SmartHealth is pleased to announce a new benefit for substance abuse and addiction treatment — the Center of Excellence Travel Benefit Program.
SmartHealth now covers Substance Abuse & Addiction Treatment under the Center of Excellence (COE) Travel Benefit Program.
This enhanced benefit program provides travel coverage and assistance for members to receive inpatient addiction treatment at the Ascension Illinois Foglia Family Foundation. This facility provides evidence-based treatment and holistic care through treatment and recovery.
We are offering this program to support our members that are struggling with addiction and are ready to begin the path to recovery. We are committed to upholding the highest standards of privacy and confidentiality for our members. Your decision to seek treatment will remain confidential and only those individuals you give permission to know will be aware of your decision.
To receive this enhanced benefit, you or your covered family member must meet the COE clinical criteria for admission. Click on the links below to learn more about each facility and the services offered.
Covered Ascension COE facility:
Ascension Illinois Foglia Residential Program
801 Gloucester Drive
Elk Grove Village, IL 60007
Phone: 847-981-5900
To learn more, click here.
Personalized concierge services
After clinical admission criteria is met and treatment is approved, the facility admission coordinator will contact Carlson Wagonlit Travel (CWT). CWT will provide travel arrangements for the member and a travel companion if needed. The member must be 18 years or older.
Coverage
- PPO Plan – The copay and deductible will be waived, and 100% of charges for medical expenses will be covered.
- HDHP Plan – HDHP members are subject to copays, co-insurance and deductibles. Federal regulation requirements for HDHP plans do not allow these fees to be waived.
Questions
- For the St. John Health System (Tulsa, Oklahoma) Ministry Market, please call Community Care at 888-589-5214.
- For all other Ascension ministries, please call Automated Benefit Services, Inc. (ABS) at 888-492-6811.
Covered travel costs
SmartHeath will cover the cost of transportation and lodging arrangements made through CWT for a member and a companion to accompany the member to the facility prior to admission and upon discharge. For members who live within a 50-mile radius of the facility, transportation will be provided to the facility if needed, but lodging is not covered for the member or companion.
Expenses incurred by the companion for hotel lodging are covered by SmartHealth when arranged through CWT travel at a pre-selected, covered hotel participating in the travel benefit program. Hotel lodging expenses will be covered for one (1) night while accompanying the member to treatment and one (1) night when accompanying the member home from treatment. Any other lodging expenses will be the responsibility of the travel companion. The travel companion will be required to provide a credit card at check-in to cover any incidental charges incurred during the stay.
Maximum Benefit
The maximum allowable lifetime benefit per participant for the SmartHealth Addiction Residential Treatment COE Travel Benefit is $10,000. Note: This travel limit accumulates separately from the maximum allowable benefit under the SmartHealth Administrative Policy: Travel Benefit.
Under applicable law, some benefits may be required to be included in taxable income.
Admittance process
- The SmartHealth member contacts the Ascension COE facility to request admission. The admissions coordinator takes basic information and advises the member that he or she must end the call to verify insurance but will call the member to complete the intake process, usually within one (1) hour.
- For members in the St. John Health System (Tulsa, Oklahoma) Ministry Market, the Ascension COE facility will contact Community Care at 888-589-5214 to confirm SmartHealth eligibility.
For all other members, the Ascension COE facility will contact ABS at 888-492-6811 to confirm SmartHealth eligibility. - The admissions coordinator contacts the member to finish phone screening and to complete the intake process. The admissions coordinator advises the SmartHealth member that he or she is responsible for having an Adult Medical Clearance Form completed by the member’s health care provider. This can occur during a primary care visit, urgent care visit or an ER visit. Once completed, the form must be faxed to the Ascension COE facility prior to admission. The admissions coordinator instructs the member on how to access the Adult Medical Clearance Form.
- The Ascension COE facility will review the Adult Medical Clearance Form upon receipt.
- Once admission is approved, the admissions coordinator will contact CWT to arrange travel for the member and companion, if applicable. The Ascension COE facility must complete a Travel Request Form on behalf of the member and email it to the CWT VIP Team at viptravel.us@contactcwt.com and the SmartHealth Finance Team at smarthealthfinance@ascension.org. Once the admission is approved, the admissions office should allow 24 to 48 hours for CWT to coordinate travel and lodging logistics with the admission date to the facility.
- The Ascension COE facility will arrange for ground transportation to and from the airport, if applicable, to their facility. Lyft is preferred when arranged by the facility for ground transportation for the member and companion.
- As the member progresses through the program, the facility will contact CWT to arrange for travel home once a discharge date has been determined.
- For members in the St. John Health System (Tulsa, Oklahoma) Ministry Market, the Ascension COE facility must notify Community Care at 888-589-5214 of the member’s Date of Admission and Date of Discharge for the Inpatient claim to be paid.
- For all other members, the Ascension COE facility must enter the members Date of Admission and Date of Discharge on the eQHealth platform for the Inpatient claim to be paid.
- SmartHealth will cover the cost of the Continued Connection Program offered at the Ascension Illinois Addictions Alumni Program offered at Foglia Family Foundation for one year following the member’s discharge.
Limitations
- SmartHealth will not reimburse members for travel expenses to return home if the member does not complete the COE program and leaves the facility against medical advice.
- SmartHealth reserves the right to deny future COE travel coverage for members who leave the facility prior to completing treatment and against medical advice.
Excluded Services
Items not directly related to travel and lodging are not payable. They include, but are not limited to:
- Meals.
- Alcoholic beverages.
- Car maintenance.
- Cards, stationery, stamps.
- Clothing.
- Dry cleaning.
- Entertainment, including WiFi, cable television, books, magazines, movie rentals and more.
- Cell phone charges.
- Household products.
- Household utilities including cleaning services, childcare and more.
- Kennel fees.
- Laundry services.
- Security deposits.
- Toiletries.
In the case of a conflict between this document and the official Ascension SmartHealth Medical Plan document, the language in the plan document will prevail. Any terms defined in the applicable plan document take precedence.