IRS expands preventive care benefits for specified chronic conditions

IRS expands preventive care benefits

The Internal Revenue Service (IRS) lengthened the list of preventive care that could be covered under a high deductible health plan (HDHP), specifically for individuals diagnosed with chronic conditions. Because these services are now provided under an HDHP, they can be paid for using HSA dollars.

It’s important to note that the IRS did not require these services be provided without cost sharing. Nor does it suggest the same characteristics could be used to expand the scope of preventive care beyond the defined list.

It remains to be seen how fully insured carriers will respond to the expansion of preventive care. It’s possible fully insured individuals needing these services will continue to pay-out-of-pocket and be reimbursed through available HSA funds. Sponsors of self-insured plans have the latitude to include these services without any or partial cost-sharing.

The additional care is considered preventive care for those diagnosed with the corresponding chronic condition. This includes items ranging from prescription drugs to purchasable health care items and medical services.

The following items are now listed by the IRS as preventive care.

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 monitor  Hypertension
Inhaled corticosteroids Asthma
Insulin and other glucose lowering agents Diabetes
Retinopathy screening Diabetes
Peak flow meter Asthma
Glucometer Diabetes
Hemoglobin A1c testing Diabetes
International Normalized Ratio (INR) testing Liver disease and/or bleeding disorders
Low-density Lipoprotein (LDL) testing Heart disease
Selective Serotonin Reuptake Inhibitors (SSRIs) Depression
Statins Heart disease and/or diabetes

All care previously considered preventive care is still qualified as preventive care. If you have any questions about these additions or are interested in establishing an HSA, please call us at 855.890.7239.