PURSUING
Indiana
Bill Number:
Status:
Pursuing
Insurance Plans Affected:
State Commercial Plans
Types of Devices Covered:
Orthoses + Prostheses
State Leads:
Sierra Diller, Alicia Carver and Eric Schopmeyer
Primary Bill Sponsor:
Senator Andrea Hundley
Co-State Lead, Disability Rights Advocate, Amputee
Co-State Lead, Disability Rights Advocate, Amputee
Co-State Lead and Director of Operations at surestep
At a Glance
Hoosier Statistics
Physical activity is one of the most important factors in maintaining overall health throughout one’s lifetime. Whether it’s vigorous exercise or simple day-to-day movement, being physically active increases strength and balance, improves mental health, supports better-quality sleep, and reduces the risk of disease and cancer for every body, including people with disabilities.
4.5X
American College of Sports Medicine, Why We Must Prioritize Equitable Access to Physical Activity for Children with Disabilities
Click Here1 in 2
Centers for Disease Control and Prevention (CDC), Inactivity Related to Chronic Disease in Adults with Disabilities
Click Here2X
Centers for Disease Control and Prevention (CDC), Disability and Obesity
Click Here60 / 150 Mins
U.S. Department of Health and Human Services, Physical Activity Guidelines for Americans, 2nd Edition
Click Here$44 Billion
Centers for Disease Control and Prevention (CDC), Disability and Obesity
Click Here“F”
Physical Activity Alliance, The 2022 United States Report Card on Physical Activity for Children and Youth
Click HereThousands of Hoosiers with limb loss, limb difference, and mobility impairment face difficulties in obtaining affordable and accessible prosthetic and orthotic care for physical activities and exercise because state, federal, and private health plans deem this care “not medically necessary.”
Without health plan coverage, adults, children, and families are forced to:
Individuals with disabilities need activity-specific prostheses and orthoses in order to participate in physical activity and recreation. Without access, physical activity is out of reach or dangerous when utilizing the wrong device. Putting more strain on a general-use prosthesis or orthosis may cause damage to the device, resulting in more expense for insurance providers.
This bill would require state commercial plans to provide coverage and reimbursement for orthotic and prosthetic care at a level that is equivalent to the federal Medicare program (also known as “insurance fairness or parity”) as well as provide coverage for an additional prosthetic or custom orthotic device for physical activity. The bill defines nondiscrimination standards, prohibits unfair trade practices, exempts reasonable useful lifetime restrictions, and deems orthotic and prosthetic care as an essential health benefit.
This bill will ensure every Hoosier covered by a state commercial plan that is living with limb loss, limb difference, or mobility impairment will have access to the prosthetic and orthotic care they need to regain their mobility and independence, return to work, and contribute to society. Ensuring appropriate prosthetic and orthotic coverage has a minimal impact on insurance premiums while reducing costly secondary health conditions including heart disease, diabetes, and obesity, as well as reducing reliance on public assistance.