IRS Expands Preventive Coverage for HSA plans

IRS Expands Preventive Coverage for HSA plans

On July 17, 2019 the IRS issued guidance expanding the preventive care benefits that can be provided by a high-deductible health plan (HDHP) and remain qualified for HSA eligibility. Ordinarily the HSA rules do not allow for preventive care for services or benefits intended to treat existing illnesses, injuries, or conditions. The new ruling allows for certain conditions to have coverage with no-deductible or below the HSA deductible limits.

The Treasury Department and the IRS, in consultation with the Department of Health and Human Services, have determined that the below medical care services received and items purchased, including prescription drugs should be classified as preventive care for someone with that chronic condition.

It’s important to note that this ruling does not expand preventive care as defined under the ACA.  It only expands the preventive services allowed under qualified HDHP plans. The notice also clarifies that services or items that treat complications or secondary conditions that happen apart from the preventive care conditions listed below are not treated as preventive care under the HSA rules.  It is unclear how much this change will be passed on in increased premium at this time. 

Preventive Care for Specified Conditions                 For Individuals Diagnosed with                              
Angiotensin Converting enzyme (ACE)  inhibitors Congestive heart failure, diabetes, and/or coronary  artery disease
Anti-resorptive therapy Osteoporosis and/or osteopenia
Beta-blockers Congestive heart failure and/or coronary artery  disease
Blood pressure monitorHypertension
Inhaled corticosteroids Asthma
Insulin and other glucose lowering agentsDiabetes
Retinopathy screeningDiabetes
Peak flow meterAsthma
Hemoglobin A1c testingDiabetes
International Normalized Ratio (INR) testingLiver disease and/or bleeding disorders
Low-density Lipoprotein (LDL) testingHeart disease
Selective Serotonin Reuptake Inhibitors  (SSRIs)Depression
StatinsHeart disease and/or diabetes

Although the law is effective immediately, we are working with the insurance carriers to determine when and how this will affect your coverage moving forward.