Genetic Testing: FSA Eligibility

Genetic Testing: requires a Letter of Medical Necessity (LMN) to be eligible with a Flexible Savings Account (FSA)
Genetic testing is eligible for reimbursement with flexible spending accounts (FSA), health savings accounts (HSA), health reimbursement accounts (HRA) with a letter of medical necessity. They are not eligible for reimbursement with and limited-purpose flexible spending accounts (LPFSA) and dependent care flexible spending accounts (DPFSA).

Under IRC 213(d)(1), "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." This includes medical equipment, supplies and devices.

What is genetic testing used for?

There are over 2000 genetic tests, also known as DNA tests, available to test blood and other tissues to find genetic disorders. Genetic testing is eligible when necessary for the diagnoses, mitigation, treatment or prevention of an existing or imminent disease. Genetic testing can also be used to determine a child's parentage or a person's general ancestry and biological relationship between people (Genetics Home Reference).

What are the different types of genetic tests?

Genetic testing helps identify changes in chromosomes, genes, or proteins. Diagnostic testing is used to identify the disease that is making someone ill. Predictive and pre-symptomatic genetic tests find gene changes that increase the likelihood of developing certain diseases.

Carrier testing is finds out if someone "carries" a change in a gene that is linked to disease and thus has the ability to pass on the gene change to their children, who may develop the disease or become carriers themselves. This type of testing is usually for people have a family history of a specific inherited disease. Prenatal testing is offered during pregnancy to help identify fetuses that have certain diseases.

Pharmacogenomic testing gives information about how certain medicines are processed by an individual's body. This type of testing can help your healthcare provider choose the medicines that work best with your genetic makeup (National Institutes of Health).

What are the benefits and drawbacks of genetic testing?

For some the benefits for a genetic test help eliminate uncertainty surrounding their health. Doctors can help make recommendations for treatment or monitoring, allowing patients to take steps to lower the chance of developing certain disease. Genetic testing has a generally low risk of negatively impacting your physical health, but it can be difficult financially or emotionally to find out your results. Genetic testing cannot tell you everything about inherited diseases such as how severe the symptom will be and a positive result does not always mean you will develop the disease. Genetic testing can cost anywhere from less than $100 to more than $2,000.