FL H0005

Requires individual accident or health insurance policies issued or renewed on or after January 1, 2012, to cover orthoses, prostheses, orthotics, and prosthetics at benefit levels equal to federal Medicare standards under 42 U.S.C. and applicable regulations.

Mandates the same orthotic and prosthetic coverage requirements for group, blanket, and franchise health insurance policies and health maintenance organization contracts issued or renewed on or after January 1, 2012.

Allows coverage to be subject to standard deductibles and coinsurance applicable to outpatient visits, but permits insurers to offer optional coverage without deductible or coinsurance restrictions for an additional premium.

Permits insurers to require prior authorization for orthoses and prosthetics and to limit coverage to medically appropriate models; repair and replacement are covered except when resulting from misuse or loss.

Excludes hospital indemnity, disability income, accident-only, long-term care, Medicare supplement, limited benefit, and specified disease policies from these coverage requirements; effective July 1, 2011.