HF3339 Summary

• Health plans must provide coverage for orthotic and prosthetic devices, supplies, and services at least equal to federal Medicare coverage, effective August 1, 2023.

• Coverage must include customized devices prescribed by authorized providers, devices for physical activities (running, biking, swimming), and devices for showering or bathing.

• Health plans cannot impose separate financial requirements on orthotic and prosthetic benefits that are more restrictive than medical and surgical benefits, and cannot deny coverage based solely on an enrollee's disability.

• Device replacement is covered without regard to continuous use or useful lifetime restrictions if medically necessary due to physiological changes, irreparable device damage, or repair costs exceeding 60 percent of replacement cost.

• Health plans must ensure access to at least two distinct prosthetic and custom orthotic providers in-network in Minnesota, with full reimbursement for out-of-network providers when medically necessary services are unavailable in-network.