California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 8 - CALIFORNIA PARTNERSHIP FOR LONG-TERM CARE › Article 1 - DEFINITIONS › Section 58010 - Elimination Period

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
"Elimination Period" is defined as either (a) or
						(b).
(a) "Elimination Period" means
					 the total number of days that covered, Formal Long-Term Care Services must be
					 received after the insured is determined to be a Chronically Ill Individual and
					 before the benefits covered by the Policy or Certificate are payable. The
					 number of days must be accumulated within a nine-month period [insurer option:
					 a period longer than 9 months, but not shorter than 9 months can be used] after
					 the insured has been determined to be a Chronically Ill Individual. The number
					 of days can be accumulated before the filing of a claim if the insured can
					 establish that he or she was a Chronically Ill Individual before filing a
					 claim. The Elimination Period need only be met once during a lifetime. Any day
					 when covered services [insurer option: days the insured receives inpatient care
					 in a general acute care hospital may also be counted] are reimbursed by other
					 insurance or Medicare may be counted toward meeting the Elimination Period.
					 Respite Care [insurer option: list other benefits that are exempted] is not
					 subject to the Elimination Period.
(b) "Elimination Period" means a provision
					 that defines the number of days the insured must be disabled before the
					 benefits covered by the Policy or Certificate are payable, and that is approved
					 by the Department of Health Services.
1. New
						section filed 8-30-93 as an emergency; operative 8-30-93 (Register 93, No. 36).
						Submitted for printing only pursuant to section
						22009,
						Welfare and Institutions Code.
2. Certificate of Compliance as to
						8-30-93 order transmitted to OAL 12-30-93 and filed 1-28-94 (Register 94, No.
						4).
3. Repealer of former section
						58010 and renumbering and
						amendment of former section
						58014 to new section
						58010 filed 10-1-98 as an
						emergency; operative 10-1-98. Submitted to OAL for printing only pursuant to
						Welfare and Institutions Code section
						22009(d)
						(Register 98, No. 41). A Certificate of Compliance must be transmitted to OAL
						by 1-29-99 or emergency language will be repealed by operation of law on the
						following day.
4. Certificate of Compliance as to 10-1-98 order
						transmitted to OAL 1-28-99 and filed 3-15-99 (Register 99, No.
						12).
5. Amendment of section and NOTE filed 5-30-2001 as an
						emergency; operative 5-30-2001. A Certificate of Compliance must be transmitted
						to OAL by 9-27-2001 or emergency language will be repealed by operation of law
						on the following day. Submitted to OAL for printing only pursuant to Welfare
						and Institutions Code section
						22009(d)
						(Register 2001, No. 22).
6. Certificate of Compliance as to
						5-30-2001 order transmitted to OAL 9-24-2001 and filed 10-31-2001 (Register
						2001, No. 44).
Note: Authority cited: Section
						  22009(a),
						  Welfare and Institutions Code. Reference: Section
						  22005.1(b),
						  Welfare and Institutions Code.