Question
A member with a Group plan wants to travel out of state for medical care. What should you check?
if they are within mileage limitations for their subplan, if they have access to the member portal, if they have the Post-Discharge Benefit activated, if they have a TRV003 or USTOO1 code
if they are within mileage limitations for their subplan, if they have access to the member portal, if they have the Post-Discharge Benefit activated, if they have a TRV003 or USTOO1 code
Answers
GPT-4o mini
When a member with a Group plan wants to travel out of state for medical care, you should primarily check **if they are within mileage limitations for their subplan**. This is important because many insurance plans have specific geographic restrictions on coverage and may only cover out-of-network care if the provider is within a certain distance from the member's home.
While it's also useful to verify their access to the member portal and check if they have activated the Post-Discharge Benefit, the mileage limitation is the most critical factor for traveling out of state for medical care. The TRV003 or USTOO1 codes might pertain to specific circumstances or authorizations, but ensuring the member's travel is within plan limits is key.
While it's also useful to verify their access to the member portal and check if they have activated the Post-Discharge Benefit, the mileage limitation is the most critical factor for traveling out of state for medical care. The TRV003 or USTOO1 codes might pertain to specific circumstances or authorizations, but ensuring the member's travel is within plan limits is key.