Dec. 20, 2024
IRS Guidance for Preventive Services
Applies to all groups
The Internal Revenue Service released two notices,
2024-71 
and
2024-75,
that provide new guidance around qualified medical expenses and preventive services.
- Notice 2024-71 clarifies that amounts paid for condoms are treated as deductible expenses for medical care.
- Notice 2024-75 expands the list of preventive care benefits the IRS allows to be covered without a deductible, or with a deductible lower than the minimum deductible for high-deductible health plans. These services can thus be covered without cost sharing for HDHP plan members before they meet their deductible.
What you need to know: In Notice 2024-71, the IRS clarified that amounts paid for condoms are eligible medical expenses and can be reimbursed through a health savings account.
In Notice 2024-75, the IRS expanded its list of preventive care benefits that can be covered for HDHP plan members without a deductible. The IRS notice does not require coverage of these services without a deductible, they allow HDHP plans to cover these as preventive.
- Over-the-counter oral contraceptives, including emergency contraception and OTC birth control pills
- Male condoms
- Breast cancer screening (i.e., mammograms, MRIs, ultrasound and similar breast cancer screening services) for anyone not previously diagnosed with breast cancer
- Continuous glucose monitors for individuals diagnosed with diabetes and certain insulin products. These can be covered as preventive regardless of whether the insulin is prescribed to treat diabetes, to prevent diabetes symptoms from worsening or to prevent the development of a secondary condition.
What’s the impact on Blue Cross and Blue Shield of Texas plans?
We are evaluating the guidance around these services/products and will advise of any related changes to our plans. For now, current member cost sharing remains as is.
- Note that male condoms and oral contraceptives, including emergency contraception and the OTC birth control pill, are already covered as preventive services under BCBSTX plans per the Affordable Care Act (when filled with a prescription) and are not subject to the deductible for HDHP plans.
