Sec. 5. A policy of accident and sickness insurance must provide coverage for orthotic devices and prosthetic devices, including repairs or replacements, that: (1) are provided or performed by a person that is: (A) accredited as required under 42 U.S.C. 1395m(a)(20); or (B) a qualified practitioner (as defined in 42 U.S.C. 1395m(h)(1)(F)(iii)); (2) are determined by the insured's physician to be medically necessary to restore or maintain the insured's ability to perform activities of daily living or essential job related activities; and (3) are not solely for comfort or convenience.
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