High-deductible health insurance plans with health savings accounts could become more attractive to people with chronic illnesses. Until recently, people who enrolled in high-deductible plans had to pay for the medications and services used to manage their conditions, such as diabetes and heart disease, until they met their plan’s annual deductible (up to $1,350 for individual coverage or $2,700 for family coverage in 2019) before their insurer would cover treatment.
This summer, in response to an executive order from the White House, the IRS added 14 treatments and services for a range of chronic health conditions to the list of items that insurers may provide as preventive-care benefits under high-deductible plans with health savings accounts. People with the named conditions may now be able to receive certain treatments at no cost or at a lower cost, depending on their insurance plan or employer.
Reducing costs. The expanded roster of preventive-care benefits could make high-deductible plans with HSAs more cost-effective for people with chronic conditions. Among the items that plans may cover are statins for heart disease, blood-pressure monitors for hypertension, beta-blockers for congestive heart failure, insulin and testing supplies for diabetes, and SSRIs, such as Prozac, for depression.
By labeling these items preventive care, patients who need them will generally not have to meet their annual deductible before benefits kick in. The recent change permits insurers to begin providing coverage for the listed treatments before the plan deductible has been met. Because the change was issued as guidance, insurers are not required to adopt the new list of preventive-care benefits or pay for the items in full. But many employers and health insurance companies are expected to incorporate the changes into their 2020 plan offerings.
Helping people with chronic conditions access treatment generally improves health over the long term and reduces costs, says David Speier, managing director of benefits accounts at benefits consultant Willis Towers Watson. High-deductible health insurance plans have become more common in recent years. If you enroll in a high-deductible plan that makes you eligible for an HSA, you can use the account to help manage the steep deductible and to cover other out-of-pocket health care expenses. The accounts offer a triple tax break: Contributions aren’t taxed, the money grows tax-deferred, and funds can be withdrawn tax-free for eligible medical expenses at any time.
As you choose your health coverage during open enrollment this fall, find out what preventive-care benefits a high-deductible plan option is offering. Before you make your selection, consider all the plans’ premiums, deductibles, provider networks and other coverage details.
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