11 NCAC 12 .0556             HOME HEALTH CARE POLICY REQUIREMENT

All Home Health Care Policies shall have the notice printed in contrasting type or color on the face of the policy as follows:  "This Is Not A Long‑Term Care Policy ‑ This Policy Provides Home Health Care Benefits Only ‑ Read Carefully".  Home health care policies must comply with G.S. 58‑51‑60 and the following items:

(1)           Prior hospitalization or skilled nursing home confinement shall not be required to satisfy eligibility for benefits.

(2)           Benefits shall be provided without a physician certification that the insured or claimant would need medical care in a skilled nursing facility or hospital setting.

(3)           Home health benefits shall not be limited to acute conditions.

 

History Note:        Authority G.S. 58‑2‑40; 58‑51‑1; 58‑51‑95;

Eff. April 1, 1989;

Amended Eff. February 1, 1992.