Dermatology Treatment: FSA Eligibility
What is dermatology?
Dermatology is the medical discipline that is concerned with the skin, hair, nails and mucous membranes, which studies and treats more than 3,000 potential disease and conditions ranging from minor issues like acne to more advanced ailments like skin cancer. However, dermatologists also specialize in a wide range of cosmetic procedures to treat or remove skin imperfections, which can make it difficult for benefits administrators to determine which types of dermatology treatments are eligible for reimbursement with consumer-directed healthcare accounts (News-Medical.net).
What types of dermatology treatments are covered?
Under IRC 213(d)(1), which regulates the eligibility of medical products and services covered under consumer-directed healthcare accounts, "medical care includes amounts paid for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for the purpose of affecting any structure or function of the body." Dermatology treatments that are for a primarily cosmetic purpose are therefore never covered under consumer-directed healthcare accounts, as they do not diagnose, cure, treat or prevent a legitimate medical condition.
Conversely, if an individual is pursuing dermatology treatments to treat a skin condition, it's important for consumer-directed healthcare account holders to check with their benefits administrators to see what types of documentation they will need to submit a claim. For instance, if a patient is pursuing a treatment for acne, this will likely be eligible for reimbursement with a prescription for the requisite medications needed to alleviate the issue. However, treatment for a skin condition like psoriasis may require a Letter of Medical Necessity (LMN), as treatment for this condition could be construed as a cosmetic expense, and therefore will need further documentation.
Ultimately, reimbursement for dermatology treatments is heavily contingent upon the service and treatment, so it's advisable that consumer-directed account holders do sufficient research on their prospective treatments and their eligibility before submitting a claim to their benefits administrators.