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Real Money: Using your FSA or HSA for DNA tests

Just a few short years ago, gene testing was seen as a brave new world for preventative medicine. When Angelina Jolie went public with her BRCA1 mutation diagnosis and subsequent double mastectomy in 2013, few people had heard of BRCA gene mutations. Many weren't even aware genetic testing could be used to inform medical decisions.

Since then, the DNA testing landscape has exploded. Companies like 23andMe, Color and Helix offer kits that can give you a clearer picture of your genetic health - specifically conditions and diseases to which you may be more susceptible.

But because the DNA testing industry is relatively new in the medical world, using your FSA or HSA to pay for a test isn't as straightforward as it would be to pay for most other medical expenses. Here's what you need to know.

Does your account cover DNA tests?

In general, you can get genetic testing from your doctor's office or from one of the many genetic testing services available, such as 23andMe. Few doctors recommend genetic testing unless you're starting a family or have a strong family history of a certain disease. In that case, they'll refer you to a lab for further bloodwork.

Since the advent of at-home DNA tests, more people have been eager to find out what conditions they're genetically at risk for, including Parkinson's, Alzheimer's, Celiac and more. Most of these tests only require a saliva sample, cost between $100 and $300, and provide results within a few weeks.

Getting reimbursed for these tests through your FSA or HSA isn't easy. These accounts only cover genetic testing when you have a Letter of Medical Necessity (LMN), which administrators require to prove that the DNA test is being used for medical reasons. Your doctor or other health care professional will need to write this letter to prove that the test is for the diagnosis, cure, mitigation, treatment, or prevention of disease.

The test might have a medical purpose as its primary goal, but a DNA test might also reveal non-medical information - such as ancestry or ethnicity - so it doesn't always have a medical use. If you order a DNA test that also provides information on your family's ethnic background, you might find it harder to get the expense approved.

If the user doesn't have a family history of a specific disease, it might be difficult to get the doctor to write a LMN for you.

If you're unsure as whether or not the DNA testing will be eligible, and what types of documentation may be required, be sure to check with your FSA administrator.

If I can't get an LMN, what's the next step?

A popular genetic test that's covered by HSAs and FSAs without an LMN is the BRACAnalysis test, which determines if the user has a mutation on the BRCA1 or BRCA2 gene. A pathogenic mutation on one of these two genes means the patient has a high chance of developing breast and ovarian cancer.

Upon testing positive, many women undergo preventative surgeries of their ovaries, fallopian tubes and breasts to lessen the cancer risk.

Because the BRACAnalysis test is shown to be medically necessary and only tests patients for a specific disease, it will typically be covered by your FSA or HSA without an LMN.

If you do test positive for a medically-relevant gene mutation, an appointment with a genetic counselor may be covered by your FSA or HSA. Follow-up appointments with your primary care doctor or specialist will also be covered.

For the latest info about your health and financial wellness, be sure to check out our Learning Center, and follow us on Facebook, Instagram and Twitter.

Eligibility

FSA Friday with Sean - 3/23/18: How to pay less for healthcare needs

For most Americans, healthcare comes through their employer, and prices for expenses -- like copays and doctor visits -- are largely determined by the available plans, before you even sign up.

But with the rising cost of healthcare in the U.S., skipping treatments or postponing doctors' appointments has become an unfortunate -- and unnecessary -- reality for some Americans.

Don't let these price increases affect your health when there are many ways to cut the costs of medical care! For this week's FSA Friday, we're going to explore some easy, money-saving tips to boost your finances.

1. Check prescription drug prices

We covered this in last week's column, but you may be spending more than you should for prescription drugs by not paying with cash. Pharmacy benefit managers (PBMs) may sometimes negotiate higher prices for co-pays than the actual cost of the drug, so you should always ask your pharmacist first if there's a difference between cash and insurance-covered prices.

2. Use free preventive care options

The Affordable Care Act mandated that insurance plans must offer a minimum standard of preventative services that are free of charge to the participant, as long as they stay within their insurance networks. Healthcare.gov has a full listing of these services, which includes vital screenings like colonoscopies, vaccinations, blood pressure testing, and more.

3. Enroll in an FSA/HSA

Maybe we're partial, but if you're offered an FSA or HSA option through your employer, this is one of the easiest ways to cut costs by reducing your taxable income. The money contributed to your account is exempt, so every purchase you make, whether it's sunscreen, co-pays or OTC medicines, is covered by tax-free money. That's way better than paying out of pocket!

4. Consider generic drug options

When you purchase name-brand medications, you're usually paying a premium for the name on the bottle. Over-the-counter (OTC) medications like pain relievers and antihistamines have identical generic versions that can offer real cost savings.

Another note -- be wary of pricey combo drugs. Instead of buying a less-effective combination cold and allergy medicine, check ingredient lists. It's often far cheaper (and effective) to buy a standard decongestant and a separate allergy medication. Of course, check with your doctor if you're unsure of how much you need of each active ingredient.

5. Track your health spending

This sounds like a no-brainer, but tracking spending is a major consideration if you have a deductible.

Let's say you anticipate having a medical procedure sometime over the next year. You can use this opportunity to make a huge dent in your deductible so that insurance can cover unexpected expenses later in the year.

Another option is to hold off on the procedure until later in the year, after you've met your deductible, when your insurance might possibly cover the whole cost. Both options make sense, as long as you track your costs so you can time your healthcare costs to match your insurance coverage.

For the latest info about your health and financial wellness, be sure to check out our Learning Center, and follow us on Facebook, Instagram and Twitter.