The Lively Blog
SIGN UP FOR OUR
Newsletter
Stay up to date on the latest news delivered straight to your inbox
Changes to HSA-eligible HDHPs for Chronic Conditions
Vicky Warren · October 2, 2019 · 4 min read
If you’re managing a chronic illness, you know how expensive it can be to take care of yourself.
In July 2019, the IRS (with the Department of Health and Human Services) provided guidance that HSA-eligible high deductible health plans (HDHPs) consider a number of medical services, medications, and devices, like insulin, statins, and inhalers as “preventative care” to be covered before the annual deductible is met.
This guidance could offer significant changes for people with certain chronic illnesses who have had to pay for devices, medications, and services out of pocket until their annual out-of-pocket maximums were met.
Typically, to qualify as a high deductible health plan, an HDHP cannot provide benefits until the annual minimum deductible is met. However, HDHPs are not required to have a deductible for preventive care (according to HDHP/HSA rules).
Let’s explore what this guidance could mean for you. It’s vital to note that this is IRS guidance only, not a mandatory requirement. You’ll have to check with your plan to see if they will be adopting these changes.
How changes to HDHP/HSAs will help those with chronic illnesses
High Deductible Health Plans (HDHPs) have gained popularity in the past few years. Between 2007 and 2017, enrollment in HDHPs with a Health Savings Account (HSA) for adults aged 18 - 64 with employment-based coverage rose while enrollment in traditional plans decreased.
A big selling point for HDHPs is that the monthly premiums are typically lower than the monthly payments for traditional medical insurance. In addition to the monthly savings, qualifying HDHPs allow participants to open an HSA.
HSAs offer three tax advantages:
The money you contribute to your HSA is tax-free. Typically, the contributions are taken out of your paycheck before taxes are calculated. If you directly contribute, that amount is tax-deductible.
The earnings on your HSA contributions grow tax-free.
When you use HSA money for allowable out-of-pocket medical expenses, the withdrawals are tax-free.
For many people, HDHP/HSA coverage works well. However, when a chronic illness creeps in, the high deductible ($1,350 per individual, $2,700 per family in 2019), can cause financial strain.
Many chronic illnesses can be managed with “preventative care,” however, this care often comes with a hefty price tag. The high deductibles can force people to pay preventative care costs out-of-pocket before the plan kicks in and shares costs.
This guidance aims to ease costs for those with HDHP/HSA coverage by covering low-cost care or services likely to prevent chronic illness from getting worse and help prevent them from developing secondary conditions that will ultimately require higher-cost treatments.
The expanded list of preventative care that can be provided by an HDHP includes:
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
In addition, the Treasury Department and the IRS, along with HHS, will review the preventative care items and services list periodically to determine if any items and services should be added or removed.
If you’re managing a chronic illness and have considered an HDHP/HSA option in the past but stayed away due to the high deductible costs, you may want to take another look.
When you combine the possible savings this new guidance may provide, and the ability to contribute tax-free money to an HSA, an HDHP/HSA combo may make good sense for you!
Benefits
2024 and 2025 HSA Maximum Contribution Limits
Lively · May 9, 2024 · 3 min read
On May 9, 2024 the Internal Revenue Service announced the HSA contribution limits for 2025. For 2025 HSA-eligible account holders are allowed to contribute: $4,300 for individual coverage and $8,500 for family coverage. If you are 55 years or older, you’re still eligible to contribute an extra $1,000 catch-up contribution.
Benefits
What is the Difference Between a Flexible Spending Account and a Health Savings Account?
Lauren Hargrave · February 9, 2024 · 12 min read
A Health Savings Account (HSA) and Healthcare Flexible Spending Account (FSA) provide up to 30% savings on out-of-pocket healthcare expenses. That’s good news. Except you can’t contribute to an HSA and Healthcare FSA at the same time. So what if your employer offers both benefits? How do you choose which account type is best for you? Let’s explore the advantages of each to help you decide which wins in HSA vs FSA.
Health Savings Accounts
Ways Health Savings Account Matching Benefits Employers
Lauren Hargrave · October 13, 2023 · 7 min read
Employers need employees to adopt and engage with their benefits and one way to encourage employees to adopt and contribute to (i.e. engage with) an HSA, is for employers to match employees’ contributions.
SIGN UP FOR OUR
Newsletter
Stay up to date on the latest news delivered straight to your inbox