MI HB6085

Health insurers offering policies in Michigan must cover prosthetic devices, components, and their repair, fitting, and replacement when determined medically necessary by the insured's treating physician

Prosthetic coverage cannot have annual or lifetime dollar maximums separate from aggregate maximums on all covered services, and deductibles or copayments cannot exceed those for physical illness generally

Out-of-network prosthetic device or service coinsurance is capped at 30% of the insurer's allowable charge for in-network providers

Amounts paid for prosthetic devices cannot be applied toward separate annual or lifetime maximums for other durable medical equipment, only toward aggregate policy maximums

Coverage excludes repairs and replacements due to insured neglect, misuse, or abuse, and devices designed primarily for athletic purposes; applies to policies delivered, issued, renewed, or extended on or after January 1, 2019