Wisconsin 2025-2026 Regular Session

Wisconsin Senate Bill SB1077

Introduced
2/26/26  
Refer
2/26/26  

Caption

An Act to create 609.865 and 632.895 (16g) of the statutes; Relating to: health insurance coverage of prosthetic limbs and custom orthotic braces. (FE)

Impact

The bill's implications could significantly enhance the quality of life for individuals requiring prosthetic limbs and orthotic braces. By mandating coverage without lifetime limits for necessary repairs or replacements when physiological changes occur, it removes financial obstacles that could otherwise hinder individuals from obtaining the right tools for daily living or work. Additionally, the requirement for managed care plans to provide a network of at least two in-state providers can facilitate better access to necessary care, promoting more personalized and timely support for patients.

Summary

Senate Bill 1077 aims to improve health insurance coverage for prosthetic limbs and custom orthotic braces, ensuring that when these devices are deemed medically necessary, individuals have adequate access to necessary equipment and services. This bill stipulates that health insurance policies, including self-insured governmental plans, are required to cover the costs associated with these devices, including their components, repairs, and patient education on use. Coverage offered must be at least equal to what is provided under the federal Medicare program, thereby setting a standard for accessibility and affordability for users.

Contention

As with any legislation that mandates coverage, there may be concerns regarding the financial implications for insurance providers, potentially leading to higher premiums or the complexity of the implementation process. Opponents may argue that applying such mandates could lead to increased costs within the health insurance system. Furthermore, the bill might need to address how it interacts with existing state regulations and policies, especially if there are current agreements under collective bargaining that conflict with the new requirements outlined in the bill.

Companion Bills

WI AB1121

Crossfiled An Act to create 609.865 and 632.895 (16g) of the statutes; Relating to: health insurance coverage of prosthetic limbs and custom orthotic braces. (FE)

Previously Filed As

WI AB1121

Health insurance coverage of prosthetic limbs and custom orthotic braces. (FE)

WI HB1669

AN ACT Relating to coverage requirements for prosthetic limbs and custom orthotic braces;

WI SB5629

Concerning coverage requirements for prosthetic limbs and custom orthotic braces.

WI LB410

Require insurance coverage of prosthetics and orthotics

WI HB2568

AN ACT Relating to extending coverage of prosthetic limbs and custom orthotic braces to public and school employees;

WI S1110

Coverage for Orthotics and Prosthetics Services

WI HB272

Insurance For Prosthetics & Orthotics

WI H1301

Coverage for Orthotics and Prosthetics Services

WI HB216

Health insurance; coverage for prosthetic and custom orthotic devices and components, reports.

WI HB564

Require health insurance coverage of orthotic, prosthetic devices

Similar Bills

No similar bills found.