Transplantation Services. Organ transplants when ordered by a Physician. Benefits are available for transplants when the transplant meets the definition of a Covered Health Care Service, and is not an Experimental or Investigational or Unproven Service. Coverage will be provided for all Medically Necessary solid organ transplants and non-solid organ transplant procedures. Examples of transplants for which Benefits are available include: • Bone marrow. • Heart. • Heart/lung. • Lung. • Kidney. • Kidney/pancreas. • Liver. • Liver/small intestine. • Pancreas. • Small intestine. Donor costs related to transplantation are Covered Health Care Services and are payable through the organ recipient's coverage under this Policy, limited to donor: • Identification. • Evaluation. • Organ removal. • Direct follow-up care. Benefits include the cost of hotel lodging and air transportation for the recipient Covered Person and a companion (or the Covered Person and two companions if the Covered Person is under the age of 18 years), to and from the site of the transplant. You can call us at the telephone number on your ID card for information about our specific guidelines regarding Benefits for transplant services.
Transplantation Services. Organ transplants when ordered by a Physician. Benefits are available for transplants when the transplant meets the definition of a Covered Health Care Service, and is not an Experimental or Investigational or Unproven Service. Examples of transplants for which Benefits are available include: • Bone marrow. SAMPLE • Heart. • Heart/lung. • Lung. • Kidney. • Kidney/pancreas. • Liver. • Liver/small intestine. • Pancreas. • Small intestine. Donor costs related to transplantation are Covered Health Care Services and are payable through the organ recipient's coverage under this Policy, limited to donor: • Identification. • Evaluation. • Organ removal. • Direct follow-up care. You can call us at the telephone number on your ID card for information about our specific guidelines regarding Benefits for transplant services.
Transplantation Services. Organ transplants when ordered by a Physician. Benefits are available for transplants when the transplant meets the definition of a Covered Health Care Service, and is not an Experimental or Investigational or Unproven Service. Examples of transplants for which Benefits are available include: • Bone marrow/stem cell. • Heart. • Heart/lung. • Lung. • Kidney. • Kidney/pancreas. • Liver. • Liver/small intestine. • Pancreas. • Small intestine. Donor costs related to transplantation are Covered Health Care Services and are payable through the organ recipient's coverage under this Policy, limited to donor: • Identification. • Evaluation. • Organ removal. • Direct follow-up care. You can call us at the telephone number on your ID card for information about our specific guidelines regarding Benefits for transplant services. Covered Health Care Services received at an Urgent Care Center. When services to treat urgent health care needs are provided in a Physician's office, Benefits are available as described under Physician's Office Services - Sickness and Injury. Virtual care for Covered Health Care Services that includes the diagnosis and treatment of less serious medical conditions. Virtual care provides communication of medical information in real-time between the patient and a distant Physician or health specialist, outside of a medical facility (for example, from home or from work). Benefits are available only when services are delivered through a Designated Virtual Network Provider. You can find a Designated Virtual Network Provider by contacting us at xxx.xxxxx.xxx/xxxxxxxx or the telephone number on your ID card. Benefits are available for urgent on-demand health care delivered through live audio with video or audio only technology for treatment of acute but non-emergency medical needs. SAMPLE Benefits do not include email or fax, or for services that occur within medical facilities (CMS defined originating facilities).
Transplantation Services. Benefits are provided for solid organ transplants and other non-solid organ transplant procedures. Benefits are available for transplants when the transplant meets the definition of a Covered Health Service, and is not an Experimental Service. Donor costs that are directly related to organ removal are Covered Health Services for which Benefits are payable through the organ recipient's coverage under the Policy. Benefits include the cost of hotel lodging and air transportation for the recipient Covered Person and a companion (or the Covered Person and two companions if the Covered Person is under the age of 18 years), to and from the site of the transplant. We have specific guidelines regarding Benefits for transplant services. Contact us at the telephone number on your ID card for information about these guidelines.
Transplantation Services. Organ transplants, when ordered by a Physician. Benefits are available for transplants when the transplant meets the definition of a Covered Health Care Service, and is not an Experimental or Investigational or unproven service. Examples of transplants for which Benefits are available include: • Bone marrow. • Cornea. • Heart. • Heart/lung. • Lung. • Kidney. • Kidney/pancreas. SAMPLE • Liver. • Liver/small intestine. • Pancreas. • Small intestine. Benefits for organ procurement costs are limited to costs directly related to the procurement of an organ, from a cadaver or a live donor. Organ procurement costs shall consist of surgery necessary for organ removal, organ transportation and the transportation, hospitalization and surgery of a live donor. Compatibility testing undertaken prior to procurement is covered if Medically Necessary. Benefits are available for travel, lodging, and food for the Covered Person and one companion. All claims filed for travel expenses must included detailed receipts, except for milage. Mileage will be calculated based on the home address of the Covered person and the transplant site. Organ transplant travel benefits are not available for cornea transplants. You can call us at the telephone number on your ID card for information about our specific guidelines regarding Benefits for transplant services.
Transplantation Services. Organ transplants, when ordered by a Physician. Benefits are available for transplants when the transplant meets the definition of a Covered Health Care Service, received from a Designated Provider, and is not an Experimental or Investigational or unproven service. Examples of transplants for which Benefits are available include: • Bone marrow/stem cell. • Cornea. • Heart. • Heart/lung. • Lung. • Kidney. • Kidney/pancreas. • Liver. • Liver/small intestine. • Pancreas. • Small intestine. Benefits for organ procurement costs are limited to costs directly related to the procurement of an organ, from a cadaver or a live donor. Organ procurement costs shall consist of surgery necessary for organ removal, organ transportation and the transportation, hospitalization and surgery of a live donor. Compatibility testing undertaken prior to procurement is covered if Medically Necessary. Benefits are available for travel, lodging, and food for the Covered Person and one companion. All claims filed for travel expenses must include detailed receipts, except for milage. Mileage will be calculated based on the home address of the Covered person and the transplant site. Organ transplant travel benefits are not available for cornea transplants. You can call us at the telephone number on your ID card for information about our specific guidelines regarding Benefits for transplant services. SAMPLE Covered Health Care Services received at an Urgent Care Center. When services to treat urgent health care needs are provided in a Physician’s office, Benefits are available as described under Physician’s Office Services – Sickness and Injury. Virtual care for Covered Health Care Services that includes the diagnosis and treatment of less serious medical conditions. Virtual care provides communication of medical information in real-time between the patient and a distant Physician or health specialist, outside of a medical facility (for example, from home or from work). Benefits are available only when services are delivered through a Designated Virtual Network Provider. You can find a Designated Virtual Network Provider by contacting us at xxx.xxxxx.xxx/xxxxxxxx or the telephone number on your ID card. Benefits are available for Urgent on-demand health care delivered through live audio with video or audio only technology for treatment of acute but non-emergency medical needs.
Transplantation Services. Sample Organ and tissue transplants, including CAR-T cell therapy for malignancies, when ordered by a Physician. Benefits are available for transplants when the transplant meets the definition of a Covered Health Care Service, and is not an Experimental or Investigational or Unproven Service. Examples of transplants for which Benefits are available include: Bone marrow, including CAR-T cell therapy for malignancies and bone marrow transplants for Covered Persons with breast cancer that has progressed to metastatic disease. Heart. Heart/lung. Lung. Kidney. Kidney/pancreas. Liver. Liver/small bowel. Pancreas. Small bowel.
