WI AB1121

Requires health insurance policies and self-insured governmental health plans to cover prosthetic limbs and custom orthotic braces when medically necessary for daily living activities, job-related activities, physical activities to maximize limb function, or showering/bathing needs

Coverage must include materials, components, related services, user instruction, and reasonable repairs; replacement or major repairs must be covered without continuous use or lifetime restrictions when medically necessary or when repair costs exceed 60% of replacement cost

Coverage levels must equal or exceed federal Medicare program standards for prosthetic and orthotic devices, with cost-sharing limited to provisions that apply to inpatient physician and surgical services

Managed care plans must provide access to at least two in-network providers in Wisconsin; if unavailable, plans must refer patients to out-of-network providers and fully reimburse at mutually agreed rates

Takes effect on the first day of the 4th month after publication, applying to new policy years or upon renewal/modification of collective bargaining agreements