Is private duty nursing or nursing in the home covered under the plan?

Charges for the services of a Registered Nurse (R.N.), Registered Nursing Assistant or Licensed Practical Nurse for private duty nursing are covered when provided in the home; provided such services are certified as medically necessary by the attending physician. Payment for such services shall exclude:

• Charges in excess of the fee level set by the largest nursing registry of Ontario
• Agency fees, commissions or overtime fees
• Charges by a nurse who is related to the patient by birth or marriage or who lives in the home of the covered person
• Charges for the services of a homemaker or any person who is not described above
• Charges incurred by any person while confined in a hospital