August 1, 2019

Preventive Care Services Expanded for HSA Participants

On July 17, 2019, the IRS released Notice 2019-45 providing guidance relating to health savings accounts (HSAs), specifically expanding the types of treatments and services that constitute preventive care. 

As a reminder, to be HSA-eligible, the individual must be covered by a qualifying high deductible health plan (HDHP) and no other coverage.  The HDHP must have a minimum statutory deductible, which for 2019 is $1,350 for individual/$2,700 for family (increasing to $1,400 for individual/$2,800 for family in 2020). 

Currently, certain preventive care, including the Affordable Care Act’s required preventive services, can be provided at low or no cost without jeopardizing HSA eligibility.  The new IRS guidance provides additional treatment and services for chronic conditions, as follows:

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


Congestive heart failure

and/or coronary artery disease

Blood pressure monitor


Inhaled corticosteroids


Insulin and other glucose lowering agents


Retinopathy screening


Peak flow meter




Hemoglobin A1c testing


International Normalized Ratio (INR) testing

Liver disease and/or bleeding disorders

Low-density Lipoprotein (LDL) testing

Heart disease

Selective Serotonin Reuptake Inhibitors (SSRIs)



Heart disease and/or diabetes


The IRS indicates that it may expand or modify this list in the future as appropriate, but at this time, these are the only kinds of conditions and services that qualify as preventive services for HSA-compatibility purposes.  Note: this guidance does not alter the ACA-required preventive services that must be provided without imposition of any cost sharing requirements when delivered by in-network providers.


The information contained in this article is provided as general guidance and may be affected by changes in law or regulation. This article is not intended to replace or substitute for accounting or other professional advice. Please consult a CBIZ professional. This information is provided as-is with no warranties of any kind. CBIZ shall not be liable for any damages whatsoever in connection with its use and assumes no obligation to inform the reader of any changes in laws or other factors that could affect the information contained herein.

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