This bill amends existing health insurance laws to require coverage for prosthetic devices for all individuals, not just children, thereby expanding the current mandate that only applies to children's prosthetics. Specifically, it modifies RSA 415:18-ff by removing the age restriction and inserting language that mandates coverage for "individuals" who are residents of the state and covered by such insurance. The bill also includes provisions for activity-specific prosthetic devices, allowing insurers to limit coverage to one such device per plan year while ensuring that medically necessary prosthetic devices are not subject to annual limits. Additionally, it clarifies that coverage for prosthetic devices must include all necessary materials, instruction on usage, and repair or replacement when deemed medically necessary.

The bill also amends RSA 415:18-n to ensure that coverage for prosthetic devices aligns with the terms and conditions applicable to other durable medical equipment, while specifically noting that activity-specific prosthetic devices are covered under the new provisions. The effective date for this act is set for 60 days after its passage. The fiscal impact of the bill is indeterminable, with potential increases in claims costs estimated between $20 million to $60 million annually, depending on utilization rates among the approximately 8,900 adults in New Hampshire with limb loss. Local and county governments may also see increased premiums as a result of the expanded coverage, although the exact financial implications remain uncertain.

Statutes affected:
Introduced: 415:18-ff, 415:18-n