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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.
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Preventive Care for Specific Conditions |
For Individuals Diagnosed with |
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Angiotensin converting enzyme (ACE) inhibitors |
Congestive heart failure, diabetes and/or coronary |
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Anti-resorptive therapy |
Osteoporosis and/or osteopenia |
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Beta-blockers
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Congestive heart failure and/or coronary artery disease |
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Blood pressure monitor |
Hypertension |
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Inhaled corticosteroids |
Asthma |
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Peak flow meter |
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Insulin and other glucose-lowering agents
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Diabetes
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Retinopathy screening |
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Glucometer |
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Hemoglobin A1c testing |
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International normalized ratio (INR) testing |
Liver disease and/or bleeding disorders |
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Low-density lipoprotein (LDL) testing |
Heart disease |
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Selective serotonin reuptake inhibitors (SSRIs) |
Depression |
Additional Resources
Bulletin - IRS Expands Preventive Care for HDHPs to Include Chronic Conditions