Over the Counter Drug Claims
On 1/16/17, OptumRX/UMR has corrected the “over the counter” or OTC drug claims issue to process as usual for all OTC drugs and supplements that have a National Drug Code (NDC) and/or were previously processed through Express Scripts/Premera. Questions to whether or not a new prescription has a NDC, should be directed to your pharmacist. If the doctor writes you a prescription for an “over the counter” drug or supplement and it has a National Drug Code, (NDC) it can be billed by your pharmacy directly and will be paid at 100%, with no copay, by UMR/OptumRX.
Pharmacists can call UMR/OptumRX at 1-877-559-8955. All contact numbers are also on your UMR card.
Please contact UMR Customer Service (Members line) at 1-800-207-3172, if you have further questions about your benefit or call Jan at the Pension office. Please remember the Pension office has no idea if your “over the counter” prescription has a NDC number but your pharmacy should be able to tell you. Items such as band aides, gauze, homeopathic creams, and items that are not medications and do NOT have a NDC, but have been prescribed by your doctor, are still covered by your medical plan but you must pay up front and submit your Simple Reimbursement form directly to UMR to get your money back. Reimbursement forms can be found on the R.S.P.O.A. website, by calling UMR or email the pension office at policepension@Seattle.gov.
UMR Provider Information
UMR has provided a flyer for your medical provider that will help them understand your coverage.
UMR has made finding claim and benefit information for your patients quick and easy.
At umr.com, you can view claims and benefit information, including:
• Explanations of benefits (EOBs)
• Eligibility and benefit information and more