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

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Important: This information is effective through Dec. 31, 2009. See the changes to coinsurance, medical deductible, and out-of-pocket limit for 2010.

The UMP 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 could 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. Read more about seeing network versus non-network providers.
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
Total Charge That Must Be Paid	$100	$150
What UMP Pays (% of Allowed Amount)	$90 (90% of $100)	$60 (60% of $100)
What You Pay (Balance)	$10	$90*
* You pay 40% of the UMP allowed amount ($40) plus the amount the provider charged over the allowed amount ($50).

Get Preventive Care Services Free When You See a Network Provider!
Only the services on this list 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.
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 pocket before UMP begins paying. You don't pay the deductible for Tier 1 (generic) drugs. See here for how much you pay for prescription drugs .
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 the list of services that must be preauthorized 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.