Bill would set insurance offer rules and require device coverage

Insurers and insurance sellers may offer certain added services and noncash gifts under stated rules. These rules cover insurers and insurance sellers offering services or noncash gifts in connection with insurance. Added services must relate to insurance and serve an allowed purpose, such as reducing risk or supporting health. Costs must stay within set limits, and offers must use documented, fair criteria. A pilot may last up to three years if the seller believes in good faith that the service qualifies but lacks enough evidence. The seller must notify the insurance director and may proceed if the director does not object within 21 days. Gifts, meals, donations, and raffles have separate rules. Customers cannot be required to buy or renew insurance to receive a gift or enter a drawing.

Insurers, insurance sellers, and their representatives may not use insurance as an incentive to buy another policy or advertise coverage as free. The restriction applies to insurers, insurance sellers, and people acting for them. The advertising restriction covers words such as “free” or “no cost” when they suggest that insurance coverage costs the customer nothing.

Health insurers must cover prosthetic and orthotic devices under the stated rules. These rules cover health plans in Alaska’s group and individual markets. Coverage must be at least at the level required by the referenced federal Medicare provisions. It includes an initial device chosen by a provider, another device needed for listed activities, materials, instructions, and needed repairs or replacements. Insurers must include at least two device providers in their networks. If needed care is unavailable in network, they must refer the person to an outside provider and pay at an agreed rate; the person pays the in-network share. The text also sets rules for replacement, coverage decisions, and cost sharing. A provider may need to confirm a repair or replacement when the device or part is less than three years old. The rules apply to plans issued, delivered, or renewed on or after the coverage section takes effect. The bill sets January 1, 2027, as the general effective date.

The bill would list prosthetic and orthotic devices and replacements among services Alaska's medical assistance program may offer. This provision concerns prosthetic and orthotic devices and replacements in Alaska medical assistance coverage. The provision takes effect only if federal health officials approve the state plan change or decide approval is unnecessary by January 1, 2029. The Department of Health must submit a state plan change for approval when needed. It takes effect only if the federal decision comes on or before January 1, 2029, and begins the day after that decision.