IRS expands HSA-qualified HDHP preventive care without a deductible

On July 17, 2019, the Internal Revenue Service and U.S. Department of the Treasury issued Notice 2019-45 to expand the list of preventive care services and items that may be provided by a Health Savings Account (HSA)-Qualified High Deductible Health Plan (HDHP) without a deductible.

In response to Notice 2019-45, and consistent with our mission to provide high-quality, affordable health care services, Kaiser Permanente will make certain diagnosis-based screening and lab tests available with a $0 copay and no deductible starting in 2021. We’ll also make specified durable medical equipment (DME) and pharmacy-dispensed DME items available with no deductible.

While the notice provides the opportunity for increased access to services and items to help our HDHP members effectively monitor and manage specified chronic conditions, Kaiser Permanente has chosen to expand the same cost-sharing changes to our non-HDHP members as well.

Screening and lab tests1

The screening and lab tests listed below will be available at no cost to members diagnosed with certain chronic conditions:

  • A1C testing for individuals diagnosed with diabetes
  • Low-density lipoprotein (LDL) testing for individuals diagnosed with heart disease
  • International normalized ratio (INR) testing for individuals diagnosed with liver disease and/or bleeding disorders
  • Retinopathy screening for individuals diagnosed with diabetes (already available at $0 in CA, MAS, and NW)

This change applies to:

  • All non-grandfathered plans and grandfathered plans that have elected the National Preventive Care Package
  • Medicare and fully insured commercial lines of business: KPIF, Small Group, and Large Group
  • Plan types: HMO, DHMO, HDHP, POS,2 PPO,2 HSA-PPO,2 and OOA2

Durable medical equipment (DME)1

These DME items will no longer be subject to the deductible:

  • Glucometers and diabetic testing supplies (including test strips, lancets, and control solution)
  • Peak flow meters

This change applies to:

  • All non-grandfathered deductible based plans
  • All fully insured commercial lines of business: KPIF, Small Group, and Large Group
  • Plan Types: DHMO, HDHP, POS,2 PPO,2 HSA-PPO,2 and OOA2

1 Self-funded employer groups will automatically have these screening, lab, and DME changes applied to their self-funded plans unless, as plan sponsor, they choose to customize or opt out of these changes.
2The HMO Tier of the Point-of-Service (POS) plan is underwritten by Kaiser Foundation Health Plan, Inc. (KFHP). Kaiser Permanente Insurance Company (KPIC) underwrites the Participating and Nonparticipating Provider Tiers of the POS plan, the PPO plan, HSA-PPO, and Out-of-Area Indemnity plan. KPIC is a subsidiary of Kaiser Foundation Health Plan, Inc.

The IRS has expanded the list of preventive care services that may be provided without a deductible by a HSA-Qualified High Deductible Health Plan.