Individuals covered by high deductible health plans may now receive coverage for certain chronic conditions as preventive care benefits. This is important because HDHP participants with conditions such as asthma, heart failure or diabetes can be covered for treatments and medications without having to first satisfy the plan’s deductible.
Under a high deductible health plan, a participant must pay all medical costs out of pocket, except the cost for preventive care, until the participant has paid the full deductible amount. A new IRS notice (IRS Notice 2019-45, which may be accessed by clicking here, expanded the definition of preventive care to include treatments for certain chronic illnesses. The notice does not require high deductible health plans to cover the treatments as preventive care, so plans have a choice of how to categorize services relating to chronic condition.
Benefits for services and items in the following list may now be considered preventive care for HDHP purposes.
|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|
|Insulin and other glucose lowering agents||Diabetes|
|Peak flow meter||Asthma|
|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|