In response to IRS Notice 2019-45, 76% of large employers with HSA-eligible plans have expanded pre-deductible coverage for medications and services that prevent the exacerbation of chronic conditions, according to an Employee Benefit Research Institute (EBRI) survey. The IRS notice gives HSA-eligible health plans the flexibility to cover 14 medications and services to prevent the exacerbation of chronic conditions prior to meeting the plan deductible.
Employers offered several reasons for adding pre-deductible coverage:
- 74% The sake of their employees
- 64% Employee retention
- 52% Employee attraction
- 48% Long-term cost-savings
Employers often added pre-deductible coverage for health care services related to heart disease and diabetes:
- 67% for blood pressure monitors and insulin/glucose lowering agents
- 61% for glucometers
- 54% for beta blockers
- 25% each for health care services that are least likely to have pre-deductible coverage including peak flow meters and INR testing
The Possibility of Expanding Pre-Deductible Coverage
Most employers say they would add pre-deductible coverage for additional health care services if allowed by law.
Nearly all employers with HSA-eligible health plans adopted pre-deductible coverage for telehealth services, allowed under the CARES Act. Three-quarters prefer to make the provision permanent, and one-fifth would like to grant a temporary extension.
Bipartisan legislation (The Chronic Disease Management Act) was introduced in both houses of Congress to provide more flexibility to extend pre-deductible coverage to services that manage chronic conditions. Paul Fronstin of EBRI says that it may be a natural evolution for health plans to include smarter deductibles for services that prevent the exacerbation of chronic conditions. Value-based reimbursement promotes evidence-based, high-quality care, he added.