{"data":{"id":"us-me/24-a-m.r.s.-5051-a","jurisdiction":"us-me","citation":"24-A M.R.S. §5051-A","heading":"Required and prohibited provisions","body":"1.  Prohibited provisions.  A long-term care policy may not:\nA.  Contain coverage for skilled nursing facilities only;\nB.  Exclude coverage for skilled, intermediate or custodial care received by a resident of a skilled nursing or intermediate care facility;\nC.  Require a prior hospital stay as a condition for any policy benefits;\nD.  Require a prior skilled nursing facility stay as a condition for intermediate care facility benefits; or\nE.  Require prior institutionalization as a condition of receipt of home health care benefits.\n2.  Required provisions.  A long-term care policy must provide:\nA.  Custodial care benefits that are at least 50% of those provided for skilled nursing care in a nursing facility provided that the benefits need not exceed usual, customary and reasonable charges;\nB.  Benefits for home health care services rendered by a home health care provider;\nC.  Home health care coverage for at least 90 visits in any continuous 12-month period during which coverage is in force; and\nD.  Per visit benefits for home health care services which are at least 50% of the daily benefit for skilled nursing facility confinement provided that the benefit need not exceed usual, customary and reasonable charges.","path":["TITLE 24-A: MAINE INSURANCE CODE","CHAPTER 68: NURSING HOME CARE AND LONG-TERM CARE INSURANCE POLICIES"],"source_url":"https://legislature.maine.gov/statutes/24-A/title24-Asec5051-A.html","current_through":"October 1, 2025","vintage":"","retrieved_at":"2026-09-04T15:12:33Z","sha256":"49a5a652e6abb23cdbef1f63586f9dc92efc0e1403a9eb45796c989b29c4ec2e","source_id":"us-me","stale":false,"prev":"us-me/24-a-m.r.s.-5051","next":"us-me/24-a-m.r.s.-5051-b"},"notice":"GroundRules: Original legal text. Not legal advice."}