The bill H.432 aims to enhance health insurance coverage for prosthetic and orthotic devices in Vermont. It amends existing law to replace the term "prosthetic parity" with "coverage for prosthetic and orthotic devices," thereby expanding the definition to include not only prosthetic limbs but also orthotic devices such as braces for arms, backs, and necks. The bill mandates that health insurance plans provide coverage that is at least equivalent to that offered by the federal Medicare program, ensuring that individuals receive necessary devices based on their medical needs. Additionally, it prohibits health plans from imposing annual or lifetime dollar maximums on coverage for these devices that are less favorable than those for other services.

Furthermore, the bill requires health insurers to report their claims experience related to prosthetic and orthotic devices for the plan years 2026, 2027, and 2028 to the Department of Financial Regulation. This report will include the number of claims and total amounts paid for these services. The provisions of the bill will take effect on January 1, 2026, applying to all health insurance plans issued or renewed after that date, while the reporting requirements will be effective upon passage.

Statutes affected:
As Introduced: 8-4088f