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Senate of Pennsylvania
Session of 2021 - 2022 Regular Session


Posted: December 3, 2020 12:40 PM
From: Senator Bob Mensch
To: All Senate members
Subject: Insurance Coverage for Prosthetics
In the near future, I plan on reintroducing Senate Bill 1298 of last session which would provide insurance coverage for any prosthetic or orthotic device and/or component.  

Unfortunately, it’s a little known fact that in Pennsylvania that most insurance coverages have some type of cap on prosthetics, including artificial limbs, which can equate to coverage for only one prosthetic per life time.  This is particularly worrisome for children or young adults who suffer a catastrophic injury and then grow out of their one device, and need a new one only to find it’s not covered under their plan.

Specifically, my legislation will require that health insurers provide coverage for expenses incurred in obtaining any orthotic or prosthetic device and/or component. The bill requires health insurers, on and after the bill's effective date, to reimburse for these benefits at the same rate as reimbursement for orthotic and prosthetic devices under the federal Medicare reimbursement schedule.

This legislation is supported by the Amputee Coalition of Pennsylvania, and right now, there are over twenty states, including New Jersey, Delaware, Maryland, and Virginia which have laws like this.  I think it is time we join these other states and extend these needed benefits to those who need it.

Last session, Senate Bill 1298 was co-sponsored by Senators MASTRIANO, J. WARD, COSTA, BLAKE, BREWSTER, COLLETT, SANTARSIERO, SCHWANK and TARTAGLIONE.

Please join me in co-sponsoring this important piece of legislation. 

Introduced as SB289