Electronic Cigarettes: FSA Eligibility

Electronic Cigarettes: reimbursement is not eligible with a Flexible Savings Account (FSA)
Electronic cigarettes are not eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), a health reimbursement arrangement (HRA), limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA). If in the rare case an electronic cigarette is recommended or required for smoking cessation, it could qualify under an FSA, HSA or HSA with appropriate documentation such as a Letter of Medical Necessity (LMN). If you’re unsure as to whether or not the product will qualify for reimbursement for you, speak with your benefits administrator.

What are electronic cigarettes?

Electronic cigarettes or “e-cigarettes” are handheld electronic devices that produce in inhalable vapor from a flavored liquid containing nicotine. The liquid is usually called e-liquid and is made of nicotine, propylene glycol, glycerine, and flavoring agents. Electronic cigarettes use rechargeable batteries to power a heating element or atomizer which causes the liquid to become vaporized. The electronic cigarette user then inhales the vapor to absorb nicotine into the bloodstream via the lungs, similar to smoking a cigarette (National Institute on Drug Abuse).

The health risks associated with using electronic cigarettes are uncertain. There are regulated nicotine replacement products such as pills, gum, and patches which have been proven effective for smoking cessation. There is tentative evidence that electronic cigarettes may help with smoking cessation, but electronic cigarettes have also been proven to have side effects such as throat and mouth inflammation, vomiting, nausea, and coughing. Regulated smoking cessation products have been proven safer than electronic cigarettes.

There are disagreements between different medical authorities on the conclusions of studies conducted to evaluate the effectiveness of electronic cigarettes in smoking cessation. Some authorities suggest the studies to date are insufficient, or are inadequately designed and conducted. Other authorities have concluded that electronic cigarettes are tentatively proven to be effective at smoking cessation.

The World Health Organization currently holds the view that there is not enough evidence to recommend electronic cigarettes for smoking cessation (World Health Organization). However, if a physician or other medical professional recommends electronic cigarettes for the primary purpose of smoking cessation, then it may be eligible with a Letter of Medical Necessity (LMN). It is always best to check with your benefits provider.