Anti-Snore Guards: FSA Eligibility

Anti-snore guards are considered dual-purpose, so they will require a Letter of Medical Necessity (LMN) from a physician that outlines how they will be used to treat a specific medical condition for reimbursement. With an LMN, anti-snore guard reimbursement is eligible with a flexible spending account (FSA), health savings account (HSA) or a health reimbursement arrangement (HRA). Anti-snore guard reimbursement is not eligible with a limited care flexible spending account (LCFSA) or a dependent care flexible spending account (DCFSA).

What is snoring?

Snoring is caused by the vibration of tissues in the airways and the mouth that signal that the individual's breathing is obstructed in some way. When we sleep, the muscles in the soft palate, tongue, and throat relax as a person drifts off to sleep. However, if these tissues begin to block airways and narrow them, this can cause significant, audible vibrations in the mouth and throat that is better known as snoring. Snoring can be caused by pre-existing conditions or by an individual's behaviors, including respiratory anatomy, sleep apnea, sleep position/deprivation, excessive alcohol consumption or nasal problems.

How is snoring treated?

First and foremost, doctors must determine whether an individual's snoring is caused by an underlying medical condition, or whether it can be alleviated with a series of behavioral or lifestyle changes. For instance, if an individual suffers from sleep apnea, one of the most common treatments available is the continuous positive airway pressure (CPAP) mask, which provides steady air pressure to de-obstruct air pathways to limit the vibrations in the mouth and throat.

In the absence of a legitimate medical condition, individuals can pursue a wide variety of potential anti-snore guards and treatments. Some of the most popular options include nasal strips, mouth guards, nasal sprays, palatal implants, traditional and laser surgery and much more. While some of these products are eligible for reimbursement, others will require a Letter of Medical Necessity (LMN) from a physician.

How do I obtain a Letter of Medical Necessity (LMN)?

If a physician suggests anti-snore guards as a means of preventing or treating a specific medical condition, a Letter of Medical Necessity (LMN) will be required for FSA, HSA and HRA reimbursement. This letter must outline how anti-snore guards will be used to alleviate the issue and how long the treatment will last. If the treatment plan exceeds the current plan year, another LMN will have to be provided to the benefits administrator to cover the duration of the treatment.

Eligibility Table

Flexible Spending Account (FSA) Limited Care FSA Dependent Care FSA Health Savings Account (HSA) Health Reimbursement Account (HRA)

Eligible

Eligible with Rx

Eligible with LMN

Not Eligible

Specifically Not Covered

Snore guards for general use are not eligible when not for treatment of a specific diagnosed medical condition.

 


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