Recently we sent out the below Compliance Bulletin regarding Notice 2019-45, which details added treatments for several chronic conditions to the list of preventive-care benefits for which a high-deductible health plan (HDHP) can pay—prior to satisfying the annual deductible—without running afoul of the rules allowing pretax contributions to health savings accounts (HSAs).
A few things to keep in mind with these changes:
- This change does not automatically make these treatments free. A plan is permitted to make them free, but not required to make them free.
- The list of free preventive care has not changed. Preventive care, by definition, is care that is designed to keep someone healthy (immunizations, routine check-ups, routine testing). It is not care for diagnosed medical conditions.
- This change is aimed at making HDHP plans and HSA accounts a more relevant option for employees with chronic conditions. Prior to now, only preventive care was permitted to be covered in an HSA-eligible HDHP plan, prior to satisfaction of the deductible. Moving forward, a high deductible plan (HDHP) will be permitted to cover a specific list of treatments for chronic conditions before the deductible is met, without sacrificing the ability to make pre-tax contributions to an HSA account. Example: an HDHP that has a $2,000 deductible and 80% coinsurance could pay 80% for these treatments (patient would pay 20%) before the deductible is satisfied. This encourages people to stick to the care regimen prescribed by their doctors.
- There is a specific list of treatments for specific chronic conditions that are permitted – it is not all treatment for chronic conditions (See the full list below).