When you're looking for a little inspiration to get back in the gym, a bit of self-investment can go a long way. Whether it's a new lineup of workout gear, a fitness tracker or a new pair of running shoes, you don't want to waste your hard-earned money -- which might just be the boost you need to stay on top of your fitness goals.
Exercise can help prevent many health issues later in life, so why wouldn't fitness products be FSA-eligible? The reality is that IRS regulations are pretty rigid about FSAs covering only products that treat a specific condition. Meaning something that seems like a natural fit for eligibility, might not even be considered because it doesn't meet a specific requirement.
Let's cut through the confusion about a few of the most asked about fitness products and services, to see if they're FSA-eligible.
1. Fitness trackers
We hear about trackers -- like Fitbit or even the Apple Watch -- all the time. While digital fitness trackers have been introduced to company wellness programs as an incentive for employees to get in better shape, they aren't considered FSA-eligible by the IRS because they don't treat or alleviate any one specific health issue.
However, we know that tracking vitals is important for some to keep on top of their wellness. That's why we carry a wide range of more targeted, hi-tech, 100% FSA-eligible health tracking products like blood pressure monitors.
Because of IRS guidelines, even the most advanced cross-training shoes don't qualify as FSA-eligible. But that doesn't mean you can't treat your feet with your flex dollars. Your FSA will cover orthotics, arthritis pain insoles and other shoe inserts. They can reduce the impact of exercise on your feet and lower body and help you avoid injuries from poorly-fitting shoes.
3. Gym memberships
As much as we want to use our FSA funds to cover your monthly gym membership, it's not considered a qualifying expense. However, if regular exercise becomes necessary for your health, this is an expense that could be eligible with a Letter of Medical Necessity (LMN).
If you have a medical condition, such as obesity, and a doctor requires you to work out, they can create an LMN for your benefits administrator that could allow you to cover these costs with your FSA. Check out our recent post for more about these exceptions, and the LMN process.
If you're looking to invest in home exercise equipment to meet fitness goals, they follow the same guidelines as gym memberships. You'll need to prove that you have a medical condition which requires you to buy specific workout equipment for your home, using an LMN provided by your physician.
Don't waste time hunting for ways to spend your tax-free funds. In That's Eligible?!, we'll bring you these updates every Monday, so you don't have to. And for all things flex spending, be sure to check out the rest of our Learning Center, and follow us on Facebook, Instagram and Twitter.
While this week's news centered around the government shutdown, the deal that ended it had an unexpected wrinkle that will affect consumer healthcare for the foreseeable future.
On Monday, President Trump signed a bill to fund the government for another three weeks. In this bill was a provision to delay the effective date of a targeted tax on high-cost, employer-sponsored health plans (the "Cadillac Tax") until 2022.
What's a "Cadillac" Tax?
Let's back up a bit. The Cadillac Tax was an attempt by the Affordable Care Act (ACA) to solve a tax subsidy issue that dates back to World War II called Employer Sponsored Insurance (ESI). The point of the Cadillac Tax was to address the impact of ESI, raise additional revenue to fund the Affordable Care Act, and encourage employers to go for more cost-effective healthcare options.
According to Forbes, ESI is a tax subsidy that was a result of wage freezes that took place during WWII, and ESI was a means for employers to use tax-free funds to cover the cost of generous health plans. However, as wages grew and ESI remained in place, this created long-term issues for the American healthcare system.
First, ESI only benefits those enrolled in employer-sponsored healthcare coverage, which accounts for about half of all Americans.
Furthermore, the ESI makes it cost-effective for employers to move more money into healthcare benefits rather than wage increases. In terms of compensation, it became cheaper for employers to provide additional healthcare benefits, as opposed to more pay.
So, the Cadillac Tax was created as a deterrent for employers who offer high-cost health plans, with the idea that more money would be available to cover uninsured individuals. This would make the most expensive plans - which some argued would lead to overuse/abuse of medical care benefits - to be less desirable to employers.
The ACA proposed an additional tax on high-cost health plans -- the "Cadillacs" of their industry. This tax adds 40% additional tax on the value of health insurance coverage they offer. This is determined by these thresholds: $10,200 for individual plans and $27,500 for families. In other words, this is the total cost of the healthcare plans, including vision and dental benefits.
The tax, which applies to health plans including FSAs, HSAs and HRAs, was originally set to begin in 2018 and had been delayed until 2022.
Why is the Cadillac Tax delayed?
While the Cadillac Tax seemed like a good idea on paper, Congress failed to implement the tax several times since the ACA passed. The main issue is that this tax is tied to general inflation -- which simply refers to the price of goods and services in an economy over time -- as opposed to medical inflation, which is roughly 2-3x lower.
Healthcare spending typically outpaces general inflation, so this could inevitably lead to a larger amount of healthcare plans being subject to the Cadillac Tax. Because of this, employers are already faced with tough decisions about whether to continue to provide the same standard of healthcare coverage, according to the Society for Human Resource Management.
Modern Healthcare reports that US employers have begun to implement healthcare changes if the Cadillac Tax ever goes into effect. A shift to high-deductible health plans (HDHPs) has been a leading trend with about 24% of workers in employer plans enrolled in a high-deductible option.
HDHPs are the only types of plans that are offer a health savings account (HSA) option, which could be contributing factor to their explosive growth. HSA enrollment has surged in 2017 to 21 million total accounts, a 16% increase year-over-year, according to research firm Devenir.
The Cadillac Tax has been a major sticking point in the world of consumer healthcare for years, and while it could see legislative changes in the future, this debate will most likely have to wait until its new implementation date in 2022.
If you're interested in diving deeper into this topic, you can read the full text of the bill to get a better idea of what it entails.
Flexible spending account (FSA) and health savings accounts (HSA) will see a number of important changes from the regulations set forth in the bill. These include:
- Repeal of the OTC Rx requirements for FSAs/HSAs:
The OTC Rx provision was originally included in the Affordable Care Act (ACA), and the Better Care Reconciliation Act will fully remove the provision for FSA and HSA users to obtain a prescription for OTC drugs. The proposed effective date is for expenses incurred after December 31, 2016.
- Repeal of the FSA maximum contribution:
As of 2017, FSA users could set aside up to $2,600 as single individuals and $5,400 for families to cover qualifying medical products and services during their current plan years. The Better Care Reconciliation Act would allow the plan sponsor to set whatever maximum they wish. The proposed effective date would be for plan years beginning after December 31, 2017.
- HSA yearly maximum contributions would increase:
HSA contribution limits have grown steadily in the past decade adjusted for inflation, growing from $3,050 for single individuals in 2010 to $3,400 for single individuals in 2017. The Better Care Reconciliation Act will almost double these limits for HSA users to $6,550 for single individuals and $13,100 for families. The effective date for qualified HSA contributions after December 31, 2017.
- HSA catch-up contributions expanded
When an HSA user reaches middle age, he/she is able to make a catch-up contribution (up to $1,000) to save in excess of the yearly contribution limit on an annual basis. The proposed legislation would keep these HSA catch-up contributions in place, but they would now be allowed for both spouses age 55 and up, as opposed to restricting contributions to the HSA holder alone.
- HSA tax penalties reduced
The Better Care Reconciliation Act also revamps the tax penalty for use of HSA funds on non-qualified expenses. Today, if an HSA user before the age of 65 withdraws HSA funds to cover non-qualifying expenses, he/she would be charged a 20 percent penalty on that amount. The Better Care Reconciliation Act would restore this tax to non-qualified HSA distributions to the pre-Affordable Care Act amount of 10%. Special rules that would allow some expenses incurred prior to the establishment of the HSA to be qualified as well.
- Further extension of the Cadillac Tax:
The Cadillac Tax is a 40% excise tax on the value of coverage exceeding set thresholds that was set to begin in 2020, which currently includes contributions to FSAs/HSAs. The tax was designed to be levied on only the most expensive employer-sponsored health insurance plans—the so-called Cadillacs of health coverage. This regulation was one of the more controversial aspects of the ACA, as while it is a tax on insurance companies, it was feared that these increased costs would be passed off onto employers, and eventually the employees themselves (IB Times, 2015). The Better Care Reconciliation Act would further delay implementation of the tax to taxable years after December 31, 2015.
The Senate is expected to fast track The Better Care Reconciliation Act for a vote before the July 4th holiday. The Congressional Budget Office (CBO), that rates proposed legislation to include potential cost and impact, has promised a score on the new bill early next week.The bill is expected to face challenges with four Senate Republicans currently voicing concern with the bill. In order for the bill to pass, no more than two Senate Republicans can vote against it, and Vice President Mike Pence would be the tie-breaking vote in the Senate if no majority prevails.
Health Savings Accounts (HSAs) maximum contributions will increase by $50 for individuals with an HSA in 2017. Read more about HSA Maximum Contributions.
Similar to FSAs in that they're also tax-free plans, HSAs allow you to set aside pre-tax money to cover qualified medical expenses. That money is exempt from federal income tax, FICA and state income taxes (most states). The money stays in your account similar to a savings account and you even interest on the savings. HSAs can be used for qualified medical costs and out-of-pocket medical expenses, ranging from co-pays to over-the-counter medical items and more.In order to getan HSA, you must be enrolled in a qualified High-Deductible Health Plan and have no other first dollar coverage - this can include a general purpose FSA.
Here's theBreakdown of Expenses andInformation About HSA Maximum Contributions for 2017:
- HSA contributions for individuals (self-only coverage) thatcan be made in 2017 will go up by $50 to $3,400 from $3,350.
- Maximum contributions for anyone with family coverage will remain the same at $6,750.
- According to the IRS for 2017, a high deductible health plan is defined as "ahealth plan with an annual deductible that is not less than $1,300 for self-only coverage or $2,600 for family coverage, and the annual out-of-pocket expenses (deductibles, co-payments, and other amounts, but not premiums) do not exceed $6,550 for self-only coverage or $13,100 for family coverage."
To read more about the IRS announcement, go tohttps://www.irs.gov/pub/irs-drop/rp-16-28.pdf
Do you have a Health Savings Account? Did you know you can buy everyday health items like eyeglasses, contact lens care, hot or cold packs, breast pumps and more with an HSA?
Shop for everyday health products with your HSA at HSAstore.com
Ever wonder about FSA eligible products that also hook up to your smartphone? Let's explore 5 smartphone compatible items for parents from FSAstore.com
As a parent, you want what's best for everyone in the family. Of course, that also aligns with healthcare and making sure everyone is healthy. Nowadays, many people are connected to their smartphones, and that means health apps and smartphone compatible items are quickly picking up. With a Flexible Spending Account or FSA, you'll be able to monitor your and your family's health with smartphone compatible items.
Here are 5 Smartphone Compatible Items for Parents
1)The Kinsa Smartphone Thermometer. This smartphone compatible item will easily give you quick (10 seconds!) and accurate temperature readings. Not only that, but it'll let you track each family member's health and share vitals with your doctor. The thermometer can be used orally, under the arms or rectally. You can download the free app for iOS and Android.
Shop for Kinsa Smartphone Thermometer at FSAstore.com
View the video from Kinsa to learn more!
2) The TempTraq Baby Bluetooth Thermometer. This wearable Bluetooth thermometer continuously monitors baby's body temperature. It not does monitors temperature, but also provides alerts so parents can stay abreast of baby's fever. This single use, 24-hour comfortable patch can be placed under baby's arm. It senses, records and transmits temperature information to a smartphone compatible device. Parents can easily monitor baby's temperature up to 40 feet away. You even email temperature data to a doctor or family member.
Shop for TempTraq Baby Bluetooth Thermometer at FSAstore.com
3) Vicks SmartTemp Wireless Smartphone Thermometer. With this thermometer, it's easy to take and track temperature readings for the entire family, and wirelessly connect to your smartphone. This thermometer allows you to individually track and store readings for each family member, and it can even send reminders about the last reading time + medicine dosage, as well. A convenient Symptom Tracker will record symptoms and a Fever InSight feature will change the phone screen from red to yellow to green depending on the temperature readings. This thermometer gets an 8-second reading and can be applied orally, rectally or under the arm. It is compatible with most iOS and Android devices, and has a free downloadable app.
Shop for the Vicks SmartTemp Wireless Smartphone Thermometer at FSAstore.com
4) Medela. New parents looking for products to help with breastfeeding and applicable accessories can shop for popular brand, Medela, with a Flexible Spending Account. Medela offers a convenient app where new moms can track their breastfeeding progress.
5) Want a variety of Hi-Tech Health items? Shop the FSAstore.com Hi-Tech Health bundle.
The bundle contains an AccuRelief Wireless Remote Control TENS unit, a Withings Wireless Blood Pressure Monitor, a Quell Wearable Pain Relief Starter Kit, a Vicks SmartTemp Wireless Smartphone Thermometer, and a DPL Flex Wrap Pain Relief System.
What does 2016 have in store for consumer-directed healthcare accounts? Each year, the IRS releases information about these accounts.
What does 2016 have in store for consumer-directed healthcare accounts? And, what exactly are these accounts? Each year, the Internal Revenue Service (IRS) releases its long-awaited consumer-directed healthcare account changes. The IRS provides an update as to whether these accounts will have different contribution limits or if there are other plan changes. Whether you have a flexible spending account (FSA) or a health savings account (HSA), these accounts are typically adjusted for inflation annually with a series of changes for the coming year.
Beloware the current regulations of each of these accounts. Learn more about the most popular consumer-directed healthcare accounts:
Flexible Spending Accounts (FSAs) (Medical)
Changes for 2016: None
Contribution Limits: $2,550 per FSA account.
Note: If anindividual and his/her spouse each have his/her own FSA, they could be setting aside $5,100 as a household.
Health Savings Accounts (HSAs)
Changes for 2016: No change in individual contribution limit, +$100 for families
High-Deductible Health Plan (HDHP) Maximum Out-of-Pocket Amounts: Individuals +$100 and +$200 for families
Contribution Limits (Employer + Employee): Individuals - $3,350, Married Couples Filing Jointly - $6,750
HSA Catch-Up Contributions (age 55 or older)*: $1,000
HDHP Minimum Deductibles: Individuals - $1,300, Family: $2,600
HDHP Maximum Out-of-Pocket Deductibles: Individual - $6,550, Family: $13,100
Health Reimbursement Accounts (HRAs)
Changes for 2016: No Changes
Contribution Limits: No Limit, Controlled by Employer
Limited Care Flexible Spending Accounts (LCFSAs)
Changes for 2016: No changes
Contribution Limits: $2,550 per FSA account. If individual and spouse each have their own FSA, could be $5,100 as a household.
For HSA-compatible LCFSA, can only be used for eligible non-medical vision or dental expenses throughout the plan year.
Dependent Care Flexible Spending Accounts (DCFSAs)
Changes for 2016: No changes
Contribution Limits: $5,000 per household, or $2,500 if married and filing separately.
As 2016 kicks off, be sure to meet with your benefits administrator to stay on top of your healthcare benefits, and spend your hard-earned dollars at FSAstore.com! If you'd like to learn more about FSAs, HSAs or HRAs, browse our comprehensive Eligibility List or Learning Center for answers to popular questions and to see details about eligible expenses.We have the web's largest selection of FSA eligible products to help you support the health and wellness of you and your dependents year-round.
Is gynecology an FSA eligible expense? What's covered by the FSA? Learn more in this blog post, and use your FSA for medical care.
Timelines and Numbers to get Right for a Gynecology visit:
Begin seeing a gynecologist at the age of 21, or earlier if you become sexually active.
After a first visit, women ages 21 to 29 should visit their gynecologist annually to get a Pap smear. A pap smear is a screening test for cervical cancer, eligible for reimbursement with a Flexible Spending Account.
Women ages of 30 to 64 should generally visit every other year.
In addition to regular checkups, you should seek a consultation or treatment for:
- Irregular periods
- Sexually transmitted infections (STIs)
- Vaginal infections.
- Contraceptive method
How to Prepare for a Gynecologist Exam
- Make appointments between menstrual periods as menstrual fluid can interfere with both examination and lab tests.
- Do not have intercourse or insert anything into the vagina 24 hours before the visit.
- Prepare a list of questions and concerns to ask your gynecologist, including any details regarding vaginal bleeding, discharge, odor, or pain.
- Your gynecologist will ask you question about your menstrual cycle, so it would be good to know the date of your last period and how long your periods typically last.
What to Expect at the Exam
- A nurse will first take down basic measurements not unlike a regular physical examination.
- Before the physical exam begins, your doctor may ask questions about your personal and family medical history, sexual history, contraceptive usage, general health and lifestyle, etc.
- For the physical exam, you will be asked undress in private and put on a paper or cloth gown given to you.
- You probably won't get an internal pelvic exam where the doctor looks inside your vagina. Instead, he or she will examine your outside genital area and your breasts. The doctor might press on different parts of your breast to feel for lumps indicative of breast cancer.
A Flex Spending Account (FSA) can cover at-home healthcare products including TENS therapy (physical therapy), wheelchairs, and even defibrillators.
Popular flex spending account products for home:
Dealing with allergies or a cold? Not really sure what's causing the sneezing or sniffling? Fight the symptoms in a drug-free way like warm steam vaporizers, personal steam inhalers, and saline nasal sprays. Use your Flex Spending Account and save up to 40% by shopping at FSAstore.com!
Shop for Cold/Allergy products at FSA Store
Experiencing back pain or other chronic pain? TENS therapy can help and are covered by your Flex Spending Account! Doctors use the same type of technology, but the TENS therapy unit is easy to use at home, or even at work.
Shop for Tens Therapy at FSA Store
Defibrillators can play an important role at home, the office or even during travel. Learn more about these products from well-known brand, Philips.
Are you dealing with pain or want to prevent future pain? Suffer from Carpal Tunnel Syndrome? Check out the FLA's selection of products for added support to wrists and ankles, too. Other products covered by a Flexible Spending Account that may help include finger splints, and walking canes.
Curious about other expenses related to home health care?
Just browse our Eligibility List for more details on covered expenses with yourFlex Spending Account.
Check out the post about home renovations: Is Home Renovation Due to a Medical Condition FSA eligible?
7 Ways to Maximize Your FSA Account
Though it's only March, it's important to think about your Flexible Spending Account (FSA) throughout the year.
You maximize what you put into the account when you use it for different out-of-pocket expenses. Your FSA is very versatile - you can use it to buy common healthcare products like first-aid kits and contact lens solution, to buy surprising items like defibrillators and sunscreen, to cover co-pays and deductibles at the doctor's office, to visit specialists not covered by your health insurance...and more!
Think about the medical exams or services you'll need during the year. You'll likely schedule annual dental visits and eye checkups. How about a yearly physical? These are all expenses that your FSA can cover.
But, above all else, here are few tips to consider to make the most of your plan year-round:
Understand your FSA
Your FSA administrator knows all the specifics of your FSA - whether you want to know what your your remaining balance is, have a question about eligibility, or checking your claims status.
You can also discover eligible products and services by searching the FSA Store FSA Eligibility List.
Confirm your deadlines
It's easy to lose track of deadlines sometimes when you already have so many other deadlines to remember! You can easily discover your FSA deadline by checking in with your FSA administrator or by viewing your information online.
Understand FSA plan extensions
Though Flexible Spending Accounts have firm deadlines by which you must use your money, your FSA plan could have a Grace Period or Carryover option (up to $500 carried over to the next plan year), or even a Run-Out Period. It's important to know if your plan has these, as they add a bit more flexibility and time to spend your money, or additional time to submit claims (Run-Out period).
Watch our video explaining the FSA Carryover vs. Grace Period
Use your FSA card
If you have an FSA (debit) card, it allows you to pay for eligible health care expenses and shop FSAstore.com while avoiding submitting paperwork and receipts. Purchases with an FSA card are substantiated automatically. If something is not considered as an FSA eligible expense under your plan guidelines, your card does not get charged. It's not a bad idea to hold on to receipts though, in case you ever need to substantiate a claim.
Stretch your contributions
Remember that you can put up to $2,550 in an FSA account. How much you can contribute is determined by what your specific plan allows for the maximum. If you and your spouse have access to separate FSA accounts, each of you can take advantage of the $2,550 cap.
Ask about life changes
Ask your FSA administrator about changes to your FSA contribution. Sometimes, if you've had a qualifying event (having a baby, getting married, switching jobs, etc.), you can change your FSA contribution in the middle of the year. Not every FSA plan allows for these, so it's best to ask your FSA administrator if this is something that your plan allows.
Read more about changes in employment and how these might affect your FSA.
Shop & Save on products with your FSA
Take advantage of special promotions on everyday health products at FSA Store. Sign up on the FSAstore.com homepage to receive special discounts and offers throughout the year.
It's America Saves Week! This important week highlights how you can save and manage your finances in the best way possible. The motto of this week is best summarized as "Set a Goal. Make a Plan. Save Automatically."
As far as the latter goes, your Flexible Spending Account (FSA) can play a huge role!
Check out these 5 Steps to Savings with Your FSA:
1. Sign up for an FSA/Maximize your existing FSA.
- If you already have an FSA, that's great! You're saving on out-of-pocket healthcare expenses every time you use your FSA - this includes medical services not covered by your regular insurance, dental and eye care, and thousands of everyday healthcare products.
- If you're thinking about enrolling in an FSA, you're taking a great step toward savings, as well. Research a bit about FSAs to learn more about what these plans can offer. Ask your HR representative or employer about FSAs, and what your specific plan would cover (how much you're allowed to set aside each year, which expenses will get reimbursed, etc.)
2. Think about Your Healthcare Needs for the Year. Throughout the year, you'll visit the dentist, and likely schedule an annual eye exam or a physical. You can you use your FSA for co-pays and deductibles for these visits, instead of paying for these expenses on an out-of-pocket basis.
3. Familiarize yourself with what exactly is covered. If you want a broader overlook of what expenses (products and medical services) are covered by Flex Spending Accounts, head on over to our FSA Eligibility List. The list will also tell you about services and items that are NOT generally covered by FSAs.
- It's always good to check in with your FSA administrator if you have specific questions, or to read over your Summary Plan Description which has all the information regarding your plan.
4. Shop for Products. Whether you're dealing with a seasonal cold, have sore muscles from exercise, or traveling somewhere, your FSA can cover a wide range of products for various situations.
- Did you know you can shop for hot/cold therapy packs, or baby care supplies like breast pumps, or even sunscreen with your pre-tax Flexible Spending Account? Not only do you save money by using your FSA, but you're also able to buy these items and effectively save up to 40% at FSA Store because you're using your account!
5. Regularly check your account. Just like you would stay on top of your checking account and savings account, you should also keep track of your FSA (remaining balance, submitting claims for reimbursement).
- If you know you have some money left over close to your plan-year deadline, then you'll be able to still use that by using it before the year expires.
- You can also set up a monthly planning sheet and schedule your medical appointments, or shop for everyday products like contact lenses and other items you need to refill on a monthly basis.
- Because FSAs are "Use-it-or-Lose-it" accounts, any money that's left at the end of the year gets forfeited (unless your plan has an extension, but even that extension has an expiration date). This is your hard-earned money, so you don't want to risk losing what you set aside.
By now you've likely already settled your New Year's Resolutions for the year, and most likely, health care is among them in some way (exercising more is a popular one!).
Many people also went through healthcare open enrollment in the last few months of the year. If that applied to you, you had to sort through your available benefits and elect new ones, or stick with the old options you had. If a Flexible Spending Account (FSA) were an option you selected, you're in for some great pre-tax savings!
FSA money is taken out of your paycheck each month, but the money is contributed on a pre-tax basis (and if you think about it, the FSA funds are taken out before you even get your paycheck). With an FSA, taxable income goes down and spendable income goes up...leaving you with additional money to use for healthcare expenses.
Updates for 2015:
1. Flexible Spending Account Contributions Increased. As of 2015, you can now contribute up to $2,550 to your FSA plan. Some employers opt to contribute extra to that (and that does not count toward the limit). Check in with your FSA administrator (or HR department, if unsure who to contact) about the contribution maximum of your plan.
2. Plan ahead. Before you signed up for an FSA, you had to estimate your healthcare expenses for the year. It can be a little tricky to think far ahead, and even if you know you'll need an eye exam or schedule a dental visit, you might still be curious about other available expenses.
Check out these resources to learn more:
- Eligibility List - browse this list for products and services
- Shop FSA Store for thousands of FSA eligible products
- FSA Calculator - estimate expenses and savings with an FSA.
- If you have the Grace Period (and your plan year ended on December 31), then you'd have until March 15, 2015 to use remaining FSA money.
- If you have a Carryover, you could have carried over up to $500 (employers determine the exact amount) in unused FSA money to this year.
Related posts you might be interested in:
A Flexible Spending Account (FSA) gives you the opportunity to pay for a variety of out-of-pocket medical expenses on a pre-tax basis. Dental care can certainly be a part of those expenses, but teeth whitening is not considered to be an FSA eligible expense.
Because it’s considered cosmetic in nature, teeth whitening will not be reimbursed with your FSA. The IRS determines and qualifies something as “FSA eligible,” including for medical services. If a service is deemed “medically necessary,” you would be able to apply your FSA toward payment. In terms of dental care, a cleaning, root canal or a filling would be covered since these are seen as “medically necessary” procedures.
Other dental care that you can use your FSA for:
- Extractions and implants
- Caps and crowns
- Fluoride treatment
*Your FSAs will list specific guidelines about coverage for orthodontia. Check with your FSA administrator to discover what's covered.
Are toothbrushes ever considered an FSA eligible expense? Learn more about these in our blog post via: https://fsastore.com/blog/post/2014/02/25/Are-Toothbrushes-Covered-Under-Healthcare-Flexible-Spending-Accounts.aspx
Search our extensive FSAstore.com Eligibility List to learn about additional FSA eligible expenses. If you’re ever unsure about eligibility, contact your FSA administrator (or your HR department) to find out what’s covered under your FSA.
Concierge Medicine (also known as a Boutique Practice) is becoming increasingly more popular. For those of you in the industry of working with FSAs, you’ve probably heard the question many times before; “Can I use my FSA to pay for concierge medicine fees?” The answer is… not unless the fee covers specific medical expenses actually performed.
Let's discuss what concierge medicine is. Concierge physicians or boutique practices charge a fee for their patients. This fee ranges from a small monthly fee to annual fees in the thousands and is usually accompanied by regular fees for services received. In exchange for the annual fee, a concierge doctor is typically available 24-hours a day and office visits are often longer and more thorough. In a world where doctors are becoming increasingly busier, more time with a doctor and a dedicated physician is an attractive option for those who can afford it.
Are concierge medicine fees FSA eligible expenses or not? Not usually.
As the IRS indicates that only fees for medical services actually performed or received can be reimbursed, the fees paid to retain a concierge doctor where no services are actually received are not eligible. However, if the patient receives an actual service from the doctor, such as a medical visit, the fee for that service is reimbursable provided that the patient has sufficient documentation. To further clarify the issue, the following are examples involving concierge medicine and their eligibility determination:
- Example 1: Anne pays Concierge Doctor Smith $2,500 annually as a retainer for his promised care as needed. Anne has a fairly healthy year, does not visit Doctor Smith, and submits the $2,500 fee to be reimbursed from her FSA. The $2,500 is not eligible, as Anne did not receive any medical services throughout the year.
- Example 2: The following year, Anne pays Doctor Smith $2,500 as a retainer for his promised care as needed, but this year, Anne visits Doctor Smith 10 times to receive medical care. Each visit is attributed to the $2,500 retainer fee, in the amount of $25 per medical visit. Provided that Anne has sufficient documentation to show that $2,500 worth of medical services was actually received, her FSA may be used to reimburse these expenses.
- Example 3: Anne changes doctors and starts using Concierge Doctor Nathan, who charges $1,000 per year plus an additional fee of $100 per office visit. Anne visits Doctor Nathan 3 times throughout the year for medical care. Anne may be reimbursed with sufficient documentation for the 3 medical visits, or $300. The $1,000 annual fee is not eligible.
Shop with a Flexible Spending Account
Got a grace period ending March 15? Shop for FSA eligible products and get free shipping on orders over $50!
Do you have questions about eligibility with an FSA? Comment below to ask us! We'll answer these right here on the blog and on social media.
As 2012 is almost over, it is crucial that your FSA funds are spent or they get forfeited because of the “use it or lose it" rule. This time of the year also marks the annual open enrollment period in which people elect their health insurance options – including signing up for an FSA. Before your plan starts, you should carefully calculate how much to contribute to the FSA. If you want help estimating your FSA health spending, you can use our FSA Calculator.
Health care reform is impacting FSA plans a bit. As of Jan. 1, 2013, there will be a $2,500 cap on yearly FSA contributions. FSA benefits don't only extend to individuals though, as Miller pointed out. "The FSA can be used for you, your spouse, dependent kids, grandparents, or anyone who is dependent," he explained.
If you need ideas on how to spend your last FSA dollars, browse FSAstore.com for thousands of FSA eligible products!