Counseling: FSA Eligibility

Counseling: eligible with a Flexible Savings Account (FSA)
Medical or mental counseling is eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), and health reimbursement account (HRA). Counseling not required for a medical or mental purpose will typically not qualify, such as marriage or family counseling, unless appropriate documentation is provided. In all types of counseling, an administrator may require a Letter of Medical Necessity. Counseling is not eligible for reimbursement with a dependent care flexible spending account (DFSA) or limited-purpose flexible spending account (LPFSA).

Marriage counseling is not eligible.

What is medical/mental counseling?

In the event of a major medical diagnosis, patients will lean on the expertise of their doctors, medical team and loved ones for support, but for many, the mental stress that is associated with the contraction of a specific illness is yet another obstacle for them to overcome during the recovery process. In light of these many emotional and practical concerns that are associated with a positive diagnosis, patients have the option of pursuing a wide variety of medical counseling options that can play a pivotal role in helping them manage the many facets of their illness (National Center for Biotechnology Information).

Medical counseling options are designed to take a full spectrum approach to disease management, and they are available for both patients and their families in a variety of different contexts. Social workers will cover a wide array of topics in relation to an individual's illness, including:

  • Disease Management/Social Issues: In most cases, doctors will suggest meeting with a medical social worker in the weeks after a diagnosis has been made to manage stress, and other psychosocial and practical issues the patient may face in the near future. Social workers can assist patients in managing the complex feelings that can arise after a diagnosis, such as adjusting to the disease treatment plan, family and social isolation, quality of life concerns, end-of-life issues and a wealth of other potential issues. These meetings can also be conducted with family members as well to teach these individuals about what emotional and practical concerns to know about when caring for a loved one with a major illness.
  • Practical Issues: Disease management can affect nearly every aspect of a patient's life, and the effort to juggle one's obligations to a job, family and other concerns can be overwhelming in light of a disease diagnosis. Social workers can provide advice, community resources and other information to tackle the most pressing concerns, such as practical information about frequent hospital visits (parking fees, out-of-town medical visits, accommodations, etc.), financial/job/education concerns, food expenses, assistance with daily activities and seeking out assistance for family members and other caregivers.
  • Mental health counseling: Whether conducted with a social worker or a psychologist, mental health counseling is an indispensable aspect of disease management to help patients navigate the complicated emotions that a disease diagnosis can bring to light. In most cases, this will involve direct therapy to help patients navigate major depression, anxiety, mood/personality/adjustment disorders, substance abuse and panic attacks that may arise after a disease diagnosis. Additionally, in some cases, these counselors may be able to prescribe medications to handle depression and distress relating to a patient's condition.

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