Post-transplant Home Custodial Care
The Program will reimburse expenses for Custodial Care (non-health related Services, such as assistance in activities of daily living including but not limited to feeding, dressing, bathing, transferring, and ambulating) for a Covered Person following an organ or tissue transplant covered under the Base Medical Program. Covered expenses are considered non-medical care and limited to a maximum of $20/hour for 24 hours/day up to a maximum of 15 days. Any custodial care, regardless of number of hours, received within a 24-hour period will count as a day. This benefit is only available if ordered by a Physician and arranged through a licensed custodial care facility/agency. The amount reimbursed is subject to tax, where applicable.
Participants must obtain Prior Approval from the Benefits Administrator. If Prior Approval is not obtained, no Benefits will be payable under the Program.
No Coordination of Benefits applies to coverage of this service under the Program. If you are enrolled in any other plan or program that provides any coverage for this service, you are not eligible for this coverage under the Program, regardless of any out-of-pocket expenses for which you may be responsible.