Your Home Health Care Benefit

What is the Home Health Care Benefit?
How Do You File A Claim?


What is the Home Health Care Benefit?
This benefit essentially will help defray the cost of care you or your eligible dependent receives in your home as part of a treatment plan approved by your physician for a condition that would otherwise require you to be in a hospital. When you or your eligible dependent require home health care services, the Fund will reimburse you for home health care service expenses to a maximum of $450 per calendar year. The reimbursement is paid at the rate of $150 for each of the first three consecutive 24-hour periods of required home health care.

How Do You File A Claim?
Submit your claim to your basic health plan first. Then, submit the following to the Fund Office within 90 calendar days after the required home health care services are rendered:

  • A copy of the Explanation of Benefits from your basic health plan.
  • A Home Health Care Claim Form, available from the Fund Office. Complete the form,providing the date or dates you or your eligible dependent received home health care and the charges for the services.
  • An itemized bill marked “paid,” indicating the date(s) and hours of home health care service as well as the license number of the agency providing the service.
  • Evidence in the form of a written statement from the attending physician ordering such care. This statement must also include a brief description of the illness for which you or your dependent required home health care.
Claims submitted after the 90-calendar day limit will be denied.

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