The bill H.432 aims to enhance health insurance coverage for prosthetic and orthotic devices in Vermont. It amends existing law to require health insurance plans to provide coverage for these devices that is at least equivalent to that offered by the federal Medicare program. The bill specifies that coverage must include a range of prosthetic and orthotic devices, as well as necessary materials, components, and instruction for use. It also mandates that health insurers consider these devices as habilitative or rehabilitative benefits and prohibits discrimination based on a covered individual's disability. Additionally, the bill requires health insurers to report their claims experience related to prosthetic and orthotic devices for the years 2026, 2027, and 2028 to the Department of Financial Regulation.

Key amendments in the bill include the replacement of the term "prosthetic parity" with "coverage for prosthetic and orthotic devices," and the expansion of the definition of covered devices to include various types of braces and artificial limbs. The bill also stipulates that coverage cannot be subject to less favorable terms than other services under the health plan, and it eliminates any annual or lifetime dollar maximums on coverage for these devices. The effective date for the coverage requirements is set for January 1, 2026, while the reporting requirements will take effect upon passage.

Statutes affected:
As Introduced: 8-4088f