Relative to health insurance coverage for prosthetics.
The introduction of SB132 is expected to have a notable impact on state laws concerning health insurance policies. By mandating that insurers provide coverage for adult prosthetics, the bill aims to address the gap in coverage that many adults faced previously. The Insurance Department projects that this change could lead to an increase in claim costs, with estimates suggesting that the total annual cost related to this expanded coverage could range between $20 million and $60 million, depending on utilization rates.
Senate Bill 132 (SB132) seeks to amend existing laws regarding health insurance coverage for prosthetics in New Hampshire. Previously, health insurance policies were mandated to cover prosthetic devices primarily for children under 19. SB132 expands this coverage to include adults, ensuring they have access to necessary prosthetic devices and activity-specific prosthetics, which can significantly enhance their ability to participate in various activities safely and effectively.
While the bill is viewed positively by advocates who argue it improves health equity by providing necessary supports to adults with limb loss, there are notable concerns regarding the financial implications for health insurers and the potential increase in health insurance premiums. Local governments and entities that provide employee health insurance may experience increased costs, potentially leading to higher premiums as a direct result of the added coverage mandated by SB132. These financial uncertainties highlight a point of contention among lawmakers and stakeholders.
The bill outlines specific limitations for coverage, indicating that insurers may limit coverage for activity-specific prosthetics to one device every five years for adults. However, there are no annual limit restrictions on medically necessary prosthetics, which bolsters the provision's intent to support individuals' long-term needs for these critical devices. The anticipated changes necessitate further discussions on the balance between improving coverage and managing costs within the state's healthcare system.