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More health care services counted as preventive care under high deductible plans

A High Deductible Health Plan (HDHP) is generally prohibited from providing coverage before the deductible is met each year, but there are exceptions allowed for preventive services. A plan may reimburse for such services before the deductible is met or may apply a lower deductible for such services. This is not a requirement of HDHPs, however.

The Treasure Department has recently (7-19-2019) revised the list of allowable preventive services under this exception. You should check with your plan administrator to see how this may apply.

LIST OF ADDITIONAL PREVENTIVE CARE SERVICES AND ITEMS FOR CHRONIC CONDITIONS THAT MAY BE TREATED AS PREVENTIVE CARE FOR PURPOSES OF SECTION 223(c)(2)(C)

The Treasury Department and the IRS consider benefits for services and items set forth in the Appendix to this notice as preventive care for purposes of section 223(c)(2)(C). These specified services and items are treated as preventive care only when prescribed to treat an individual diagnosed with the associated chronic condition specified in the Appendix, and only when prescribed for the purpose of preventing the exacerbation of the chronic condition or the development of a secondary condition. If an individual is diagnosed with more than one chronic condition, all listed services and items applicable to the two or more conditions are preventive care. However, services and items not listed in the Appendix that are for secondary conditions or complications that occur notwithstanding the preventive care are not treated as preventive care for purposes of section 223(c)(2)(C).

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