2023 Archdiocese of Atlanta Meritain Group Plan Doc - Manual / Resource - Page 64
Limitations
Transplant coverage does not include charges for the following:
(1)
Outpatient drugs, including bio-medicals and immunosuppressants not expressly related to an outpatient
transplant occurrence.
(2)
Services and supplies furnished to a donor when recipient is not a Covered Person.
(3)
Home infusion therapy after the transplant occurrence.
(4)
Harvesting or storage of organs without the expectation of immediate transplant for an existing Illness.
(5)
Harvesting and/or storage of bone marrow, tissue or stem cells without the expectation of transplantation
within 12 months for an existing Illness.
(6)
Cornea (corneal graft with amniotic membrane) or cartilage (autologous chondrocyte or autologous
osteochondral mosaicplasty) transplants, unless otherwise authorized by the Medical Plan.
Travel and Lodging Expenses
Travel and lodging expenses will be covered under the Medical Plan subject to the conditions described below.
(1)
Distance requirement. The IOE facility must be more than 100 miles away from the patient’s residence.
(2)
Travel allowances. Travel is reimbursed between the patient’s home and the facility for round trip (air, train or
bus) transportation costs (coach class only). If traveling by auto to the facility, mileage, parking and toll cost
will be reimbursed per IRS guidelines.
(3)
Lodging allowances. Reimbursement of expenses Incurred by the patient and any companion for hotel lodging
away from home is reimbursed at a rate of $50 per night per person, to a maximum of $100 per night.
(4)
Overall maximum. Travel and lodging reimbursement is limited to $10,000 for any one transplant or procedure
type, including tandem transplants. This is a combined maximum for the patient, companion and donor.
(5)
Companions. One companion is permitted per adult and 2 parents or guardians are permitted per Child.
60