Bill > SB265

This bill requires health insurance policies in Georgia to cover medically necessary orthotic and prosthetic devices starting January 1, 2026. The legislation defines these devices as custom-designed aids that help restore physical function, correct body part disorders, or improve mobility. Specifically, the bill mandates coverage for devices that assist with daily living activities, job-related tasks, personal hygiene, and physical activities. Insurers must cover up to three devices per affected limb every three years, including all materials, components, design, fabrication, fittings, education, training, and repairs. The coverage must be comparable to other medical and surgical benefits and can be subject to standard cost-sharing requirements. Replacement of devices within three years is allowed under certain conditions, such as changes in the patient's physiological condition or significant device damage. The bill does not require replacement for devices lost, stolen, or damaged through misuse. By 2032, the Insurance Commissioner must submit a report detailing the implementation of this coverage, with insurers required to provide comprehensive claims data. The legislation aims to ensure that individuals with physical limitations have access to necessary medical devices that can improve their quality of life and functional capabilities.

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https://www.legis.ga.gov/legislation/70862