IRS Expands Preventive Care for HDHPs to Include Chronic Conditions

Sep 3, 2019 | Compliance

The IRS released Notice 2019-45 to add care for certain chronic conditions to the list of preventive services that can be offered under high deductible health plans (HDHPs) without a deductible. Under a qualified HDHP plan, individuals need to meet a certain minimum deductible before any benefits can be paid by the plan. However, individuals may receive certain preventive services without having to pay a deductible.

The IRS has provided guidance on what are considered preventive services for HDHPs. These benefits include: annual physicals; routine prenatal and well-child care; immunizations and screening devices (cancer screenings). Generally, preventive services do not include treatment for existing illness or injury; however, Notice 2019-45 provides certain medical care as well as prescription drugs for specific chronic conditions. The additional services will be treated as preventive when prescribed to treat one or more of the chronic conditions listed below and only when used to prevent the worsening of the chronic condition or prevent a secondary condition from developing.

What Employers Should Know

Employers with HDHPs should work with their consultant/carrier to review their current benefits and understand how their plans cover preventive care benefits.

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