Blog 7/18/2019

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
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

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.

 

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