This bill establishes a mandate for health insurance plans in New Jersey to provide coverage for home care services specifically for individuals who are disabled or elderly. It defines "home care" as a range of medical services, including preventative, primary, specialty, or urgent care, delivered by licensed health care professionals in a patient's home when they are unable to attend in-person visits. The bill emphasizes that these services must be documented by the health care professional and adhere to clinical standards, while explicitly excluding custodial care from the definition of home care.
Furthermore, the legislation stipulates that no health insurance contracts can be issued or renewed without including benefits for home care that are equivalent to those for any other medical condition. It clarifies that the bill does not impose new network adequacy requirements, ensuring that all individuals, regardless of their age or disability status, can access necessary home care services. This comprehensive approach aims to enhance the availability of medical treatment for those who face challenges in accessing traditional clinical settings.