627.94071 Minimum standards for home health care benefits. - Florida Statutes

627.94071 Minimum standards for home health care benefits.

A long-term care insurance policy, certificate, or rider that contains a home health care benefit must meet or exceed the minimum standards specified in this section. The policy, certificate, or rider may not exclude benefits by any of the following means:

   (1) Providing that home health care cannot be covered unless the insured or claimant would, without the home health care, require skilled care in a skilled nursing facility.

   (2) Requiring that the insured or claimant first or simultaneously receive nursing or therapeutic services in a home setting or community setting before home health care services are covered.

   (3) Limiting eligible services to services provided by registered nurses or licensed practical nurses.

   (4) Requiring that a nurse or therapist provide services covered by the policy that can be provided by a home health aide or by another licensed or certified home care worker acting within the scope of his or her license or certification.

   (5) Requiring that a licensed home health agency provide services covered by the policy that can be provided by a nurse registry licensed under chapter 400.

   (6) Excluding coverage for personal care services provided by a home health aide.

   (7) Requiring that the provision of home health care services be at a level of certification of licensure greater than that required by the eligible service.

   (8) Requiring that the insured/claimant have an acute condition before home health care services are covered.

   (9) Limiting benefits to services provided by Medicare-certified agencies or providers.

   (10) Excluding coverage for adult day care services.

History. s. 147, ch. 92-33; s. 3, ch. 96-275; s. 18, ch. 97-179.