In addition to the benefits coverage otherwise available, you may be eligible for a travel benefit when you use certain providers.
When services are referred by or through Care Coordination, the travel benefit is available when you receive treatment from:
- A Center of Expertise for a designated procedure
- University of Kentucky's A.B. Chandler and Good Samaritan Hospitals
- Surgery Center of Oklahoma
- A Bundled Surgery Services provider
The following table clarifies the preauthorization, referral/coordination, and pre-approval requirements related to the travel benefit:
|If you receive care from...||Is preauthorization for the health care services required to avoid the 25% benefit penalty (100% benefit penalty for transplants)?||Is referral assistance by Care Coordination required to receive the highest level of medical coverage?||Is referral assistance by Care Coordination required to receive the travel benefit?||Is pre-approval of travel expenses through Care Coordination required to receive the travel benefit?|
|A Center of Expertise for a designated procedure||Yes, for all services listed on "Appendix C: Services and Products that Require Preauthorization."||No. Eligible expenses will still qualify for coverage at the Center of Expertise benefit level.||Yes|
|University of Kentucky, or Surgery Center of Oklahoma for a procedure that is not a designated procedure||No. Eligible expenses will still qualify for coverage at the Alliance Coal Direct benefit level.|
|A designated Bundled Surgery Services provider||No. Eligible expenses will still qualify for coverage at the Alliance Coal Direct benefit level.|
The travel benefit provides reimbursement for pre-approved expenses, up to $10,000 per calendar year. To be eligible for reimbursement, expenses must be approved in advance (before you incur the expenses) through Care Coordination. Expenses eligible for reimbursement are:
- Transportation in your personal vehicle reimbursed at the current IRS standard rate for medical travel (for example, 17 cents per mile in 2020)
- Transportation by air (at the "coach" fare rate), for the patient and a travel companion to and from the provider
- Transportation by rental car (standard class), bus, taxi (including alternative services such as Uber or Lyft), or shuttle
- Lodging (one room) for up to five nights (night before procedure and four days of post-procedure recovery)
- Meal and incidental expenses for you and your travel companion (including actual meal expenses up to $100 per day, and not including alcohol, tobacco, or other non-food expenses)
Per diem reimbursement will be mailed to you from Care Coordination upon receipt of supporting documentation of medical travel.
For more information about the travel benefit, call Member Services at (855) 979-5192.
Important: If your reimbursed expenses exceed certain IRS limits for medical-related transportation, the IRS will consider the excess amounts to be taxable income to you. For example, current IRS limits include $50/day per person for lodging. The IRS generally considers meal expenses to be non-medical and therefore taxable income to you.