A new IRS notice expands the list of preventive care benefits that may be covered. Expansion provides coverage without a deductible for some chronic conditions.

“This notice expands the list of preventive care benefits permitted to be provided by a high deductible health plan (HDHP) under section 223(c)(2) of the Internal Revenue Code (Code) without a deductible, or with a deductible below the applicable minimum deductible (self-only or family) for an HDHP.”

Carriers / Plan Sponsors can now use a lower than the minimum deductible for the preventive care benefits, but still need a minimum deductible for the other services. The new change doesn’t affect what is generally considered “free preventive” but instead simply allows carriers / plan sponsors — if they wish — to start offering CDHPs which cover these additional items, while not endangering their ability to be combined with an HSA.

Thus, employees could still contribute to an HSA now that these services are considered to be preventive. These services would not need to be “free”; for non-HDHP group plans, it will not make a difference to the participant, but for someone in an HDHP plan who wants to contribute to an HSA, it’s a big deal.

The following treatments have now been classified as preventive care for the chronic conditions indicated.

  • Angiostatin converting enzyme (ACE) inhibitors (for congestive heart failure, diabetes, and coronary artery disease);
  • Anti-resorptive therapy (for osteoporosis and osteopenia)
  • Beta-blockers (for congestive heart failure and coronary artery disease)
  • Blood pressure monitors (for hypertension)
  • Inhaled corticosteroids (for asthma)
  • Insulin and other glucose-lowering agents (for diabetes)
  • Retinopathy screening (for diabetes)
  • Peak flow meter (for diabetes)
  • Glucometer (for diabetes)
  • Hemoglobin A1c testing (for diabetes)
  • International normalized ratio testing (for liver disease and bleeding disorders)
  • Low-density lipoprotein (LDL) testing (for heart disease)
  • Selective serotonin reuptake inhibitors (SSRIs) (for depression)
  • Statins (for heart disease and diabetes)

The change is effective July 17, 2019.


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