Capital Expenditures: FSA Eligibility

Treas. Reg. '1.213-1(e)(1)(iii)

What are capital expenditures?

A capital expenditure is an accounting term that refers to money spent by a business, organization or private individual to improve or maintain their fixed assets, such as land, buildings and equipment. However, when capital expenditures are discussed in the realm of consumer-directed healthcare accounts, these expenses refer to a variety of home improvements and adaptive equipment that may be medically necessary for homeowners to install in order to live comfortably in their own abodes.

Some examples of capital expenditures with a medical necessity include elevators, ramps, expanded doorways and wheelchair lifts. Under current IRS regulations, these improvements fall under the status of products necessary to treat a legitimate medical condition. Under [IRS Section 213(d)], these capital expenditures must be "for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for the purpose of affecting any structure or function of the body." Another vital distinction for capital improvements is that if these expenses are permanent improvements that increase the value of the building/property, the excess value is not reimbursable to the account holder (Investopedia).

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

Home improvements that are required to improve an individual's personal mobility or help them cope with the limits of their medical conditions fall under the classification of capital expenditures, which require further substantiation from a doctor in the form of a Letter of Medical Necessity (LMN). This letter must outline how the account holder's medical condition necessitates the installation of capital expenditures to land, building or equipment.