How FSAs work when you're on a cruise

Escaping the daily grind with a cruise through crystal clear waters and lounging on white sand beaches is as good as it gets - unless you find yourself sidelined with a stomach bug or a sprained ankle. Unfortunate medical issues can pop up at any time - whether you're in your own backyard or halfway around the world, so it's important to know your payment options before you set off on your next cruise adventure.
Can I use my FSA while traveling international waters?
Generally speaking, you are able to use your FSA for medical expenses outside of the United States, but there are a few restrictions and caveats you'll want to keep in mind before you do.
For an expense to be eligible outside of the United States, it must be a treatment that is considered eligible and legal in the United States and something that is going to be used or incurred while you're outside of the country. This can include doctor's visits, treatment for an illness, emergency procedures, or even surgeries.
As long as the treatment would be eligible while you're at home, you'll be able to use your FSA to cover the cost or reimburse yourself at a later date.
Things get a little bit trickier when it comes to prescription medications though. According to the IRS, a medication purchased outside of the United States is only an eligible expense if the medication is to be used while you're there. The medications also need to be legal and prescribed by a doctor.
As an example, if you're swimming in the ocean while your cruise is in port and stung by a jellyfish, you might want to see the ship's doctor. The trip to the doctor would be FSA-eligible since it's medical care to treat an ailment. And if the doctor decided to prescribe you a medication to reduce the pain and swelling, that would also be eligible since it's intended to be used while you're there recovering from the sting.
On the other hand, you might run out of sunscreen or misplace your reading glasses while you're on the ship. While these expenses would normally be covered at home, they probably won't be eligible while you're out of the county. That's because these items can be brought home in your suitcase and used long after your trip is over.
Should I use my FSA outside of the USA?
Just because you can use your FSA outside of the country doesn't mean you always should.
One thing to keep in mind is that you might be charged a conversion fee if you use your FSA card to pay for expenses while out of the country. Depending on your administrator, these fees usually range from 1-3%, and can consequently make your medical expenses more expensive than they would be if you paid out of pocket.
On the other hand, using your FSA to cover the cost of expensive procedures and products allows you to save your out-of-pocket money to use for other expenses that might come up while you're on your trip. Whether or not you choose to use your FSA while outside of the country might come down to your individual financial needs.
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