This bill amends current health insurance laws to require coverage for prosthetic devices for individuals over 19 years of age, in addition to the existing requirement for children under 19. Specifically, it modifies RSA 415:18-ff by deleting the previous limitation of coverage to children and inserting provisions that mandate insurers to provide coverage for both children and adults. The bill allows insurers to limit coverage for activity-specific prosthetic devices to one device every five years for adults, while medically necessary prosthetic 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.

Furthermore, the bill includes a provision that states it does not apply to plans available through the Small Business Health Options Program (SHOP) and adds a reference to RSA 415:18-ff in the coverage requirements for durable medical equipment. The effective date for this act is set for January 1, 2027. The fiscal impact of the bill is expected to result in increased claims costs for insurers, with estimates suggesting an annualized impact of $4 to $12 million, depending on the uptake of the benefit by eligible individuals.

Statutes affected:
Introduced: 415:18-ff, 415:18-n
SB408 text: 415:18-ff, 415:18-n