This bill amends current health insurance laws to expand coverage for prosthetic devices to include adults over the age of 19, in addition to the existing coverage for children under 19. Specifically, it requires insurers to provide coverage for medically necessary prosthetic devices, including activity-specific prosthetic devices, for all residents of New Hampshire, regardless of age. The bill allows insurers to limit coverage for activity-specific prosthetic devices to one device every five years for adults, while maintaining that medically necessary devices will not be subject to annual limits. The bill also clarifies that coverage for prosthetic devices must include all necessary materials, instructions for use, and repair or replacement when deemed medically necessary.

The bill modifies existing legal language by deleting references to coverage being limited to children and inserting provisions that extend this coverage to adults. It also specifies that the coverage for prosthetic devices must adhere to the same terms and conditions as other durable medical equipment, with the exception of the new provisions outlined in this bill. The act is set to take effect on January 1, 2026, and is expected to have a significant fiscal impact, potentially increasing claims costs and insurance premiums due to the expanded coverage.

Statutes affected:
Introduced: 415:18-ff, 415:18-n
As Amended by the Senate: 415:18-ff, 415:18-n