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.

Update: As of March 2020 with the passage of the CARES Act, the OTC Rx requirement has been repealed and prescriptions are no longer necessary to purchase over-the-counter medicines with an FSA or HSA. Additionally, menstrual care products like tampons and pads are fully FSA-/HSA-eligible. Learn more here.

"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.

"Do I have to wait to spend my FSA funds until they accrue?"

FSAs are funded through regular payroll deductions from an account holder's paycheck over the course of the year - tax-free! This has the benefit of reducing your taxable income and helping you pay less in taxes. But for many who are on the fence about an FSA, how these payroll deductions take place can be a point of confusion.

But the solution is actually quite simple: an account holder's FSA contribution (which they elect during their open enrollment period) is available in full at the beginning of their plan year. So if you elected the maximum for 2020 ($2,750), that full amount would be available to spend on qualifying items and services from the start of the plan year.


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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