Home health care services defined (a)(1) In this section, “home health care services” means medical or nonmedical services provided to ill, disabled, or infirm individuals in their residences.
(2) “Home health care services” includes:
(ii) assistance with activities of daily living; and
(iii) respite care services.
Limitations or exclusion of benefits (b) A policy or certificate of long-term care insurance that provides benefits for home health care services may not limit or exclude benefits by:
(1) requiring that the insured would need care in a nursing facility if home health care services were not provided;
(2) requiring that the insured first or simultaneously receive nursing or therapeutic services at home or in a community setting before home health care services are covered.
(3) limiting eligible services provided by registered nurses or licensed practical nurses;
(4) requiring that a nurse or therapist provide services covered by the policy or certificate of long-term care insurance that can be provided by a home health aide or other licensed or certified home care worker who acts within the scope of licensure or certification;
(5) requiring that the insured have an acute condition before home health care services are covered; or
(6) limiting benefits to services provided by Medicare-certified agencies or providers.
Determination of maximum coverage (c) Coverage for home health care services may be applied to the coverage for other benefits provided in the policy or certificate of long-term care insurance when determining maximum coverage under the terms of the policy or certificate.
Credits
Added by Acts 1997, c. 35, § 2, eff. Oct. 1, 1997.
Formerly Art. 48A, §§ 642, 645.
Current through legislation effective through April 9, 2023, from the 2024 Regular Session of the General Assembly. Some statute sections may be more current, see credits for details.
