Pastoral Counseling: FSA Eligibility

Pastoral counseling is typically not eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), health reimbursement arrangement (HRA), limited care flexible spending account (LCFSA) or a dependent care flexible spending account (DCFSA).

What is pastoral counseling?

Pastoral counseling is counseling by a minister, rabbi, imam, priest, or other religious authority figure. Most states in the United States have laws that consider a pastoral counselor as an equivalently credentialed, examined and certified social worker or mental health professional. The degree requirements vary, and in some states there is an actual graduate degree of pastoral counseling granted by universities. However, pastoral counselors face the same or similar requirements for becoming eligible to provide pastoral counseling services.

Pastoral counseling services are a mixture of traditional mental health counseling and the traditions and philosophies of a specific religious faith, with special attention given to psychospiritual issues.

Pastoral counseling is not normally received for the types of medical conditions and mental health conditions that would make it eligible for reimbursement with a consumer-directed healthcare account. However, mental health counseling that is received in help an individual manage the facets of their illness and recovery, such as disease management and mental health counseling, is still considered eligible for reimbursement with a consumer-directed healthcare account. Pastoral counseling can technically provide the same services and benefit for the same types of needs, and in those cases, pastoral counseling would be considered eligible for reimbursement.

What is medical/mental counseling?

In the event of a major medical diagnosis, patients will lean on the expertise of their doctors, medical team and loved ones for support, but for many, the mental stress that is associated with the contraction of a specific illness is yet another obstacle for them to overcome during the recovery process. In light of these many emotional and practical concerns that are associated with a positive diagnosis, patients have the option of pursuing a wide variety of medical counseling options that can play a pivotal role in helping them manage the many facets of their illness.

Medical counseling options are designed to take a full spectrum approach to disease management, and they are available for both patients and their families in a variety of different contexts. Social workers will cover a wide array of topics in relation to an individual's illness, including:

Disease Management/Social Issues: In most cases, doctors will suggest meeting with a medical social worker in the weeks after a diagnosis has been made to manage stress, and other psychosocial and practical issues the patient may face in the near future. Social workers can assist patients in managing the complex feelings that can arise after a diagnosis, such as adjusting to the disease treatment plan, family and social isolation, quality of life concerns, end-of-life issues and a wealth of other potential issues. These meetings can also be conducted with family members as well to teach these individuals about what emotional and practical concerns to know about when caring for a loved one with a major illness.

Practical Issues: Disease management can affect nearly every aspect of a patient's life, and the effort to juggle one's obligations to a job, family and other concerns can be overwhelming in light of a disease diagnosis. Social workers can provide advice, community resources and other information to tackle the most pressing concerns, such as practical information about frequent hospital visits (parking fees, out-of-town medical visits, accommodations, etc.), financial/job/education concerns, food expenses, assistance with daily activities and seeking out assistance for family members and other caregivers.

Mental health counseling: Whether conducted with a social worker or a psychologist, mental health counseling is an indispensable aspect of disease management to help patients navigate the complicated emotions that a disease diagnosis can bring to light. In most cases, this will involve direct therapy to help patients navigate major depression, anxiety, mood/personality/adjustment disorders, substance abuse and panic attacks that may arise after a disease diagnosis. Additionally, in some cases, these counselors may be able to prescribe medications to handle depression and distress relating to a patient's condition.

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

Marriage counseling is not eligible.

 


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