Long Term Care: FSA Eligibility

What is long term care?

Long term care is a form of support and services that is designed for elderly or homebound individuals who need additional assistance to perform the basic personal tasks of daily life. Long term care is not a form of medical care and no medical services are provided to the individual, rather this care is conducted by a series of caregivers and helpers who will assist the recipient with the many activities they need to perform to maintain their independence and comfort.

Caregivers who provide long term care to elderly or homebound individuals perform a wide range of services, predominantly inside the home, including bathing, dressing, using the toilet, transferring from beds to chairs, caring for incontinence and assistance with eating. Some long term care services will also assist in Instrumental Activities of Daily Living (IADLs), which are separate from the typical basic services long term care agencies provide, but are no less important to a patient's well-being. These include housework, money management, medication assistance, preparing meals, grocery/basic necessities shopping, pet care and responding to emergency alerts like fire alarms (U.S. Department of Health and Human Services).

Why isn't long term care eligible for reimbursement?

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. Because long term care does not involve any medical care and is instead a form of assistance for elderly and homebound individuals, long term care expenses are not eligible with consumer-directed healthcare accounts.