Travel and lodging guidelines

We’ll arrange or reimburse transportation expenses for:

• Travel for you (the member) when referred by a Plan doctor for covered services outside your region, or
• Travel for you and a parent, guardian, or caregiver if a Plan doctor determines it’s medically necessary, or
• Travel for you and one parent, guardian, or caregiver, if you’re a minor

If we make your travel arrangements, we’ll prepay the full cost of round-trip travel by way of the most cost-effective and clinically appropriate transportation method. If you (as the member or parent/guardian/caregiver) make your own arrangements, we’ll pay you back up to the amount we would have paid if we had made the arrangements.

We’ll cover temporary lodging expenses for one hotel room per night to be shared by you and your parent/guardian/caregiver (when applicable) as follows:

If you’re getting an organ transplant:

• If we make your travel arrangements, we’ll prepay the full cost of lodging.
• If you arrange lodging for yourself (and your parent/guardian/caregiver, if applicable), we’ll pay you back up to the maximum daily allowance for lodging.

If you’re getting a service other than a transplant:

• You’re responsible for making lodging arrangements for yourself (and your parent/guardian/caregiver, if applicable).
• We’ll pay you back up to the maximum daily allowance of $100 per night for lodging.

Note: If community resources provide local lodging options other than hotels, we reserve the right to arrange for lodging through these options.

In addition to lodging, we’ll reimburse you (and your parent/guardian/caregiver, when applicable) a flat rate of $50 per day for living expenses. If you’re admitted to the hospital, this daily allowance won’t apply to you while you’re there. However, your parent/guardian/caregiver (when applicable) will continue to get the daily rate for living expenses as long as they remain with you.

Coverage for temporary lodging and living expenses for organ transplant patients is limited to costs related to:

• Transplant evaluation
• Pre-transplant visits
• Transplant procedure
• Follow-up visits

In addition to any limitations or exclusions in the Authorized Referrals Outside Your Region Travel and Lodging Policy, as described above, Kaiser Permanente will not cover the following travel and lodging expenses:

• Expenses for items not expressly specified above or that have not been pre-authorized or processed as described above.
• Transportation to or from outside the 50 United States.
• Expenses resulting from the member's (or parent/guardian/companion’s, if member is a minor) personal preference to receive care at an alternate site.
• Expenses resulting from the member's parent/guardian/companion's personal preference to extend his/her length of stay prior to or after the length of stay that is deemed to be medically necessary.
• Additional expenses associated with changes in travel arrangements made by the member or companion for personal convenience which are not medically related and/or not approved by Kaiser Permanente.
• Travel costs for a parent/guardian/caregiver that exceed the covered travel costs for members.
• Lodging expenses resulting from the member's or parent/guardian/companion's personal preference to stay at a private residence.
• Daily expenses that exceed the flat rate per diem.
• Daily travel to and from the lodging and the referral site.
• A rental car.
• Any medical monitoring required for the member's parent/guardian/caregiver and any non-medical monitoring required for the member or member's parent/guardian/caregiver.
• For any time periods during which the member is not, or is no longer, a member.

When you are referred by a Plan physician for residential treatment services outside your region, we’ll cover travel for you to and from the facility, and round-trip travel for one parent, guardian, or caregiver to take you to and pick you up from the facility, when determined to be medically necessary by your Plan provider. If your treating provider determines that participation in person by a parent, guardian, or caregiver is medically necessary to your treatment, and that participation cannot be done via video (e.g., Skype) or over the phone, we’ll pay for round-trip travel for the one parent, guardian, or caregiver to participate in your treatment.

We’ll arrange or reimburse transportation expenses for:

• Travel for you (the member) when referred by a Plan doctor for covered mental health or substance use disorder residential treatment services outside your region, or;
• Travel for a parent, guardian, or caregiver to drop you off and pick you up from the residential treatment facility, when a Plan provider determines it is medically necessary.
• Travel for a parent, guardian, or caregiver to participate in your treatment in person if a Plan provider determines it is medically necessary, or;
• Travel for you and one parent, guardian, or caregiver, if you’re a minor, to drop you off and pick you up from the residential treatment facility.

If we make your travel arrangements, we’ll prepay the full cost of round-trip travel by way of the most cost-effective and clinically appropriate transportation method. If you (as the member or parent, guardian, or caregiver) make your own arrangements, we’ll reimburse you up to the amount we would have paid if we had made the arrangements.

Transportation includes:

• Round-trip, coach-class airfare
• Economy train or bus tickets
• Taxi or equivalent rideshare services from the airport, train station, or bus terminal to or from the residential treatment facility or hotel.
• Mileage (calculated to and from the residential treatment facility at the current IRS mileage rate if you or your companion drive your own vehicle).

We will reimburse you (or your parent/guardian/caregiver) when traveling by personal automobile at the IRS mileage rate to and from your home to the referral site, up to the amount that we would have paid for round-trip coach class airfare if we had made the arrangements.

We’ll cover temporary lodging and living expenses for your parent, guardian, or caregiver when a Plan mental health or substance use disorder provider refers you to a residential treatment facility outside your region. Your Plan provider will determine the length of covered temporary lodging and living expenses for your parent, guardian, or caregiver.

For lodging for mental health or substance use disorder residential treatment outside your region:

• Lodging and living expenses are not covered for your parent/guardian/caregiver while you’re residing in a residential treatment facility. Lodging and living expenses are only covered as part of your treatment plan.
• You’re responsible for making lodging arrangements for yourself (and your parent/guardian/caregiver, if applicable).
• We’ll pay you back up to the maximum daily allowance of $100 per night for lodging.

Note: If community resources provide local lodging options other than hotels, we reserve the right to arrange for lodging through these options.

In addition to any limitations or exclusions in the Mental Health Residential Treatment Outside Your Region Travel and Lodging Policy, as described above, Kaiser Permanente will not cover the following travel and lodging expenses:

• Expenses for items not expressly specified above or that have not been pre-authorized or processed as described above.
• Expenses in connection with non-covered services.
• Transportation to or from outside the 50 United States.
• Expenses resulting from the member's (or parent/guardian/companion’s, if member is a minor) personal preference to receive care at an alternate site.
• Expenses resulting from the member's parent/guardian/companion's personal preference to extend his/her length of stay prior to or after the length of stay that is deemed to be medically necessary.
• Additional expenses associated with changes in travel arrangements made by the member or companion for personal convenience which are not medically related and/or not approved by Kaiser Permanente.
• Travel costs for a parent/guardian/caregiver that exceed the covered travel costs for members.
• Lodging expenses resulting from the member's or parent/guardian/companion's personal preference to stay at a private residence.
• Daily travel to and from the lodging and the residential treatment facility.
• Daily living expenses while receiving authorized services at the residential treatment facility.
• Expenses for anyone related to personal needs, including but not limited to phone calls.
• A rental car
• Any medical monitoring required for the member's parent/guardian/caregiver and any non-medical monitoring required for the member or member's parent/guardian/caregiver.
• Additional expenses, including non-medical or services not authorized by your doctor, associated with changes in travel arrangements made by the member, parent, guardian, or caregiver for personal convenience.
• For any time periods during which the member is not, or is no longer, a member.

For the member and caregiver/parent:

• Travel for you (the member) and caregiver/parent, as applicable, within the member's region is not reimbursed. You and your caregiver/parent must arrange and pay for transportation to and from the transplant center.

For the transplant donor:

• Travel is not reimbursed for a transplant donor if the donor lives within the member's region. The donor must arrange and pay for travel to and from the transplant center.
• If the Plan refers a donor to a transplant center inside the member's region and the donor lives outside the region, we will cover the full cost of round-trip travel. If we make the donor's travel arrangements, we’ll prepay the full cost of round-trip travel by way of the most cost-effective and clinically appropriate transportation method. If the donor makes his or her own arrangements, we’ll reimburse the cost up to the amount we would have paid if we had made the arrangements.
• If the donor travels by personal automobile, we will reimburse at the mileage rate set by the Internal Revenue Service for the mileage to and from their home and the transplant center up to the cost of round-trip, coach-class airfare.
• Covered travel includes air, train, or bus transportation, or mileage reimbursement, as well as a taxi or shuttle from the airport, station, or terminal to the transplant center or hotel.
• The transplant donor is eligible for travel as described in this program even if they are not a Kaiser Permanente member. If the donor is not a Kaiser Permanente member, the member will receive the check for reimbursement of the donor's covered expenses. It is the responsibility of the member to reimburse the donor.

For the member:

• We will reimburse you (the member) for one room up to $100 per night to be shared by you and your caregiver/parent, as applicable, while receiving outpatient services. Lodging is not covered for your caregiver/parent while you are inpatient.
• Coverage of temporary lodging for member/caregiver is limited to:
  • Transplant evaluation when travel to and from the transplant center in the same day is medically contraindicated, as determined by your Kaiser Permanente physician, and
  • Pre-transplant outpatient visits when the transplant center requires you to temporarily relocate to the vicinity of the transplant center for at least two consecutive days to undergo pre-transplant tests or treatment, or when travel to and from the transplant center for pre-transplant tests or treatment in the same day is medically contraindicated, as determined by your Kaiser Permanente physician, and
  • Post-transplant follow-up care when the transplant center requires you to temporarily relocate to the vicinity of the transplant center to participate in a post-transplant outpatient care program for consecutive weeks, or for at least two consecutive days to undergo post-transplant care or treatment, or when travel to and from the transplant center for post-transplant care or treatment in the same day is medically contraindicated by your Kaiser Permanente physician.

• Lodging is not covered for your caregiver/parent while you are inpatient.

For the transplant donor:

• If the transplant donor lives within the member's region, lodging is not reimbursed.
• If the Plan refers a donor to a transplant center inside the member's region and the donor lives outside the region, we will cover actual costs of temporary lodging up to $100 per day. The donor is responsible for making their own travel arrangements and will be retroactively reimbursed.
• Coverage of temporary lodging for the transplant donor is limited to:
  • When a Kaiser Permanente physician recommends that the donor temporarily relocate for pre-donation evaluation and tests, or
  • When a Kaiser Permanente physician recommends that the donor temporarily relocate for post-donation outpatient care for at least two consecutive days, or until medical release following hospital discharge for:
    • Transplant evaluation
    • Post-evaluation, pre-transplant follow-up visits
    • Donation period
    • Follow-up visits

• The transplant donor is eligible for lodging reimbursement as described above, even if they are not a Kaiser Permanente member. If the donor is not a Kaiser Permanente member, the member will receive the check for reimbursement of the donor's covered expenses. It is the responsibility of the member to reimburse the donor.

For the member:

• Living expenses for the member and caregiver/parent, as applicable, are not reimbursed when the member is referred inside their region.

For the transplant donor:

• If the transplant donor lives within the member's service area, living expenses are not provided.
• If the transplant donor does not live within the service area, in addition to lodging, we’ll reimburse the transplant donor a flat rate of $50 per day for living expenses. This daily allowance won’t apply while the transplant donor is inpatient.
• The transplant donor is eligible for living expense reimbursement described above even if they are not a Kaiser Permanente member. If the donor is not a Kaiser Permanente member, the member will receive the check for reimbursement of the donor's covered expenses. It is the responsibility of the member to reimburse the donor.

In addition to any limitations or exclusions in the travel and lodging policy for authorized transplant referrals within your region, as described above, Kaiser Permanente will not cover the following travel and lodging expenses:

• Expenses for items not expressly specified above or that have not been pre-authorized or processed as described above.
• Transportation to or from outside the 50 United States.
• Expenses resulting from the member's (or donor's, or caregiver/parent's), personal preference to receive care at an alternate site.
• Expenses resulting from the member's, donor's, or caregiver/parent's personal preference to extend his/her length of stay prior to or after the length of stay that is deemed to be medically necessary.
• Additional expenses associated with changes in travel arrangements made by the transplant donor for personal convenience, which are not medically related and/or not approved by Kaiser Permanente.
• Lodging expenses resulting from the member's, donor's, or caregiver/parent's personal preference to stay at a private residence.
• Daily expenses that exceed the flat rate per diem.
• Daily travel to and from the lodging and the referral site.
• A rental car
• Any medical monitoring required for the member's parent/guardian/caregiver and any non-medical monitoring required for the member, donor, or caregiver/parent.
• For any time periods during which the member is not, or is no longer, a member.
• Caregiver costs for the donor.