Sexual Dysfunction: FSA Eligibility

When recommended for treatment of a medical condition, costs associated with treatment of sexual dysfunction are eligible with a Letter of Medical Necessity (LMN) from a doctor with a flexible spending account (FSA), health savings account (HSA) or a health reimbursement arrangement (HRA). Sexual dysfunction treatment reimbursement is not eligible with a limited care flexible spending account (LCFSA) or a dependent care flexible spending account (DCFSA).

What is sexual dysfunction?

Sexual dysfunction is the medical term for any persistent problems with sexual response, desire, orgasm, or pain that could lead to issues and strain over the course of a couple's relationship. Sexual dysfunction takes a number of different forms between men and women, and these issues can be the result of an underlying medical condition or a complex mix of the body's physiology, emotions, experiences and beliefs that can contribute to issues that only occur during sexual situations.

Treatments for sexual dysfunction are largely tied to whether or not these issues are a result of a physical or psychological problem. For instance, there are a multitude of treatments for erectile dysfunction and it is considered a legitimate medical condition that can be treated after a visit to a physician, but issues such as low sexual desire or work-related stress/anxiety leading to poor performance are better treated through sexual counseling with a psychologist/therapist.

Some of the most common forms of sexual dysfunction that can affect both men and women include physical and medical conditions that can interfere with normal sexual function, including diabetes, heart disease, neurological disorders, hormonal imbalances, alcoholism/drug abuse, medication side effects and psychological issues such as anxiety, marital or relationship issues, depression, and past sexual trauma. Gender-specific sexual issues (pain during intercourse, ejaculation disorders, etc.) are typically best handled by physicians, but they also may be important subjects to discuss during sexual counseling.

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

If the reason for pursuing sexual dysfunction treatment is the result of an underlying medical condition (erectile dysfunction, diabetes, heart disease, etc.), these services would be eligible for reimbursement with a Letter of Medical Necessity (LMN) from a doctor. A LMN for sexual dysfunction treatment is necessary for reimbursement with most benefits providers to ensure that it is necessary for the treatment of a medical condition. This letter must outline how an account holder's medical condition necessitates sexual dysfunction treatment, how the treatment 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

 


AZ-PROD-WEB01 11/22/2017 3:27:52 AM