Your Coverage - Facts & Questions
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 condition after discharge from the hospital – including physical therapy, follow-up visits or additional surgeries will also be covered under this program.
Q: What services/benefits are NOT covered under this program?
A: The following are not covered under this program: any elective outpatient services not related to the covered program services; convenience items (i.e. telephone, movies, hotel room mini-bar, laundry services, etc.); travel to and from the home airport; costs associated with unapproved flight changes.
Q: What travel expenses are covered?
- 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
- Concierge service to arrange travel and lodging
- Transportation between the airport, hotel and Smart Care Center
Q: Can a participant choose which doctors/hospital to use for these services?
A: No. The Smart Care 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.