1998 Florida Code
TITLE XXXVII INSURANCE
Chapter 627 Insurance Rates And Contracts  
PART XVIII LONG-TERM CARE INSURANCE POLICIES (ss. 627.9401-627.9408)
627.94071   Minimum standards for home health care benefits.

1627.94071  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.

1Note.--Section 34(1), ch. 97-179, provides that "[e]xcept as provided in subsection (2) and as otherwise provided in this act, the changes made by this act apply to policies or contracts with plan years that begin on or after July 1, 1997."