Plans A, B and D

To provide quality care at a reasonable cost, PEIA has partnered with the Charleston Area Medical Center (CAMC) and West Virginia University Hospitals (WVUH) to provide a Hemophilia Care Program to PEIA PPB Plan members. Members who participate in the program will be eligible for the following benefits:

• An annual evaluation by specialists in the Hemophilia Disease Management Program which will be paid at 100% with no deductible, copay or coinsurance. (This evaluation is not intended to replace or interrupt care provided by your existing medical home provider or specialists.)
• Hemophilia expenses, including factor replacement products, incurred at CAMC or WVUH will be paid at 100% with no deductible, copay or coinsurance.
• Reimbursement for travel and lodging
- Child and 1 or 2 parents
- Adult and an accompanying adult
- Lodging will be at an approved travel lodge for a maximum of two (2) nights for one room only.
- Gas will be reimbursed at the federal rate for one vehicle only.
- Receipts for food will be paid at 100% for the child and parents or for the 2 adults.

Lodging and Travel Expenses

Lodging expenses include:

• Expenses incurred by the patient traveling between his or her home and the participating facility to receive services in connection with the Hemophilia Disease Management Program
• Expenses incurred by the patient’s companion to enable the patient to receive services from the Hemophilia Disease Management Program
- For children under the age of 18, lodging will be covered for one (1) or two (2) parents.
- For patients over the age of 18, lodging will be covered for one (1) companion.
• Lodging will be covered at 100% of the charge at an approved travel lodge.

Travel expenses (gas & meals) include:

• Expenses incurred while traveling with the patient between the patient’s home and the medical facility to receive services in connection with the Hemophilia Disease Management Program.
• Gas receipts are required for reimbursement.
• Reimbursement of meal expenses up to $30 per day per person. Receipts are required for the reimbursement of meals.

All claims must be submitted within the six-month timely filing period, including the submission of all lodging and travel expenses.

For more information about this program please contact: UMR at 888-440-7342.

Plan C

To provide quality care at a reasonable cost, PEIA has partnered with the Charleston Area Medical Center (CAMC) and West Virginia University Hospitals (WVUH) to provide a Hemophilia Care Program to PEIA PPB Plan members. Members who participate in the program will be eligible for the following benefits:

• An annual evaluation by specialists in the Hemophilia Disease Management Program which will be paid at 80% after deductible. (This evaluation is not intended to replace or interrupt care provided by your existing provider or specialists.)
• Hemophilia expenses, including factor replacement products, incurred at CAMC or WVUH will be paid at 80% after deductible.
• Reimbursement for travel and lodging
- Child and 1 or 2 parents
- Adult and an accompanying adult
- Lodging will be at an approved travel lodge for a maximum of two (2) nights for one room only
- Gas will be reimbursed at the federal rate for one vehicle only
- Receipts for food will be paid at 80%, after deductible, for the child and parents or for the 2 adults

Lodging and Travel Expenses

Lodging expenses include:

• Expenses incurred by the patient traveling between his or her home and the participating facility to receive services in connection with the Hemophilia Disease Management Program
• Expenses incurred by the patient’s companion to enable the patient to receive services from the Hemophilia Disease Management Program
- For children under the age of 18, lodging will be covered for one (1) or two (2) parents.
- For patients over the age of 18, lodging will be covered for one (1) companion.
• Lodging will be covered at 80% of the charge, after deductible, at an approved travel lodge.

Travel Expenses (gas & meals) include:

• Expenses incurred while traveling with the patient between the patient’s home and the medical facility to receive services in connection with the Hemophilia Disease Management Program
• Gas receipts are required for reimbursement.
• Reimbursement of meal expenses up to $30 per day per person. Receipts are required for the reimbursement of meals.

All claims must be submitted within the six-month timely filing period, including the submission of all lodging and travel expenses.

For more information about this program please contact UMR at 888-440-7342.