This bill amends New Jersey law to require health insurance coverage for an additional orthotic or prosthetic appliance when deemed medically necessary by a physician. The new provision mandates that health insurance contracts cover expenses for both a primary orthotic or prosthetic appliance and an additional one, specifically designed to support individuals in engaging in physical and recreational activities such as running, swimming, and skiing. The reimbursement for these appliances will be aligned with the rates established under the federal Medicare reimbursement schedule, ensuring that individuals can access necessary devices to enhance their mobility and participation in various activities.

The bill applies to a range of entities, including hospital, medical, and health service corporations, as well as commercial insurers, health maintenance organizations, and state health benefit programs. This expansion of coverage aims to provide individuals with the necessary orthotic and prosthetic support for both medical and recreational purposes, ultimately enhancing their quality of life. The provisions of the act will take effect 90 days after enactment and will apply to policies or contracts issued or renewed thereafter.

Statutes affected:
Introduced: 17:48-6, 17:48A-7, 17:48E-35.30, 17B:26-2.1, 17B:27-46.1, 17B:27A-7.13, 17B:27A-19.17, 26:2J-4.31, 52:14-17.29