N.M. Code R. § 13.10.34.14

Current through Register Vol. 35, No. 11, June 11, 2024

Section 13.10.34.14 - ADDITIONAL REQUIREMENTS FOR HOSPICE CARE BENEFITS

A hospital indemnity plan that provides hospice coverage, separately or in conjunction with other hospital indemnity coverage, is subject to these additional requirements.

A.Scope The hospice benefit shall apply to care received in a facility or through an in-home program, licensed, certified or registered in accordance with state law that provides a formal program of care that is:

(1) for terminally ill patients whose life expectancy is less than six months;

(2) provided on an inpatient or outpatient basis; and

(3) directed by a physician.

B.Benefits trigger Hospice benefits shall be payable when the attending physician of the covered person provides a written statement that the covered person has a life expectancy of six months or less, and the person is receiving hospice care as described in this rule.

C.Hospice benefit A hospice care benefit shall be no less than a lump-sum of $2,500.

N.M. Code R. § 13.10.34.14

Adopted by New Mexico Register, Volume XXXI, Issue 18, September 29, 2020, eff. 10/1/2020, Amended by New Mexico Register, Volume XXXIII, Issue 15, August 9, 2022, eff. 7/1/2023