UMP plans offer several programs to help you improve your health.
You can access UMP's wellness programs to improve your health and reduce long-term health risks. You can even earn rewards toward your SmartHealth incentive when you participate.
The Centers of Excellence (COE) Program covers single knee and single hip replacement surgery and spine evaluation and/or lumbar fusion surgery at low to no cost to qualifying UMP Achieve 1, UMP Achieve 2, and UMP High Deductible members. Premera administers the COE Program for UMP, and Virginia Mason Medical Center is the COE for knee and hip replacement and spine care.
Eligibility
If you have a UMP Achieve 1, UMP Achieve 2, or UMP High Deductible plan, are 18 or older, and not enrolled in Medicare as your primary coverage, you may qualify for this program. For spinal care, you must also have had more than 12 weeks of lower back or leg pain (the pain must be of confirmed spinal origin with neurologic symptoms or signs). Medicare and UMP Plus members have access to covered services related to joint replacement and spine care outside of this program, which may be paid at the standard rate.
Cost
For UMP Achieve 1 and UMP Achieve 2 members, treatment is covered in full. For UMP High Deductible members, treatment is covered in full after you meet your annual deductible.
How to participate
You may refer yourself, or your provider may refer you, by calling Premera at 1-855-784-4563 (TRS: 711). Premera will determine if you qualify for the program, and if you do, they will refer you to Virginia Mason Medical Center for further assessment.
The below programs are not available to Medicare retirees enrolled in UMP.
Diabetes Prevention Program
The Diabetes Prevention Program, offered through UMP’s partner, Omada Health, combines the latest technology with ongoing support to help you build healthy habits that last. You’ll get a professional health coach, a wireless scale, and a supportive peer group. Your UMP medical plan covers the entire cost of the program.
You may be eligible for the program if you are enrolled in a UMP plan, are age 18 or older, and not enrolled in Medicare.
Learn more about the Diabetes Prevention Program powered by Omada Health.
Diabetes Management Program
The Diabetes Management Program, offered through UMP"s partner, Omada Health, includes extensive support tools such as glucose tracking, live coaching, and mental and emotional care to help you improve your health and manage your diabetes.
If you have Type 1 or Type 2 diabetes, are age 18 or older, and not enrolled in Medicare, you may be eligible to participate in the online Diabetes Management Program.
Learn more about the Diabetes Management Program powered by Omada Health.
Palliative care is specialized medical care for people living with serious illness or significant injury. Palliative care is not hospice care and the patient does not need to have a terminal diagnosis to receive palliative care. It is focused on providing relief from symptoms and stress, and the program goal is to improve quality of life for both the patient and their loved ones.
Palliative care is patient-centered, family-oriented, and compassionate. It provides physical and emotional support throughout all stages of a serious illness or injury.
Palliative care support includes adult and pediatric case management. Case managers help coordinate care, explain your benefits and resources, act as advocates, and provide support and advice.
The program also includes services, such as:
- Home health medical services - pain and symptom management
- Home health psychological and social services - counseling services and spiritual support visits
To learn more, visit the Palliative care webpage on the HCA website.
The Washington Death with Dignity Act allows terminally ill adults seeking to end their life to request lethal doses of prescription drugs. These terminally ill patients must be Washington residents who have less than six months to live. For more information about this Act, see Chapter 70.245 RCW.
Care described under this Act includes services covered by UMP, subject to standard plan requirements.
If you have questions about medical services UMP covers, contact UMP Customer Service. If needed, UMP may assign a case manager to support you. If you have questions about prescription drugs UMP covers, contact ArrayRx Customer Service.
If your current provider is unable to meet your needs, or if you need assistance in finding a provider for these services, visit End of Life Washington’s website. End of Life Washington is a community resource available to support the public in finding available providers.
For more information about the Death with Dignity Act, visit:
The Pregnancy Program offers knowledge, support, and comfort for expectant parents. With the Pregnancy Program, you receive:
- Regular updates about what to expect during your pregnancy and at prenatal appointments
- Expert information about nutrition, breastfeeding, and common pregnancy concerns
- Tips for enjoying those first few weeks home with baby
- Access to a nurse by telephone 24/7
- Regular contact from an assigned program nurse (if high-risk)
- Personalized pregnancy milestones and activity/appointment reminders through the free Regence Pregnancy Program app
The Pregnancy Program is covered at no cost to you. To get started with the Pregnancy Program, sign in to your Regence account or call 1-888-569-2229.
The Expert Second Opinion program, provided by 2nd.MD, is a treatment decision support service that provides UMP Achieve 1, UMP Achieve 2, and UMP High Deductible members the opportunity to consult virtually with specialists. By using this program, you can learn more about your medical conditions and make an informed decision on your treatment plans alongside your provider. Visit the 2nd.MD website or call 1-866-982-1434 to learn more. Contact UMP Customer Service for a detailed list of services and criteria.
UMP offers access to programs and coaches to help you live tobacco-free.
Nicotine replacement therapy
Our plans cover certain nicotine replacement therapy products (such as gum, patches, sprays, inhalers, tablets, or lozenges) at the preventive rate. These are shown on the UMP Preferred Drug List with “Preventive” in the Tier column. UMP does not normally cover over-the-counter drugs, but UMP covers nicotine replacement products when they are purchased at a network pharmacy using your UMP member ID card. You may get nicotine replacement therapy directly from Pelago, or by following these steps:
- Get a prescription from your provider.
- Take the prescription to a network pharmacy.
- Make your purchase at a network pharmacy. Give your prescription and your UMP member ID card to the pharmacist. The purchase must be submitted through the prescription drug system to be covered.
UMP plans do not cover e-cigarettes or vaporizers (“vapes”).
Counseling
UMP also covers in-person counseling related to tobacco cessation at the preventive rate when you see a network provider. Phone or online counseling is covered only through the Pelago tobacco cessation program. UMP members age 17 and under may use the Smokefree Teen program.
Smoking and tobacco cessation program
Smoking and tobacco use are the number one cause of preventable disease and death in the world. The Pelago tobacco cessation program is available to all UMP members 18 and older except members who have Medicare primary. This program is available at no cost and provides a dedicated certified tobacco treatment specialist, 24/7 access to digital cognitive behavioral therapy, and nicotine replacement therapy. Visit the Pelago website or call 1-877-349-7755 to learn more or download the app in the Apple App Store or on Google Play.
Smokefree Teen
UMP members age 17 and under may use the Smokefree Teen program in addition to nicotine replacement therapy and counseling or by calling 1-800-QUIT-NOW (784-8669).
Virtual Primary Care by Doctor On Demand
UMP members (except UMP Plus members) have access to high quality virtual primary care, on-demand urgent care, and behavioral health services through Doctor On Demand. First-time primary care appointments can be scheduled within days, and you are able to choose a provider for an annual wellness exam and ongoing routine care. You will see the exact cost of your visit upfront and will receive a care kit in the mail before your first annual wellness exam. You can also see a provider on-demand for urgent medical care, as well as schedule behavioral health appointments. Visit Doctor On Demand to learn more.
See the Behavioral health page for information about virtual behavioral health support tools.
Premera Blue Cross is a separate company solely responsible for its products/services.
Omada Health is a separate company that provides care and disease management services.
2nd.MD is a separate company that provides treatment decision support through their Expert Second Opinions program.
Pelago is a separate company that provides tobacco cessation/addiction services.
Doctor On Demand is a separate company that provides telehealth services.