On July 17, 2019, the Internal Revenue Service released Notice 2019-45 to add care for a range of chronic conditions to the list of preventive care benefits that may be provided by a high deductible health plan without a deductible.
Individuals covered by an HDHP generally may establish and make contributions to a health savings account. To qualify as an HDHP, the plan cannot provide benefits for any year until a minimum deductible is satisfied, except for preventive care. Preventive care includes services like routine physical exams, well-child visits, immunizations and cancer screenings. Preventive care generally does not include any service or benefit intended to treat an existing illness, injury or condition.
For cost reasons, individuals with chronic conditions may not obtain necessary medical care, leading to consequences that require considerably more extensive medical intervention (for example, amputation, blindness, heart attacks and strokes). Notice 2019-45 provides that certain medical care services and items, including prescription drugs, for certain chronic conditions should be classified as preventive care under the HDHP rules for individuals with those chronic conditions.
These medical services and items are limited to the ones listed in Notice 2019-45 for individuals with the corresponding conditions. Additionally, any medical care previously recognized as preventive care for these rules is still treated as preventive care.
Employers with HDHPs should consult with their benefit advisors to determine how their plans cover preventive care benefits and whether any changes should be made.