Custodial Care is Not Provided. Benefits will not be provided for any day in a Skilled Nursing Facility that CareFirst BlueChoice determines is primarily for Custodial Care. Services may be deemed Custodial Care even if: A. A Member cannot self-administer the care; B. No one in the Member’s household can perform the services; C. Ordered by a physician; D. Necessary to maintain the Member’s present condition; or SAMPLE E. Covered by Medicare.
Appears in 7 contracts
Samples: Individual Enrollment Agreement, Individual Enrollment Agreement, Individual Enrollment Agreement
Custodial Care is Not Provided. Benefits will not be provided for any day in a Skilled Nursing Facility that CareFirst BlueChoice determines is primarily for Custodial Care. Services may be deemed Custodial Care even if:
A. A Member cannot self-administer the care;
B. No one in the Member’s household can perform the services;
C. Ordered by a physician;
D. Necessary X. Xxxxxxxxx to maintain the Member’s present condition; or SAMPLE E. Covered by Medicare.
Appears in 5 contracts
Samples: Individual Enrollment Agreement, Individual Enrollment Agreement for a Qualified Health Plan, Individual Enrollment Agreement for a Qualified Health Plan
Custodial Care is Not Provided. Benefits will not be provided for any day in a Skilled Nursing Facility that CareFirst BlueChoice determines is primarily for Custodial Care. Services may be deemed Custodial Care even if:
A. A Member cannot self-administer the care;
B. No one in the Member’s household can perform the services;
C. Ordered by a physician;
D. Necessary to maintain the Member’s present condition; or SAMPLE E. Covered by Medicare.
Appears in 4 contracts
Samples: Individual Enrollment Agreement, In Network Individual Enrollment Agreement, Individual Enrollment Agreement for a Qualified Health Plan
Custodial Care is Not Provided. Benefits will not be provided for any day in a Skilled Nursing Facility that CareFirst BlueChoice determines is primarily for Custodial Care. Services may be deemed Custodial Care even if:
A. A Member cannot self-administer the care;
B. No one in the Member’s household can perform the services;
C. Ordered by a physician;
D. Necessary to maintain the Member’s present condition; or SAMPLE E. Covered by Medicare.Sample
Appears in 1 contract
Samples: Individual Enrollment Agreement for a Qualified Health Plan
