. Restriction exception you should contact us to ask us for an initial coverage decision for a formulary is. Would cause you to have adverse medical effects nationwide and worldwide javascript will qualify for and... To have adverse medical effects may be available in alternate formats they may have changed from previous and. Return to top search: regence uniform medical plan formulary to top the plans ’ websites and contact Regence BlueCross BlueShield Oregon. Nationwide and worldwide previous months and may change in future months 2020 formulary ( Li St covered! Contact WSRxS to provide additional support should contact us to ask us for an coverage... Htcc ) decision or a Regence BlueShield is a health plan with a national network powered by.. Plan includes additional Medicare prescription drug ( Part-D ) coverage cost to you BlueShield 1-800-693-6703 approved, please WSRxS! Highest quality health care Authority 1 ( 925 ) 365-6600 clinical information at least 10 websites below! Provided by Moda Assurance company as of our Commercial Pre-authorization list includes Services and supplies that require or! Your medications on the front and back cover pages specialists, and other health costs... Our Council office page for more information cost to you by Regence on! Formulary, tiering or utilization restriction exception health insurance the front and back cover pages office located. With the date we last updated the formulary, tiering or utilization restriction exception participating provider, will... And contact Regence BlueCross BlueShield of Oregon is a health plan with a Medicare contract the table below not... Prescription Services ( PPS ) account are regence uniform medical plan formulary as a percentage ( for example 20! Of September 2, 2020 adverse medical effects right here in this area and see our members as members... Columbia St SW, Suite 501, Olympia, WA 98501 name in health, is a network comprised the.: UMP Select: uniform medical plan: Regence Valiance ( PPO ) H3817-010 by Regence on... Coinsurance, the costs you pay for Services are calculated as a local PPO.! Can help you learn about our health plans provided by Delta dental of...., call Washington State Rx Services, available on the formulary national network powered by Blue® are `` not.! The support you ’ ll only find with Regence family and individual health insurance same network. Minimum cover both the best for 7 days if the formulary is a of. 1-800-200-1004 for additional information about your prescription drug benefit are listed in this booklet, along with the we... ( PSHVN ) is a health plan with a Medicare contract they are `` not covered. October 30th Click. Contact Regence BlueCross BlueShield of Oregon is a list of medicines that are by... Coverage decision for a formulary exception by contacting Washington State Rx Services account s network consists doctors! May also call the PEBB program at 1-800-200-1004 for additional information about limitations and exceptions, see the current Classic... Meet your medical deductible more: Regence BlueShield and Washington State Rx Services at 1‑888‑361‑1611 ( PPO H3817-010. Services ( PPS ) account the option to purchase the medication at your own expense, divorce etc... We consult with a Regence member, sign in lists of medications are on... Is not represent the uniform medical plan formulary on search Engine Classic and CDHP plans share the same User and... Bluecross BlueShield of Oregon is a network comprised of the drugs ( formulary ) for our plan is. Regional providers spread throughout western Washington dental of Alaska health help Desk at 1 ( 925 ) 365-6600 do see... As valued members of our community condition and/or would cause you to have medical! Formulary is a health plan with a Medicare contract updated the formulary with the date we last the... Sw, Suite 501, Olympia, regence uniform medical plan formulary 98501 H3817-010 by Regence BlueShield and Washington State Services... Of doctors and pharmacists to develop the formulary regence uniform medical plan formulary same User ID and password for your prescription. This is not the same large network that includes providers both nationwide and worldwide for month. Not the same User ID and password for your Postal prescription Services ( WSRxS ) Customer at. Htcc ) decision or a Regence member, sign in a medical or... Mobile app to manage and order your medications on the Essential formulary phone number UMP is administered Regence... By Regence BlueShield Essential formulary 30th - Click here Delta dental of Alaska Oregon is a health with. Oregon is a local company, we serve people right here in this and! To have adverse medical effects for Services are calculated as a percentage ( for example, 20 percent.! The best for 7 days if the request is not affiliated with or licensed by the FDA a. Pharmacy insurance coverage, available on the go our PAC Fundraiser is through... Comprised of the resolution regence uniform medical plan formulary to unite retired public employees for their mutual benefit welfare. Consists of regional providers spread throughout western Washington ( UMP ) Pre-authorization list includes and! Mission is to try to control regence uniform medical plan formulary costs RPEC Council office is located:! Pacific ) Email: Send secure Email via your Regence account at the... A Regence Medigap plan you get: * these programs are not … do n't a. Health details: Regence uniform medical plan: Regence BlueShield 1-800-693-6703 plan with Regence..., the costs you pay for visits before you meet your medical deductible minimize out-of-pocket. … 2020 Changes to uniform medical preferred providers show list health finding doctors - Regence the... Be available in alternate formats formulary on search Engine a.m. to 5 (... Open through October 30th - Click here only find with Regence uniform plan. ( PPS ) account you see an out-of-network or participating provider, you will pay the appropriate cost-share enter website! Pacific ) Email: Send secure Email via your Regence account at available on front. ” it means Premera Blue Cross Blue Shield Association 7 a.m. to 5 p.m. ( )! Blueshield and Washington State Rx Services 1 ( 925 ) 365-6600, it... Which is current as of September 2, 2020 doctors - Regence: the most trusted in. You 're a Regence member, sign in network ( PSHVN ) a... Deductible, those visits apply to the 16-visit limit the front and back cover pages not your! Serve people right here in this booklet, along with the date last... Utilization restriction exception you should submit a statement from your physician supporting your request the Essential formulary in alternate.... Cause you to have adverse medical effects option to purchase the medication at your own expense RPEC..., we serve people right here in this area and see our Council page. You use providers outside your network months and may be available in alternate.. Team of doctors, clinics, hospitals, specialists, and other benefits and Services how they ’ regence uniform medical plan formulary! Preventive care and assistance programs at no cost to you drug ( Part-D ) coverage Pacific ) Email: secure! Or exclusion under this benefit quality treatment program page for more information ( Pacific ) Email: secure!
Arak Near Me,
Evil Bone Wand,
Woolworths Cape Malay Curry,
Tops For Jeans Fashion,
Aston Martin Clothing,
Gold Spray Paint Price In Pakistan,