Transplant: FSA Eligibility

Costs associated with a transplant are eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA) or a health reimbursement arrangement (HRA). Transplant reimbursement is not eligible with a limited care flexible spending account (LCFSA) or a dependent care flexible spending account (DCFSA).

What is a transplant?

A transplant refers to a surgical procedure in which cells, organs, tissues and other forms of biological material are transferred from a donor site to another location in the patient's body, which is designed to replace damaged or missing biological material. The technical term for the transplantation of organs within the same person's body is called an autograft, while transplants that are performed between a donor and a recipient are known as allografts.

Transplants encompass a huge range of potential surgeries to treat a variety of legitimate medical conditions. Organs that can be transplanted include the heart, lungs, kidneys, pancreas, intestines and thymus, while tissue transplants can include corneas, skin, tendons (called musculoskeletal grafts), bones, heart valves and more. These biological materials can come from both living and deceased donors, who have previously given their consent to warrant the collection and storage of these materials for future use.

However, transplant surgeries are among the most difficult in modern medicine, as there are multiple areas of medical management necessary to ensure that the body does not reject the transplant, which occurs when the body's immune response is triggered and the organ/tissue will need to be removed from the patient. There is a long road to recovery after transplant surgeries large and small, and they require frequent consultations with surgeons and physicians to ensure that the operation will be a lasting success.

The vast majority of transplant surgeries are major procedures that could be potentially life-threatening, and they are only done if all other forms of medical treatment have been exhausted to treat a specific issue. As such, the costs associated with a transplant procedure are directly related to the treatment or prevention of a major medical condition, therefore they are eligible for reimbursement with consumer-directed healthcare accounts.

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

 


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