Bill > SB101

This bill requires health insurance policies in Georgia to cover medically necessary orthotic and prosthetic devices starting January 1, 2026, with specific comprehensive provisions. The bill defines key terms like orthotic and prosthetic devices, establishing that coverage must support activities of daily living, job-related tasks, personal hygiene, and physical activities to maximize a person's whole body and limb function. Insurers must cover up to three devices per affected limb every three years, including all device components, materials, design, fabrication, fittings, education, training, and repairs. The coverage must be comparable to other medical and surgical benefits and can be subject to similar cost-sharing requirements. Replacement of devices under three years old is allowed for documented physiological changes or significant device damage. The bill explicitly excludes coverage for devices damaged through misuse or theft and requires insurers to report implementation data to state committees by July 2032. Importantly, the bill does not prevent insurers from offering more generous coverage than the minimum requirements and allows the Insurance Commissioner to develop additional implementation regulations.

Health and Social Services

https://www.legis.ga.gov/legislation/69955