SmartHealth Administrative Policy: Center of Excellence Travel Benefit Program - Substance Abuse & Addiction Treatment
The Center of Excellence travel benefit program for Substance Abuse & Addiction Treatment allows for reimbursement of transportation and lodging when an Ascension SmartHealth Medical Plan (SmartHealth) member seeks services at an Ascension Network Center of Excellence (COE) facility.
Covered travel costs
This benefit is only available for members who receive Inpatient addiction treatment at Ascension Illinois Foglia Family Foundation (COE facility). SmartHealth will cover the cost of transportation and lodging arrangements made through Carlson Wagonlit Travel (CWT) for the member and one (1) travel companion who will accompany the member to the facility prior to admission and upon discharge.
For members who live within a 50-mile radius of the facility, the cost of transportation to the facility will be covered if needed, but the cost of lodging will not be covered for the member or travel companion.
Hotel lodging expenses incurred by the companion 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.
*Travel must be arranged by the Covered Ascension COE facility through CWT in order to be covered by this program.
Covered Ascension COE facilities:
Ascension Illinois Foglia Residential Program
801 Gloucester Drive
Elk Grove Village, IL 60007
Phone: 847-981-5900
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.
This benefit is only available when the member is receiving treatment on an Inpatient basis at one of the Covered Ascension CEO facilities. It is not available for any stay that is considered a Hospital Observation Stay (as defined in the SmartHealth plan document) even if an overnight stay may be required. This benefit is also not available for treatment received at a National Network or Out-of-Network provider.
Allowances – In General
- Travel allowances – The costs of round trip transportation between the patient’s home and the facility (air - economy class only, train, bus, rental car) is reimbursed only if arranged through CWT. If traveling by rental car, the cost of parking, tolls and gasoline will be reimbursed in addition to the cost of the rental car. If traveling by personal auto, mileage is reimbursed at the published IRS standard reimbursement rate for personal vehicle usage on the date the claim is incurred in addition to the cost of parking, tolls and gasoline. Standard mileage rate information is available at www.irs.gov.
- Lodging allowance – Expenses incurred by the member and/or a companion for hotel lodging are covered by SmartHealth when arranged through CWT for one (1) night before admission and one (1) night upon discharge.
- Companions – One (1) companion is allowed for an adult member.
- Maximum Benefit – The maximum allowable lifetime travel benefit is $10,000 per participant.
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
The costs for items not directly related to travel and lodging are not reimbursable. 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 plan document take precedence.
Policy date: January 2021