Cayenne Pepper: FSA Eligibility

Cayenne Pepper: requires a Letter of Medical Necessity (LMN) to be eligible with a Flexible Savings Account (FSA)
Cayenne pepper/herbs are sometimes eligible if the item is being used to treat a medical condition (e.g. migraine) with a Letter of Medical Necessity (LMN) from a physician, and the individual would otherwise not have purchased the item "but for" the medical condition. Under these circumstances, cayenne pepper reimbursement would be eligible with a flexible spending account (FSA), health savings account (HSA) or a health reimbursement arrangement (HRA). Cayenne pepper reimbursement is not eligible with a limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA).

Cayenne pepper for cooking purposes is not eligible.

Information Letter 2010-0080; Information Letter 2001-0297

What is the medical use for cayenne pepper?

Cayenne pepper is most often associated with cooking and spicy foods, but it also been embraced as a medicinal herb for thousands of years by myriad cultures (Medical News Today). The substance capsaicin, which gives cayenne pepper its spicy taste, is an active ingredient in many over-the-counter (OTC) treatments for arthritis and muscle pain, but it also plays a role in treating a wide variety of potential maladies, including:

  • Migraines: Numerous studies have found that the active ingredient capsaicin can bring relief to the pain associated with migraines by depleting Substance P, a neurotransmitter that transmits pain impulses. Additionally, cayenne pepper is known to help regulate blood pressure, and as migraines are caused by a constriction of blood vessels in the head, this can make a tangible difference in alleviating headache pain symptoms (LIVESTRONG).
  • Nasal Congestion: Cayenne pepper is a powerful decongestant that can help to alleviate nasal congestion symptoms. The active ingredient capsaicin stimulates the release of mucous from respiratory passages to open airways. Ingesting cayenne pepper in food is the appropriate delivery method to help treat congestion (LIVESTRONG).
  • Blood Circulation: Individuals who suffer from venous issues and poor blood circulation could respond positively from cayenne pepper treatment. Cayenne pepper in conjunction with other medications and supplements can significantly improve blood circulation and lower blood pressure (Dr. Axe).
  • Psoriasis: A study published in the Journal of the American Academy of Dermatology found that topical application of capsaicin can dramatically reduce the itching and discomfort that arises from psoriasis flare-ups. Capsaicin, utilized in both anti-itch creams and gels, is widely used as a natural treatment for psoriasis itching and skin lesions (WebMD).

How do I obtain a Letter of Medical Necessity (LMN) for cayenne pepper?

A Letter of Medical Necessity (LMN) from a doctor for cayenne pepper 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 cayenne pepper, 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.