IRS Updates Preventive Care Benefits for High-Deductible Health Plans

Published October 18, 2024

The Internal Revenue Service (IRS) issued Notice 2024-75 expanding the list of preventive care benefits permitted to be provided by a high deductible health plan (HDHP) under section 223(c)(2)(C) of the Internal Revenue Code without a deductible, or with a deductible below the applicable minimum deductible for the HDHP, to include over-the-counter (OTC) oral contraceptives (including emergency contraceptives) and male condoms.

The notice also clarifies that:

All types of breast cancer screening for individuals who have not been diagnosed with breast cancer are treated as preventive care under section 223(c)(2)(C);
Continuous glucose monitors for individuals diagnosed with diabetes are generally treated as preventive care under section 223(c)(2)(C);
The new safe harbor for absence of a deductible for certain insulin products in section 223(c)(2)(G) applies without regard to whether the insulin product is prescribed to treat an individual diagnosed with diabetes or prescribed for the purpose of preventing the exacerbation of diabetes or the development of a secondary condition.

IRS also issued Notice 2024-71 to expand the products available for reimbursement under Code 213(d). Code 213 allows these expenses to be paid or reimbursed under an HSA, FSA, Archer MSA, or HRA. If not paid or reimbursed from one of these plans, an individual make tax a deduction during the tax year if certain requirements are met.

The notice adds condoms to the list of expenses eligible for reimbursement. The purchase must be considered a medical expense, which the IRS defines as “the costs of diagnosis, cure, mitigation, treatment, or prevention of disease, and for the purpose of affecting any part or function of the body.” Whether an expense meets that definition depends on the specific facts and circumstances surrounding the purchase.