11 N.C. Admin. Code 12.0556

Current through Register Vol. 39, No. 13, January 2, 2025

Section 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.

11 N.C. Admin. Code 12 .0556

Authority G.S. 58-2-40; 58-51-1; 58-51-95;
Eff. April 1, 1989;
Amended Eff. February 1, 1992;
Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. May 1, 2018.

Authority G.S. 58-2-40; 58-51-1; 58-51-95;
Eff. April 1, 1989;
Amended Eff. February 1, 1992.