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§ 18-110. Policy limitations and exclusions -- Home health care services

MD Ins Code § 18-110 (2019) (N/A)
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(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:

(i)    homemaker services;

(ii)    assistance with activities of daily living; and

(iii)    respite care services.

(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.

(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.

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§ 18-110. Policy limitations and exclusions -- Home health care services