IRS Notice 2019-45 Requires HDHPs to Provide Additional Preventive Care Benefits
The IRS announced a short list of services (medications, tests and equipment) that can now be covered “pre-deductible” for participants in a HDHP plan that deal with specific health conditions. This means these services are either not subject to a deductible or have a deductible lower than the plan’s regular deductible.
Many employers have already been covering some of these services as “preventive” for affected employees for a while now, so the IRS is recognizing what’s becoming a fairly standard practice. The idea is that by covering these medications pre-deductible for HDHP participants, patients will actually fill those prescriptions, stick to the regimen prescribed by their doctors and delay/prevent the onset of more serious and acute conditions—which, in turn, will save both the employer and the employee money.
Here are the services in question, and the related diagnoses:
|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|
It’s important to note that this does NOT change the list of preventive services that must be covered in full under the ACA—these services are only applicable to individuals with specific health conditions.
For the full IRS notice, click here.