FL H1239

Creates new requirements for individual accident or health insurance policies issued after January 1, 2015, to evaluate and review coverage for orthotics, prosthetics, orthoses, and prostheses, with coverage standards matching federal Medicare provisions under 42 U.S.C. sections 1395k, 1395l, and 1395m.

Requires group, blanket, or franchise accident or health insurance policies issued after January 1, 2014, to recommend coverage for orthotics and prosthetics at levels equal to federal Medicare standards, with optional enhanced coverage available for an additional premium without deductibles or coinsurance.

Mandates health maintenance organizations to evaluate and review coverage for orthotics and prosthetics under similar standards as individual and group policies, effective January 1, 2014.

Allows insurers and health plans to require prior authorization for orthotics and prosthetics, limit benefits to the most appropriate model meeting medical needs, and require services be provided by licensed orthotists/prosthetists and vendors.

Exempts specified insurance types including hospital confinement indemnity, disability income, accident-only, long-term care, Medicare supplement, and limited benefit policies from these coverage requirements; effective date July 1, 2015.