19 Miss. Code. R. 3-8.05 - Policy Definitions
No long-term insurance policy delivered or issued for delivery in this state shall use the terms set forth below, unless the terms are defined in the policy and the definitions satisfy the following requirements:
A. "Acute condition"
means that the individual is medically unstable. Such an individual requires
frequent monitoring by medical professionals, such as physicians and registered
nurses, in order to maintain his or her health status.
B. "Home health care services" means medical
and nonmedical services, provided to ill, disabled or infirm persons in their
residences. Such services may include homemaker services, assistance with
activities of daily living and respite care services.
C. "Medicare" shall be defined as "The Health
Insurance for the Aged Act, Title XVIII of the Social Security Amendments of
1965 as "Then Constituted or Later Amended", or "Title I, Part 1 of Public Law
89-97, as Enacted by the Eighty-Ninth Congress of the United States of America
and popularly known as the Health Insurance for the Aged Act, as then
constituted and any later amendments or substitutes thereof", or words of
similar import.
D. ."Mental or
nervous disorder" shall no be defined to include more than neurosis,
psychoneurosis, psychopathy, psychosis, or mental or emotional disease or
disorder.
E. "Skilled nursing
care", "intermediate care", "personal care", "home care", and other services
shall be defined in relation to the level of skill required, the nature of the
care and the setting in which care must be delivered.
F. All providers of services, including but
not limited to "skilled nursing facility", "extended care facility",
"intermediate care facility", "convalescent nursing home", "personal care
facility", and "home care agency" shall be defined in relation to the services
and facilities required to be available and the licensure or degree status of
those providing or supervising the services. The definition may require that
the provider be appropriately licensed or certified.
Notes
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