Compliance Briefing Center

Legislation and Reform

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HSAs and Preventive Care

Health Savings Accounts and the Affordable Care Act Health Savings Accounts (HSAs) are individually-owned health reimbursement accounts individuals fund with un-taxed dollars. Interest or dividends accumulate in a tax-free environment and payment of qualified medical expenses has no additional tax consequences.

Individuals making tax-favored contributions to HSAs must be covered by a qualified high-deductible health plan (HDHP). The HDHP must satisfy minimum deductible amounts with certain out-of-pocket maximums. Account holders may not be covered by any other insurance plan that is not an HDHP or that covers benefits provided by the HDHP.

However, the HDHP may provide "preventive care" that is below the minimum deductible amount or without a deductible. The Affordable Care Act (ACA) rules mandate that specific preventive care benefits be provided at no charge to those covered by health insurance policies.

Recently-released Notice 2013-57 clarifies that an HDHP utilized for establishing an HSA may provide certain preventive care services or screenings without satisfying the minimum deductible requirement for HSAs. This rule was originally detailed in Notice 2004-23 and clarified in Notice 2004-50.

See a comprehensive list of safe harbor preventive care screening services in Notice 2004-23.