(1) No long term care insurance policy shall be delivered or issued for delivery in this state unless the policy determines eligibility for benefits through a determination that is not more restrictive than requiring that:
(a) The policyholder be functionally impaired and needing assistance in any three or more activities of daily living as defined by the Director of the Department of Consumer and Business Services, by rule, after consultation with the Director of Human Services.
(b) Benefits must be payable when the beneficiary is receiving covered services from any of the following providers approved by the insurer:
(A) Nursing home;
(B) Assisted living;
(C) Home care; and
(D) Adult foster care.
(c) The insurer shall approve nursing home, assisted living, home care, adult foster home and any other providers of covered services by using standards that have been submitted to and approved by the director in consultation with the Director of Human Services.
(2) No long term care policy that offers only nursing home benefits shall be sold in this state. [1989 c.1022 §§13,14; 2003 c.14 §449]Section: Previous 743.648 743.650 743.651 743.652 743.653 743.654 743.655 743.656 743.657 743.660 743.662 743.663 743.664 743.666 743.669 Next
Last modified: August 7, 2008