Concerning coverage requirements for prosthetic limbs and custom orthotic braces.

Substitute House Bill 1669 mandates that health plans offered in Washington's large and small group markets must provide coverage for medically necessary prosthetic limbs and custom orthotic braces. This directly affects individuals enrolled in these plans by ensuring access to devices needed for daily living, job-related tasks, and various physical activities. The bill requires coverage for materials, instruction, and reasonable repair or replacement, including replacements due to changes in a patient's condition or significant device damage. It also prohibits denying coverage to enrollees with disabilities if similar services would be covered for non-disabled individuals, while allowing for standard utilization management. These requirements apply to plans issued or renewed on or after January 1, 2026.