ComplianceTax & AccountingJuly 30, 2019

Health savings accounts: IRS expands preventive care HDHP exceptions list

For an individual to make (or receive) a regular contribution to a Health Savings Account (HSA) he/she must meet all eligibility criteria, which includes having coverage under an HSA eligible High Deductible Health Plan (HDHP). For a health plan to be considered an HSA eligible HDHP it generally may not provide any benefit for a year until the minimum deductible, defined by Internal Revenue Code (IRC) section 223(c)(2)(A), for that year is satisfied. However, section 223(c)(2)(C) contains a safe harbor that allows an HDHP to provide preventive care benefits prior to the plan’s deductible being satisfied. More information regarding preventive care can be found in IRS Notice 2004-50, Q&As 26 and 27.

On July 17, 2019, the Internal Revenue Service (IRS) released Notice 2019-45 which expands the list of preventive care benefits that an HDHP may cover without affecting the ability for a regular contribution to be made to an individual’s HSA. The expanded list includes certain medical care services received and items purchased, including prescription drugs, for certain chronic conditions an individual may have.

The Notice provides that the following services and items may be added to an HDHP and treated as allowable preventive care for individuals with the specified chronic conditions.

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
Diana Theis
Senior Specialized Consultant, Tax Advantaged Accounts
With more than 30 years of experience, Diana has worked closely with hundreds of financial organizations to help them create, implement, and maintain their tax-advantaged accounts program.