Quick Tips: How to Get the Most From Your UMP Benefits

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The UMP 2008 Certificate of Coverage (COC) is the source of coverage rules for UMP, so we recommend that you review it carefully. This quick guide to UMP coverage may help you get started.

Use Network Providers.
When you see a network provider, you will pay much less (10% coinsurance in most cases, after you've paid your deductible). Check our online provider directory or call Customer Service at 1-800-762-6004 to find network providers.
Avoid Using Non-Network Providers.
You can see non-network providers, but you will pay much more. The example in the table below gives you an idea of the large difference you might pay to non-network providers. Even if a network provider refers you to a non-network provider, claims will be paid at the non-network rate. For more information, see pages 3-4 of your 2008 COC.
The example below assumes you've met your medical deductible.

	Network Provider	Non-Network Provider
Provider's Billed Charge	$150	$150
UMP Allowed Amount	$100	$100
Provider Discount	-$50	0
What UMP Pays	$90 (90% of $100)	$60 (60% of $100)
What You Pay	$10	$90*
* You pay the $40 coinsurance plus the $50 over the allowed amount

Get Preventive Care Services Free When You See a Network Provider!
Only the list of services shown on pages 30-35 of the COC are covered at 100%. If your provider orders tests or services in addition to what's listed, those services may be covered under the medical benefit and subject to the medical deductible.
Learn How the Medical Deductible Works.
You pay the first $200 per person ($600 per family of three or more people) for medical services before UMP starts paying for most services. You pay your provider, not UMP. To better understand the billing process, see "How Billing Works: Step by Step." You don't have to pay the deductible for some services, such as routine vision and preventive care. See page 7 in the COC for complete information about the deductible.
Learn How the Prescription Drug Deductible Works.
For Tier 2 (preferred brand-name) and Tier 3 (nonpreferred brand-name) drugs, you pay the first $100 for prescription drugs out of your pocket before UMP begins paying. You don't pay the deductible for Tier 1 (generic) drugs. See pages 39-40 in the COC.
Confirm That Hospital-Based Providers Are in the UMP Network.
Physicians such as anesthesiologists and emergency room doctors may not be network providers, even if they work at a UMP network hospital. Check the hospital listings in our online provider directory or call UMP Customer Service at 1-800-762-6004 before scheduling surgery to make sure your providers are in the UMP network.
Check Which Services Require Preauthorization
See pages 48-49 of the COC for services that require prior approval (called preauthorization) by UMP.
Use Your UMP ID Card.
Whenever you see a provider or fill a prescription, make sure you show your UMP ID card. Pharmacies need this information to charge you the right amount.