The Utah Travel Benefit is established to offset the cost of travel for patients and/or their support person or family members when Utilization Management provides the physician and/or covered person, as an option for Tertiary Care (evaluation and/or treatment), authorization to receive treatment at the University of Utah Medical Center, Intermountain Healthcare providers or Primary Children’s in Utah.
Tertiary Care: Highly specialized medical care usually over an extended period of time that involves advanced and complex procedures and treatments performed by medical specialists in state-of-the-art facilities. Examples of tertiary care services are specialist cancer care, neurosurgery (brain surgery), burn care and plastic surgery.
To quality for the Utah Travel Benefit, the following must apply:
1.Covered Person and/or their treating physician has requested a referral to a specific facility/provider for Tertiary Care that is not in the primary PPO network and will require travel outside of Nevada.
2.Utilization Management has determined that the requested services are medically necessary and Tertiary Care cannot be provided in the primary PPO network.
3.Utilization Management has provided the physician and/or Covered Person, as an option, to receive Tertiary Care at the University of Utah Medical Center, Intermountain Healthcare or Primary Children’s in Utah.
4.Covered Person has agreed to be in Case Management, and followed by Case Manager while in Tertiary Care.
5.Prior to travel to Utah for Tertiary Care, the covered person must advise the RN Case Manager of travel to receive the benefit.
Single Episode of Care
Travel Expenses Per Day, Per Trip: $250* per patient, support person/caregiver or parent as defined below.
Travel Expenses Maximum, Per Trip: $2,500* per single episode of care.
*Per diem rates. No exclusions, no receipts necessary.
Covered Travel Expenses
1.For a covered child under the age of 19, travel expenses will be reimbursed at $250 per person for the patient and two parents or legal guardians.
2.For a covered adult age 19 and older, travel expenses will be reimbursed for the patient and one person/caregiver.
3.Coverage will include the day prior to schedule service and the day following the scheduled service not to exceed the $2,500 per episode of care.
Hometown Health complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.