New Jersey Assembly Bill A5875

New Jersey 2022-2023 Regular Session

• Introduced: 12/11/23
• Refer: 12/11/23

Caption

Requires health benefits coverage for additional prosthetic appliance under certain circumstances.

Impact

By mandating this coverage, A5875 will modify existing health laws which previously did not require insurance contracts to cover additional prosthetic appliances. This change ensures that insured individuals will have access to the necessary equipment that aids in their physical activities. It is expected to increase the financial burden on insurance companies, as they will need to expand their coverage to comply with this new requirement, potentially affecting premium rates.

Summary

Assembly Bill A5875 is aimed at expanding health benefits coverage related to orthotic and prosthetic devices. The bill mandates that health service and insurance contracts must provide coverage for additional prosthetic appliances when deemed medically necessary by a physician. The requirement is specifically for appliances that assist individuals in engaging in various physical and recreational activities such as running, swimming, and skiing. This coverage is pivotal to allow those with prosthetic needs to maintain an active lifestyle and participate in sports.

Contention

The bill has sparked discussions regarding the potential costs associated with extending coverage for additional prosthetic devices. Supporters argue that it enhances the quality of life for individuals requiring prosthetics by enabling active lifestyles. Conversely, critics are concerned about the financial implications for insurance providers and the possibility of increased premiums for all policyholders. Balancing the needs of a vulnerable population while managing insurance costs presents a significant point of contention.