Section 37-9 - Minimum Standards for Home Health Care Benefits in Long-Term Care Insurance Policies (a) A long-term care insurance policy or certificate may not, if it provides benefits for home health care services, limit or exclude benefits: - (i) By requiring that the insured/claimant would need skilled care in a skilled nursing facility if home health care services were not provided;
- (ii) By requiring that the insured/claimant first or simultaneously receive nursing and/or therapeutic services in a home or community setting before home health care services are covered;
- (iii) By limiting eligible services to services provided by registered nurses or licensed practical nurses;
- (iv) By requiring that a nurse or therapist provide services covered by the policy that can be provided by a home health aide, or other licensed or certified home care worker acting within the scope of his or her licensure or certification.
- (v) By requiring that the insured/claimant have an acute condition before home health care services are covered.
- (vi) By limiting benefits to services provided by Medicare-certified agencies or providers.
(b) Home health care coverage may be applied to the non-home health care benefits provided in the policy or certificate when determining maximum coverage under the terms of the policy or certificate.
044-37 Wyo. Code R. § 37-9