Expansion of Health Savings Account (HSA)-eligible preventive care medicines and services for chronic illnesses 

Date Posted: July 19, 2019


HSA-eligible preventive care benefits expansion for chronic illnesses

The IRS released notice that the list of health savings account (HSA)-eligible preventive care benefits, for those with chronic conditions, has been expanded.

IRS Notice 2019-45, effective July 17, 2019, expands the list of preventive care benefits permitted by a qualifying high-deductible health plan (HDHP) under Section 223 of the Internal Revenue Code. This change, to expand the list of preventive care benefits, applies to plans without a deductible or with a deductible below the applicable minimum deductible for an HDHP.

Here’s what you need to know:

  • These medical services and items are limited to specific medical care services or items listed for the associated chronic conditions specified in Notice 2019-45 (see chart below).
  • IRS explains its criteria – in consultation with HHS – that each listed service or item, when prescribed for an individual with the related chronic condition is low cost and that it has a high likelihood of preventing exacerbation of the chronic condition and/or developing a secondary condition that requires significantly higher cost treatments.

Notice 2019-45 provides that the following services and items for individuals with the specified chronic conditions listed are treated as preventive care:

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