A. Each health maintenance organization which delivers or issues for delivery in this state an individual or group contract shall make available to the contract holder the option of home health care coverage which includes benefits for the services described in this section.

Terms Used In New Mexico Statutes 59A-46-40

  • Contract: A legal written agreement that becomes binding when signed.

B. Home health care coverage offered shall include:

(1)     services provided by a registered nurse or a licensed practical nurse; (2)     health services provided by physical, occupational and respiratory therapists and speech pathologists; and

(3)     health services provided by a home health aide. C. Home health care coverage may be limited to:

(1)     services provided on the written order of a licensed physician, provided such order is renewed at least every sixty days;

(2)     services provided, directly or through contractual agreements, by a home health agency licensed in the state in which the home health services are delivered; and

(3)     services, as set forth in Subsection B of this section, without which the insured would have to be hospitalized.

D. Coverage shall be provided for at least one hundred home visits per enrollee per year, with each home visit including up to four hours of home health care services.

E. For the purposes of this section, “home health care” means health services provided on a part-time, intermittent basis to an individual confined to his home due to physical illness.