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Vasectomy Coverage on HDHP Plans and HSA Contributions

We cover contraceptives and voluntary sterilization procedures for contraceptive purposes with no copayments or deductibles for our members under fully insured policies in Illinois. This coverage is required in part by the Illinois Insurance Code, pursuant to 215 ILCS 5/356z.4 

Recently, the IRS reinforced that as defined by the federal government, male contraceptives and male sterilization are not preventive services. Therefore, plans covering these products and services without satisfying the minimum deductible for High Deductible Health Plans (HDHP) are not HDHPs that qualify an individual to deduct contributions to a Health Savings Account (HSA).

The IRS has provided transition relief for periods before 2020, which will allow individuals on a plan that would qualify as an HDHP except for its male sterilization or male contraceptives coverage to be treated as eligible for deducting contributions to an HSA.

We will work with industry partners, regulatory agencies, and the state legislature to work towards a solution for our members. We’ll continue to update you on this issue as it develops.