Gambling Treatment: FSA Eligibility

Gambling treatment, if related to the treatment of a legitimate medical condition, is eligible for reimbursement with a Letter of Medical Necessity (LMN) from a physician with a flexible spending account (FSA), health savings account (HSA) or a health reimbursement arrangement (HRA). Gambling treatment reimbursement is not eligible with a limited care flexible spending account (LCFSA) or a dependent care flexible spending account (DCFSA).

What is gambling treatment?

Treatment for compulsive gambling can be an extremely difficult proposition for addicts and their families, as the individual who cannot control his/her need to gamble may not readily admit that he/she has a problem and a pivotal first step in the recovery is coming to terms with one's gambling addiction. Gambling treatment is designed to help to give men and women who have a compulsive gambling problem the chance to rebuild their lives, understand the nature of their addictions and regain a sense of control over their lives.

Gambling treatment can take on numerous forms, some of which are medical in nature, while others are complementary treatments meant to provide support for those trying to overcome their compulsions. The most common forms of gambling treatment include:

  • Psychotherapy: There are a variety of forms of therapy that have proven effective in treating an individual's compulsive gambling problem, such as behavioral modification and cognitive behavioral therapy techniques. Behavioral modification refers to the practice of identifying specific behaviors and learning skills that teach the individual how to reduce the urge to gamble, while cognitive behavior therapy aims to identify the unhealthy thoughts and emotions that lead to excessive gambling and aims to replace them with healthier, positive emotions.
  • Medications: In some cases, doctors may recommend specific medications that treat other conditions that may be contributing to a patient's compulsive gambling problem, such as depression, obsessive compulsive disorder or ADHD. Medications that have proven successful in the past include mood stabilizers, antidepressants and narcotic antagonists.
  • Support Groups: Last but not least, in the same way that alcoholics, smokers and other addicts can rely on one another to share their experiences and struggles with their recovery, this can also be extremely effective for compulsive gamblers to overcome their addictions. Gamblers Anonymous and other groups are the most prominent and have a proven track record of success.

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

If doctors recommend gambling treatment as a means of helping a patient overcome his/her addiction, a Letter of Medical Necessity (LMN) must be obtained for reimbursement through an FSA, HSA or HRA. This letter must outline how an account holder's needs for help, related to their medical condition, necessitates the use of gambling treatment, how the gambling treatment will be used to alleviate the issue; and how the gambling treatment will be used. 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

 


AZ-PROD-WEB01 11/21/2017 5:41:56 PM