TRANSPORTATION BENEFITS
Transportation and Lodging for Bone Marrow Donors Paid for a donor who is either a covered person, or someone donating to a covered person. When a covered person is the donor, this benefit is payable in lieu of any other benefits payable under the policy. • Actual charges to $2,500 for medical expenses directly relating to the services provided to the donor during the transplant. • Actual charges for round trip coach fare on a common carrier, or a personal automobile allowance of 50 cents per mile if distance is more than 50 miles one-way. Maximum 700 miles round trip. • Actual charges to $75 per day for lodging and meal expenses incurred by the donor. *Transportation for Non-Local Treatment Which Requires Hospital Confinement Actual charges for round trip coach fare, or a personal automobile allowance of 50 cents per mile if the distance is more than 50 miles one-way. Maximum 700 miles round trip. Prescribed treatment must not be available locally and must require hospital confinement. *Transportation and Lodging for Non-Local Treatment Which Does Not Require Hospital Confinement • Actual charges for round trip coach fare, or a personal automobile allowance of 50 cents per mile if the distance is more than 50 miles one-way, maximum 700 miles round trip. Maximum of $1,500 per calendar year. • Actual charges to $50 per day for lodging and meal expenses. Payable only for the days you receive treatment for cancer or dread disease for which a benefit is payable.
Prescribed treatment must not be available locally and must not require hospital confinement.
*Adult Companion Transportation and Lodging Payable only for an adult companion residing and traveling within the continental United States. • Actual charges for one adult companion to be near a covered person who is hospital confined in a non-local hospital for covered treatments. Maximum $2,500 per confinement. • Actual charges to $50 per day for lodging and meal expenses incurred. Limited to the number of days of the covered person’s hospitalization. • Actual charges of one round trip coach fare, or a personal automobile allowance of 50 cents per mile, if the distance is more than 50 miles one-way. Maximum 700 miles round trip.
*Not payable for periodic checkups, cancer screening tests, or for treatments, services, or procedures for which a benefit is not payable under this policy
Made with FlippingBook Annual report maker