<?xml version='1.0' encoding='utf-8'?>
<section article="gin" article_name="Insurance" number="18-110" title_number="18" title_name="Long-Term Care Insurance" subtitle_number="1">
  <level label="a">
    <level label="1">
      <text>In this section, “home health care services” means medical or nonmedical services provided to ill, disabled, or infirm individuals in their residences.</text>
    </level>
    <level label="2">
      <text>“Home health care services” includes:</text>
      <level label="i">
        <text>homemaker services;</text>
      </level>
      <level label="ii">
        <text>assistance with activities of daily living; and</text>
      </level>
      <level label="iii">
        <text>respite care services.</text>
      </level>
    </level>
  </level>
  <level label="b">
    <text>A policy or certificate of long-term care insurance that provides benefits for home health care services may not limit or exclude benefits by:</text>
    <level label="1">
      <text>requiring that the insured would need care in a nursing facility if home health care services were not provided;</text>
    </level>
    <level label="2">
      <text>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.</text>
    </level>
    <level label="3">
      <text>limiting eligible services provided by registered nurses or licensed practical nurses;</text>
    </level>
    <level label="4">
      <text>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;</text>
    </level>
    <level label="5">
      <text>requiring that the insured have an acute condition before home health care services are covered; or</text>
    </level>
    <level label="6">
      <text>limiting benefits to services provided by Medicare-certified agencies or providers.</text>
    </level>
  </level>
  <level label="c">
    <text>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.</text>
  </level>
</section>
