This bill amends existing health insurance laws to require coverage for prosthetic devices for both children and adults. Specifically, it modifies RSA 415:18-ff by removing the previous limitation of coverage solely for children and inserting provisions that mandate coverage for individuals over 19 years of age as well. Insurers are required to provide coverage for medically necessary prosthetic devices, including activity-specific prosthetic devices, for both age groups. For children, coverage may be limited to one activity-specific device per plan year, while for adults, it may be limited to one device every five years. The bill also clarifies that coverage is subject to the terms and conditions of the insurance policy, including any applicable cost-sharing.

Additionally, the bill includes a provision that applies to the state of New Hampshire's employee health benefit plan and specifies that coverage for prosthetic devices must be provided under the same terms as other durable medical equipment, with the exception of the new provisions outlined in RSA 415:18-ff. The bill is set to take effect on January 1, 2028, and is expected to have a fiscal impact, potentially increasing claims costs for health insurance providers and the state employee health benefit plan. The estimated annualized fiscal impact could range from $4 to $12 million, depending on the uptake of the benefit by eligible individuals.

Statutes affected:
Introduced: 415:18-ff, 415:18-n
As Amended by the Senate (2nd): 415:18-ff, 415:18-n
As Amended by the House: 415:18-ff, 415:18-n
Version adopted by both bodies: 415:18-ff, 415:18-n
SB408 text: 415:18-ff, 415:18-n