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Preventative Care for HDHPs is Expanded to Include Chronic Conditions

preventative care

2 minute read

The IRS has expanded the scope of preventative care benefits for some chronic conditions that can be provided by high deductible health plans (HDHP) without a deductible.

Individuals who are covered by an HDHP generally may establish and make contributions to a health savings account (HSA). To quality as an HDHP, the plan can’t provide benefits for any year until a minimum deductible is met. However, an HDHP can provide preventative care benefits without using a deductible. This includes certain medical services and medications used to treat chronic conditions like asthma, depression, diabetes, and congestive heart failure.

This change is in response to President Trump’s executive order last month regarding increased health care transparency.

Public sector organizations may want to review their plans and confer with their broker/consultant to determine how their plans cover preventative care benefits. For more information, contact your Employee Benefits Consultant.

 

Preventive Care for Specific Conditions

For Individuals Diagnosed with

Angiotensin converting enzyme (ACE) inhibitors

Congestive heart failure, diabetes and/or coronary

Anti-resorptive therapy

Osteoporosis and/or osteopenia

Beta-blockers

 

Congestive heart failure and/or coronary artery disease

Blood pressure monitor

Hypertension

Inhaled corticosteroids

Asthma

Peak flow meter

Insulin and other glucose-lowering agents

 

 

 

Diabetes

 

Retinopathy screening

Glucometer

Hemoglobin A1c testing

International normalized ratio (INR) testing

Liver disease and/or bleeding disorders

Low-density lipoprotein (LDL) testing

Heart disease

Selective serotonin reuptake inhibitors (SSRIs)

Depression

 

Additional Resources

Bulletin - IRS Expands Preventive Care for HDHPs to Include Chronic Conditions

IRS Notice 2019-45

 

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Steve Smith

Steve Smith

Steve Smith, Employee Benefits Consultant for National Insurance Services, has his energy level permanently set at “high.” His maxim is “work hard, play hard." In addition to coaching youth basketball and his relentless addiction to volunteering, Steve’s community service and political activities make him an expert in stirring the groundswell and getting groups of people working together for a higher cause. Minnesota schools, cities, and counties rely on Steve’s unique and creative ideas of engaging employees in their own health and wellness to lower utilization trends. He has a background in the health insurance field doing compliance, cost mitigation, utilization, analytics, wellness plans, and strategic planning. Steve is a licensed insurance agent and is Medicare Certified. He holds the designations for Managed Healthcare Professional (The Health Insurance Association of America), Certified Patient Protection and Affordable Care Act Professional (National Association of Health Underwriters), and Group Benefits Disability Specialist (Hartford School of Insurance). Steve is a member of the Minnesota Assocation of Health Underwriters (MAHU). He specializes in Employee Benefits Consulting for Minnesota schools, cities, and counties including fully insured, self-insured, and stop-loss plans.