1. Prohibited provisions. A long-term care policy may not: A. Contain coverage for skilled nursing facilities only; [PL 1989, c. 556, Pt. B, §3 (NEW).] B. Exclude coverage for skilled, intermediate or custodial care received by a resident of a skilled nursing or intermediate care facility; [PL 1989, c. 556, Pt. B, §3 (NEW).] C. Require a prior hospital stay as a condition for any policy benefits; [PL 1989, c. 556, Pt. B, §3 (NEW).] D. Require a prior skilled nursing facility stay as a condition for intermediate care facility benefits; or [PL 1989, c. 556, Pt. B, §3 (NEW).] E. Require prior institutionalization as a condition of receipt of home health care benefits. [PL 1989, c. 556, Pt. B, §3 (NEW).] [PL 1989, c. 556, Pt. B, §3 (NEW).] 2. Required provisions. A long-term care policy must provide: A. Custodial care benefits that are at least 50% of those provided for skilled nursing care in a nursing facility provided that the benefits need not exceed usual, customary and reasonable charges; [PL 1989, c. 556, Pt. B, §3 (NEW).] B. Benefits for home health care services rendered by a home health care provider; [PL 1989, c. 556, Pt. B, §3 (NEW).] C. Home health care coverage for at least 90 visits in any continuous 12-month period during which coverage is in force; and [PL 1989, c. 556, Pt. B, §3 (NEW).] D. Per visit benefits for home health care services which are at least 50% of the daily benefit for skilled nursing facility confinement provided that the benefit need not exceed usual, customary and reasonable charges. [PL 1989, c. 556, Pt. B, §3 (NEW).] [PL 1989, c. 556, Pt. B, §3 (NEW).]
‹ Prev All Maine sections Next ›
Lexace provides legal information, not legal advice, and no attorney–client relationship is created. Statute text is provided for general information and may not reflect the most recent amendments; verify against the official state code.