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The Florida Statutes

The 2018 Florida Statutes

Title XXXVII
INSURANCE
Chapter 627
INSURANCE RATES AND CONTRACTS
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F.S. 627.94071
627.94071 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.