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HOME CARE SERVICES Sample Clauses

HOME CARE SERVICES. Home Care Services means those services provided under a home care plan authorized by a physician including full-time, part-time, or intermittent care by a licensed nurse or home health aide (certified nursing assistant) for patient care and including, as authorized by a physician, physical therapy, occupational therapy, respiratory therapy, and speech therapy. Home care services include laboratory services and private duty nursing for a patient whose medical condition requires more skilled nursing than intermittent visiting nursing care. Home care services include personal care services, such as assisting the client with personal hygiene, dressing, feeding, transfer and ambulatory needs. Home care services also include homemaking services that are incidental to the client’s health needs such as making the client’s bed, cleaning the client’s living area, such as bedroom and bathroom, and doing the client’s laundry and shopping. Homemaking services are only covered when the member also needs personal care services. Home care services do not include respite care, relief care, or day care.
HOME CARE SERVICES. Health Services performed by a Home Health Care Agency or other Provider in Your residence. Home Health Care includes professional, technical, health aide services, supplies, and medical equipment. The Enrollee must be confined to the home for medical reasons, and be physically unable to obtain needed medical services on an Outpatient basis. Covered Health Services include the following.
HOME CARE SERVICES. Those services provided under a home care plan authorized by a physician including full-time, part time, or intermittent care by a licensed nurse or home health aide (certified nursing assistant) for patient care and including, as authorized by a physician, physical therapy, occupational therapy, respiratory therapy, and speech therapy. Home Care Services include personal care services, such as assisting the client with personal hygiene, dressing, feeding, transfer and ambulatory needs. Home Care Services also include Homemaker Services that are incidental to the client’s health needs such as making the client’s bed, cleaning the client’s living area, such as bedroom and bathroom, and doing the client’s laundry and shopping.
HOME CARE SERVICES. (A) Home Care Services include: (1) Skilled Nursing visits provided by a certified Home Health Care Agency, for Medical Assistance, up to the service limit described in Minnesota Statutes, § 256B.0651, subd. 6(b), § 256B.0653, subds. 4, and subd. 2(m), telehomecare skilled nurse visit. (2) Home Health Aide services provided by a certified Home Health Care Agency, up to the service limit described in Minnesota Statutes, § 256B.0652, subd. 4, and § 256B.0653, subd. 3. (3) Personal Care Assistance (PCA) Services as specified in Minnesota Statutes § 256B.0659 subds. (1)-(30) and below, with the exception of subd. (5)(c),(d), and (e). (a) PCA Assessment/ LTCC Assessment. The MCO must provide assessments for PCA services as required under Minnesota Statutes, § 256B.0659 subd. 3a, or for MCOs who are lead agencies, under Minnesota Statutes § 256B.0911, and must authorize home care services utilizing the home care rating criteria, service amounts and limits under Minnesota Statutes, § 256B.0659, subd.
HOME CARE SERVICES. (A) Home Care Services include: (1) Skilled Nursing visits provided by a certified Home Health Care Agency, for Medical Assistance, up to the service limit described in Minnesota Statutes, § 256B.0651, subd. 6(b), § 256B.0653, subds. 4, and subd. 2(m), telehomecare skilled nurse visit. (2) Home Health Aide services provided by a certified Home Health Care Agency, up to the service limit described in Minnesota Statutes, § 256B.0652, subd. 4, and § 256B.0653, subd. 3. (3) Personal Care Assistance (PCA) Services as specified in Minnesota Statutes‌ § 256B.0659 subds. (1)-(30) and below, with the exception of subd. (5)(c),(d), and (e).
HOME CARE SERVICES. A. Home Care Services include: 1.) Nursing services provided by a certified Home Health Care Agency, up to the service limit described in Minnesota Statutes, Section 256B.0627, Subd. 5(e)(1). 2.) Home Health Aide services provided by a certified Home Health Care Agency, up to the service limit described in Minnesota Statutes, Section 256B.0627, Subd. 5(e)(1). 3.) Personal Care Services, up to the service limits established in Minnesota Statutes, Section 256B.0627, Subd. 4 and Subd. 5(e)(2). The HEALTH PLAN must ensure that an explanation of any changes in service levels is documented. 4.) Nursing supervision of Personal Care services, up to the service limits established in Minnesota Statutes, Section 256B.0627, Subd. 4(a) and Subd. 5(e)(2). 5.) Private Duty Nursing Services, up to the limits established in Minnesota Statutes, Section 256B.0627, Subd. 5(e)(3). 6.) Therapy Services, including physical therapy, occupational therapy, speech therapy and respiratory therapy, up to the limits established in Minnesota Rules, Part 9505.0220(V). 7.) Medical Equipment and Supplies, pursuant to Section 6.1.14. B. For Enrollees who are ventilator-dependent, the limits described in 1-6 above, do not apply; the limits for these Enrollees are as described in Minnesota Statutes, Section 256B.0627, Subd. 5(e)4. C. If the HEALTH PLAN prior authorizes Home Care Services, it shall comply with Section 6.21. of this Contract. D. The HEALTH PLAN shall use the criteria established in Minnesota Statutes, Section 256B.0627, Subd. 4(b)(10) to determine whether or not to grant a hardship waiver to an Enrollee’s relative. E. Enrollees over age 65 who require more than the Home Care Services covered under Minnesota Statutes, Section 256B.0627, Subdivision 2 or who require services provided under the Elderly Waiver program in addition to Home Care Services, shall be referred to the Elderly Waiver program.
HOME CARE SERVICES. Caring Friends will provide you with home-care services or make arrangements for another agency to provide those services, as described on Exhibit A. If you choose to have home care services provided by Caring Friends, Caring Friends will charge you for these home care services on a discounted fee-for-service basis.
HOME CARE SERVICES. For all Covered Services, see the Schedule of Benefits for any applicable Deductible, Coinsurance, Copayment, and Benefit Limitation information. To be considered a Covered Service, a Health Care Service must be Medically Necessary. (1) Services performed by a Home Health Care Agency or other Provider in your residence. Home Health Care includes professional, technical, health aide services, supplies, and medical equipment. The Covered Person must be confined to the home for medical reasons, and be physically unable to obtain needed medical services on an Outpatient basis. (2) Covered Services include the following. • Intermittent Skilled Nursing Services by an R.N. or L.P.N. • Medical/Social Services. • Diagnostic Health Care Services. • Nutritional Guidance. • Home Health Aide Services. The Covered Person must be receiving skilled nursing or therapy. Health Care Services must be furnished by appropriately trained personnel employed by the Home Health Care Provider. Other organizations may provide Health Care Services only when approved by us, and their duties must be assigned and supervised by a professional nurse on the staff of the Home Health Care Provider. • Therapy Services in the home (except for Massage, Music, and Manipulation Therapy). Home Care visit limits specified in the Schedule of Benefits for Home Care Services apply when Therapy Services are rendered in the home. • Private Duty Nursing. (3) Non Covered Services include the following. • Food, housing, homemaker services and home delivered meals. • Physician charges. • Helpful environmental materials (hand rails, ramps, telephones, air conditioners, and similar services, appliances and devices). • Services provided by registered nurses and other health workers who are not acting as employees or under approved arrangements with a contracting Home Health Care Provider. • Services provided by a member of the patient’s immediate family. • Services provided by volunteer ambulance associations for which patient is not obligated to pay, • Visiting teachers, vocational guidance and other counselors. • Services related to outside, occupational and social activities. (4) Home infusion therapy will be paid only if you obtain Precertification. Benefits for home infusion therapy include a combination of nursing, durable medical equipment and pharmaceutical services which are delivered and administered intravenously in the home. Home IV therapy includes but is not limited to: injections (intra-muscular,...
HOME CARE SERVICES. Home Care Services include:
HOME CARE SERVICES. We will provide benefits for the services listed below. i. Part time or intermittent skilled nursing care by or under the supervision of a registered nurse. ii. Part time intermittent home health aide services, provided that such services consist primarily of caring for the patient and do not include custodial care. iii. Therapy Services if provided by home health agency personnel. iv. Medical supplies, drugs, the purchase or rental of durable medical equipment, and laboratory services, to the same extent that such laboratory services would have been covered if you were an inpatient in a Hospital or Skilled Nursing Facility.