New Preventative Services Allowed for HSA Qualified Health Plans

The IRS has released Notice 2019-45, expanding the list of services considered ‘preventative’ and not subject to cost-share for individuals enrolled in high deductible health plans (HDHPs), while preserving the Health Savings Account (HSA) eligibility of these plans. The notice is effective immediately.

The Notice states in relevant part, “Generally, under [the Code], an HDHP may not provide benefits for any year until the minimum deductible for that year is satisfied. However, section 223(c)(2)(C) provides a safe harbor for the absence of a deductible for preventive care.” In the past, the list of ‘preventative care’ services to meet this safe harbor did not include services aimed at treating many chronic conditions, such as asthma, diabetes, and heart disease. The Notice now includes a broader range of services, but these are not mandatory for many health plans within the Affordable Care Act (PHS section 2713). Rather, the list is permissive, should plans wish to cover these additional items as preventative, without cost share or deductible.

For a full list of services that can be covered without deductible or cost share, while still preserving the HSA eligibility of HDHPs, view page 6 in Notice 2019-45. It will now be up to health plan providers how to implement these additional permitted preventative services, so employers can expect to see any changes at upcoming plan renewals.