The IRS has issued Notices 2024-71 and 2024-75 (the “Notices”) to expand the definition of “preventive care” for high deductible health plans (“HDHPs”).
Law. In general, individuals are eligible to contribute (or have their employer contribute) to a Health Savings Account (“HSA”) on a tax-favored basis if they are:
- covered by a HDHP;
- not covered under another medical insurance plan;
- not enrolled in Medicare;
- not receiving Social Security benefits; and
- not claimed as a dependent on another person’s tax return.
In most cases, under the rules for HSAs, an HDHP may not pay benefits until its deductible has been satisfied. In one exception to the general rule, expenses for “preventive care” may be paid before the deductible has been reached.
NOTE: The Affordable Care Act (“ACA”) requires non-grandfathered group health plans to cover “preventive health services” without imposing cost-sharing requirements. However, the definition of “preventive health services” in the ACA is different from the definition of “preventive care” that applies to HDHPs. To reconcile these two sets of requirements, the IRS has issued guidance (IRS Notice 2013-57) stating that a health plan will not fail to qualify as a HDHP merely because it provides the “preventive health services” required under the ACA.
Notices. The Notices expand the list of preventive care benefits permitted to be provided by an HDHP without a deductible, to include:
- over-the-counter oral contraceptives (including emergency contraceptives) and male condoms;
- all types of breast cancer screening for individuals who have not been diagnosed with breast cancer;
- continuous glucose monitors for individuals diagnosed with diabetes; and
- certain insulin products without regard to whether the insulin product is prescribed to treat an individual diagnosed with diabetes or prescribed for the purpose of preventing the exacerbation of diabetes or the development of a secondary condition.
The Notices also provide a safe harbor under which the IRS will treat amounts paid for condoms as amounts paid for medical care. The Notices state that because amounts paid for condoms are treated as expenses for medical care, the amounts are eligible to be paid or reimbursed under a Health FSA, Archer MSA, HRA, or HSA.
The Notices are available at: https://www.irs.gov/pub/irs-drop/n-24-71.pdf and https://www.irs.gov/pub/irs-drop/n-24-75.pdf.