UMP Classic Medicare with Part D (PDP)

This plan is available only to members who are no longer enrolled in active group coverage (retirees, survivors, PEBB COBRA, retired employees of a former employer group, and their eligible dependents) through the PEBB and SEBB Program, and who are enrolled in Medicare parts A and B. Enrollees must meet all PEBB and CMS eligibility requirements.

Medicare requires that all members have a physical address within the U.S. or its territories on file. If you have been using a PO Box for your physical address, you will need to update your profile to reflect a physical address or you may lose coverage. You may use a PO Box for a mailing address.

If you are retired but you or an eligible dependent are not yet eligible to enroll in Medicare, the UMP Classic Medicare with Part D (PDP) does not apply to you. Visit ump.regence.com to view available plan options.

As you approach age 65, the PEBB program will send you a letter explaining what you need to do to keep PEBB retiree health plan coverage and apply for Medicare Part A and Part B. For questions about Medicare eligibility, enrollment, and premiums, call PEBB Customer Service at 1-800-200-1004 (TRS: 711).

This plan and Medicare are two separate health plans that work together to pay for covered services and supplies. Here is how coordination of benefits generally works:

• Your provider bills Medicare. Medicare pays your claims first. After Medicare processes the claim, Medicare sends the claim to UMP.
• UMP pays your claims second. For most covered services, UMP pays the rest of the Medicare allowed amount and you owe $0.

Each calendar year, you must meet your UMP medical deductible before UMP starts paying benefits. These rules are explained in full in the UMP Classic Medicare with Part D (PDP) Certificate of Coverage.

Visit ArrayRx for information related to your Medicare Part D drug plan.

Medicare Part B pays for some prescription drugs and supplies under the medical benefit, and they are subject to the Medicare medical deductible. Medicare Part B also covers some prescription drugs and supplies available at network pharmacies. Be sure to choose a network pharmacy that can bill Medicare Part B directly to avoid paying more. Medicare accepts claims only from providers, not from individuals. If Medicare Part B covers a drug or supply and the pharmacy doesn't send the claim to Medicare first for payment, UMP will reject the claim. Be sure to confirm that the network pharmacy can bill Medicare Part B directly.

UMP Classic Medicare with Part D (PDP) covers some provider-administered drugs (administered by a health care provider in a physician's office or other clinical setting) and related supplies under the medical benefit. Covered provider-administered drugs and related supplies are subject to the UMP Classic Medicare with Part D (PDP) medical deductible. Some diabetes care supplies are covered under the durable medical equipment benefit, and the UMP Classic Medicare with Part D (PDP) medical deductible applies. See the Diabetes care supplies section in your certificate of coverage for more about this benefit.

Find out more about Vision Service Plan (VSP) coverage and costs, including access to Choice Network providers.

When services are covered by Medicare, you must see providers who accept Medicare for the services to be covered by both Medicare and UMP. If your provider is not contracted with Medicare or has opted out of participating, UMP will not cover services by that provider.

Providers that opt out of Medicare are supposed to have you sign a private contract before providing services, but you are responsible for all costs even if you did not sign a contract.

For benefits not covered under Medicare but covered under your UMP Classic Medicare with Part D (PDP), you’ll pay less when you see a preferred provider for these services.

If you have questions about Medicare coverage or providers, call UMP Customer Service or Medicare. If you have questions about your UMP prescription drug coverage, call ArrayRx. For open enrollment information, visit the UMP PEBB Open Enrollment webpage.