Custodial Care

This policy addresses custodial care—non‑skilled personal care services and supplies provided primarily to assist members with activities of daily living (e.g., walking/transferring, bathing, dressing, feeding, toileting), preparation of special diets, and supervision of usually self‑administered medications. Coverage is determined by the member’s benefit plan/SPD and may be excluded or limited (including dollar/duration caps), is not considered medically necessary when there is no reasonable expectation of clinical improvement, and may be further restricted by state regulations; plan/contract language governs if it conflicts with this policy.

"Coverage for custodial care is not defined by this policy; whether custodial services and supplies are covered is determined by the member's benefit plan/contract."

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