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That's Eligible?! Real answers to common FSA eligibility questions

Eligibility

With new deadline extensions in place, thousands of eligible products available for purchase, and the freedom to use an FSA card, flexible spending accounts are easier than ever to use. We've seen a little bit of everything since we founded our company in 2010, but year after year there are still common questions on the minds of FSA holders.

So, once and for all, we're tackling the three most common eligibility questions we receive from FSA users. Whether you're an HR professional or an account holder, you can be armed with the knowledge necessary to take full advantage of your tax-free funds.

"Why do I need to get a prescription for items like Advil or Tylenol that I can buy without one in a pharmacy?"

New visitors to our site may think that we're putting FSA users through the ringer to purchase over-the-counter (OTC) medicines, but in reality, we are simply complying with rules put into place through the Patient Protection and Affordable Care Act (PPACA).

The provision requires FSA users to submit prescriptions for any OTC products that have a medicated ingredient like Advil or Claritin to obtain reimbursement. Our team continues to support the repeal of this provision, but until that happens, we can help you navigate this requirement.

First, FSA users should be mindful of any upcoming OTC medicine purchases they may need to make in the coming months, and pick up prescriptions during routine doctor office visits. If you don't have an appointment on the horizon, we created the Prescription Process to help.

Simply provide your physician's name, phone number and address and we will obtain the documentation necessary for you to make your purchase.

"So, diapers aren't FSA-eligible, but toddler training pants are?"

This is a common point of confusion for FSA users as it would seem that these two products perform the same function. As is often the case, diapers are considered "general health" items by the IRS. In short, diapers are used after a healthy function of the body, therefore it has no medical purpose.

However, toddler and young child training pants are eligible because they protect against bed-wetting, an involuntary function of the body. Training pants are commonly used in treatment plans for bed-wetting to help kids develop nighttime bladder control.

"Why aren't tampons eligible?"

When it comes to FSA eligibility, there is no product or service that has been more confusing than tampons. Currently, tampons are not eligible for FSA reimbursement in accordance with IRS regulations. And we understand why there's so much frustration.

The answer lies in an IRS regulation that dictates which products and services are FSA-eligible -- regulation IRS 213(d), which states:

"The term 'medical care' means 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."

Furthermore, the IRS claims, "...medical care expenses must be primarily to alleviate or prevent a physical or mental disability or illness. They don't include expenses that are merely beneficial to general health, such as vitamins or a vacation."

We think this means the IRS views them as a means of treating a healthy function of the body, as opposed to treatment of an illness or long-term condition.

Products like these, which are designed for "general health" purposes, are not FSA-eligible. But, we'd love for the IRS to make an FSA-eligibility exception, so women can cover more of their personal expenses with tax-free funds, and help FSAs do more for their families.


Claritin Non-Drowsy Allergy Relief

Non-drowsy indoor and outdoor allergy relief.

Motrin Ibuprofen Pain Reliever

Relieve headache pain and bring down fevers quickly with Motrin IB tablets

GoodNites Underwear

A better way to manage bedwetting, with complete nighttime protection.

Tranquility Adult Disposable Underwear

Ensure confidence and comfort during active daytime hours.

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Don't waste time hunting for ways to spend your tax-free funds. In That's Eligible?!, we'll bring you these updates every Monday, so you don't have to. And for all things flex spending, be sure to check out the rest of our Learning Center, and follow us on Facebook, Instagram and Twitter.

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