Relating to: health insurance coverage of prosthetic limbs and custom orthotic braces. (FE)

This bill requires health insurance plans, including those for government employees and public schools, to cover prosthetic limbs and custom orthotic braces when deemed medically necessary by a licensed healthcare provider. The law defines prostheses as devices that replace missing limbs and custom orthotic braces as personalized devices that correct or support musculoskeletal conditions, ensuring coverage includes materials, instruction, and repairs under specific circumstances. Coverage must match or exceed federal standards and apply to replacement or repair when medically needed due to changes in the patient's condition or when repair costs exceed 60 percent of replacement costs. The bill also mandates that plans maintain access to at least two in-network providers in the state and requires written explanations for any coverage denials based on medical necessity.