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" and expands the definition of covered devices to include not only artificial limbs but also braces for arms, backs, and necks. The bill mandates that health insurance plans provide coverage for these devices that is at least equivalent to that offered by the federal Medicare program. Additionally, it specifies that coverage must include medically necessary repairs, replacements, and all components required for the use of the devices, while prohibiting any annual or lifetime dollar maximums that are less favorable than those for other covered 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 on or after that date, while the reporting requirements will be effective upon passage.

Statutes affected:
As Introduced: 8-4088f