VT H0432

Expands health insurance coverage requirements for prosthetic and orthotic devices to include coverage for physical activities (running, biking, swimming, strength training) and for showering/bathing, in addition to basic medical needs

Requires coverage for all necessary materials, components, instruction on device use, and medically necessary repairs or replacements without continuous use or useful lifetime restrictions

Mandates health plans include at least two in-network prosthetic and orthotic providers located in Vermont, with out-of-network referral processes when necessary services are unavailable in-state

Prohibits insurers from denying coverage based on disability and requires nondiscriminatory utilization review; cost-sharing cannot be less favorable than for other non-primary care services

Requires health insurers to report claims experience for prosthetic and orthotic devices for plan years 2026-2028 to the Department of Financial Regulation, with an aggregated report due to the General Assembly by December 1, 2029