| | All health plans and insurers to are now required to offer (make something available for those who want it) coverage for orthotic and prosthetic devices and services as follows:
- Annual and lifetime maximums for orthotic and prosthetic devices and services cannot be lower than the maximums applicable to other plan benefits; and
- Copayments, coinsurance, deductibles, and maximum out-of-pocket amounts cannot be higher than the most common amounts on the benefit plan. AB 2012 Health and Safety Code §1367.18 Insurance Code §10123.7
Links
San Pedro Shoes
Excellent Orthotics
spenco.com/ insoles
Medicare on Orthotic & Prosthetic's
Prosthetic/ Orthotic Items
Including arm, leg, back, and neck braces; artificial eyes; artificial limbs (and their replacement parts); breast prostheses (after mastectomy); and prosthetic devices needed to replace an internal body part or function (including ostomy supplies, and parenteral and enteral nutrition therapy) when ordered by a doctor. For Medicare to cover your prosthetic or orthotic, you must go to a supplier that is enrolled in Medicare. You pay 20% of the Medicare-approved amount, and the Part B deductible applies.
               
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