TELEMEDICINE PREVENTATIVE CARE

HEALTH PLANS CAN COVER TELEMEDICINE LIKE PREVENTATIVE CARE

Effective immediately, HSA-qualified health plans can (but are not required to) cover telemedicine and remote care services before an HSA participant meets their deductible—or at reduced or no cost-sharing.

Prior to the CARES Act, HSA-qualified health plans were required to assess a fair market value charge for telemedicine services and apply the participant’s deductible. HSA-qualified health plans that covered pre-deductible telemedicine services were not considered HSA-qualified and therefore participants couldn’t open or contribute to an HSA.

Telemedicine is an important part of the future of healthcare, and it’s especially important today. Adopting this new safe harbor means your people can gain greater access to telemedicine services and reduce exposure to unnecessary health risks.

Now, HSA-qualified health plans can cover telemedicine services in the same way they cover preventative care services without interrupting a member’s HSA eligibility. The telemedicine provision is temporary and effective for plan years beginning on or before December 31, 2021. That means these new telemedicine rules will apply to some plans through late 2022.

If the insurance provider you work with has chosen to adopt this safe harbor, it will automatically apply for all covered individuals. If your organization is self-insured and offers an HDHP, you have the option to make this change.

These changes could materially influence open enrollment decisions, so communication is critical. Easy access to telemedicine services continues to be especially important during this public health crisis. Expanding pre-deductible coverage could make
HSA-qualified health plans even more appealing. As with the previous two provisions, this update may result in employees enrolling in an HSA-qualified plan for the first time.

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Status

By carrier discretion; optional
for self-insured organizations

Source

The CARES Act

Effective timeline

Effective March 27, 2020 and
applies for plans beginning
before January 1, 2022

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