IL SB2195

Amends the Illinois Insurance Code to require insurance policies covering prosthetic and custom orthotic devices to include benefits for devices determined medically necessary by the enrollee's provider to perform physical activities such as running, biking, swimming, and lifting weights.

Expands coverage to apply to enrollees at any age and requires coverage for the most appropriate model of prosthetic or custom orthotic device that maximizes whole body health and strengthens limb function.

Requires coverage to apply to policies amended, delivered, issued, or renewed 6 months after the effective date, with terms and conditions no less favorable than other medical and surgical benefits under the plan.

Permits insurance carriers to require prior authorization for prosthetic and orthotic devices, limit coverage to licensed providers in their network, and apply standard co-payments, deductibles, and exclusions for misuse or loss.

Effective January 1, 2025; does not apply to accident-only, specified disease, dental, vision, Medicare supplement, workers' compensation, or automobile medical payment insurance.