Q: What medical services/benefits are paid for under the Edison HealthCARE program?
A: Most of the medical services associated with the surgery are covered – including coinsurance, co-pays and deductibles. Most medically necessary services related to the event covered by Edison will be covered by Edison while at our SmartCare Center. After discharging from the SmartCare Center, services back in the patient’s local market will be covered under their customary health insurance with their employer, with the rules and deductibles of their partciular plan.
Q: What services/benefits are NOT covered under this program?
A: The following are not covered under this program: any elective medical services not directly related to the covered program services, convenience items (i.e. telephone, movies, hotel room mini-bar, laundry services, etc.), prescriptions or over the counter medications, and any costs associated with unapproved flight or lodging changes.
Q: What travel expenses are covered?
Concierge service to arrange travel and lodging
Airfare or travel allowance for the participant and a companion
Lodging for the member before and after surgery and lodging for the companion for their entire stay
Daily food allowance (loaded onto a debit card)
Transportation between the airport, hotel and SmartCare Center
Rental vehicle (when necessary) and gas if driving to SmartCare Center instead of flying
Q: Can a participant choose which doctors/hospital to use for these services?
A: No. The SmartCare Medical Center will be selected by the Edison Healthcare team based upon the participant's individual medical need and the medical center's area of expertise.