Allergy Products and Treatment: FSA Eligibility
Allergy treatment products without a Letter of Medical Necessity from a qualified physician are not eligible.
Private Letter Ruling 8009080; Revenue Ruling 76-80
What are allergies?
Allergies are a direct immune response after allergens enter or come into contact with the body and produce an allergic reaction. These allergic responses are caused by the body's natural ability to produce antibodies, which typically ward off foreign invaders and fight infections in the body. However, when an allergen (such as dust, pollen or pet dander) is introduced to the immune system, antibodies will recognize this as a potential threat (when it is actually harmless), and will trigger an immune system response that can manifest itself as sinus, digestive system, skin or respiratory issues (Mayo Clinic).
How do non-drug allergy products help?
There are non-drug allergy products on the market, including natural remedies, hypoallergenic home furnishings, HEPA air purifying systems and more, which are specially designed to improve allergy sufferers' quality of life and control their symptoms. However, these products do not fall under the IRS's rules for medical product reimbursement, as they do not directly prevent or alleviate a specific medical condition. As such, non-drug allergy products and treatments are rarely covered by FSAs, HSAs or HRAs without a Letter of Medical Necessity (LMN) from a doctor (Mayo Clinic).
For allergy products and treatments to be eligible for reimbursement, they must be for diagnosis, cure, mitigation or treatment of a disease and must not be purchased but for that primary purpose. To show that the expense is primarily for medical care, a LMN from a physician recommending the item to treat a specific medical condition is normally required. This letter must outline how the allergy products and treatments will be used to alleviate the issue and how long the treatment will last. If additional products will be needed in the future that will fall outside the current plan year, another LMN will need to be provided.