New Jersey has taken a significant step forward in supporting individuals with limb loss or limb difference by expanding health insurance coverage for specialized prosthetic and orthotic devices. Governor Murphy recently signed Assembly Bill A-3856 into law, ensuring that residents can access the equipment they need to participate fully in physical and recreational activities.
What the New Law Covers
The legislation requires most health insurance plans in New Jersey to cover an additional orthotic or prosthetic appliance when a physician determines it’s medically necessary for physical and recreational activities. This includes devices needed for running, swimming, bicycling, skiing, snowboarding, climbing, and various team and individual sports.
The law applies to a wide range of insurance providers, including hospital and medical service corporations, health maintenance organizations, and state employee health benefit programs. However, it does not extend to Medicaid coverage. Patients can obtain these devices from any licensed orthotist, prosthetist, or certified pedorthist as determined by their physician.
Who Benefits
Nearly 4 million Americans live with limb loss or limb difference, and this law directly addresses their needs for specialized equipment that enables active lifestyles. The legislation is particularly meaningful for children and adults who participate in sports and recreation but previously faced financial barriers to obtaining the necessary specialized devices.
Medical research consistently shows that physical activity leads to better health outcomes for people with disabilities, including reduced risk of chronic diseases and improved mental health. By making recreational prosthetic and orthotic devices more accessible, this law removes significant obstacles to maintaining an active lifestyle.
Financial Impact
The fiscal analysis indicates the law will have a modest financial impact. State and local government expenditures for employee health benefit programs are projected to increase by approximately $461,000 to $577,000 annually—representing just a 0.01% increase in medical claims costs. The impact on commercial insurance premiums is expected to be minimal, making this an affordable way to significantly improve quality of life.
A Growing Movement
New Jersey joins several other states that have enacted similar legislation, reflecting a broader national trend toward greater accessibility and equity for people with disabilities. The bill, sponsored by Assemblymen Herb Conaway Jr., William B. Sampson IV, and Antwan L. McClellan, demonstrates bipartisan support for removing barriers to active living for all residents.