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April 14, 2024 Clouds | 50°F
The 193rd General Court of the Commonwealth of Massachusetts

Section 8I: Home care benefits

Section 8I. Any subscription certificate under a group nonprofit hospital service agreement, except certificates which provide supplemental coverage to medicare or other governmental programs which shall be delivered, issued or renewed in the commonwealth, shall provide, as benefits to all group members having a principal place of employment within the commonwealth, for the expense of medically necessary health care services determined to be medically necessary and provided by a participating home health agency to a member in his residence; provided, however, that such residence is neither a hospital nor an institution primarily engaged in providing skilled nursing or rehabilitation services. Said services shall include, but not be limited to, nursing and physical therapy. Additional services such as occupational therapy, speech therapy, medical social work, nutritional consultation services, the services of a home health aid and the use of durable medical equipment and supplies shall be provided to the extent such additional services are determined to be a medically necessary component of said nursing and physical therapy. Said benefits for home care services shall meet all other terms and conditions of the subscriber certificate. The provisions of this section shall not apply to group insurance plans issued pursuant to the provisions of chapter thirty-two B.