Eligibility

Flex-Ed: Clearing up the mysteries about vitamins and FSA/HSA eligibility

At first glance, vitamins and supplements seem like natural candidates for FSA- and HSA eligibility. They are designed to fill "gaps" in the average diet, and maybe offset minor nutritional deficiencies along the way -- yes, even those related to larger health problems.

But the IRS -- which governs FSA- and HSA-eligibility -- disagrees, while continuing to cite IRS 213(d), which states all FSA-eligible expenses must conform to the following standard:

"The diagnosis, cure, mitigation, treatment, or prevention of disease, or for the purpose of affecting any structure or function of the body."

And this is where the arguments start. Arguments such as...

"My vitamins are necessary! Why am I being punished?"

Vitamins are perhaps the most-glaring example of a product that can either be necessary or "dual-purpose." Daily multivitamins are used to promote better health and well-being, but because there's no specific health need or condition that is helped by using multivitamins, they fall outside the accepted qualifications for FSA- and HSA- eligibility.

Is there a medical basis for needing a multivitamin? Sure - it's for your health, after all. But promoting general well-being and treating a specific condition are two very different things in the eyes of the IRS.

In the past, we've used toothbrushes and floss as a good comparison point for the vitamin debate, and it still holds up. Though we all know proper dental cleaning is necessary for all-around health and wellness, using a toothbrush and floss has not been identified as having a direct role in treating or solving the specific medical condition.

"My vitamins are eligible? How did that happen?"

Though multivitamins are likely the most-popular OTC supplement, only a handful of targeted vitamins have achieved FSA- and HSA-eligibility, provided the patients have documentation from their doctors claiming the need.

I think we can all agree prenatal vitamins meet the IRS requirements for eligibility, since they have shown to prevent birth defects and boost fetal development in ways that most modern diets can't quite seem to achieve.

Likewise, glucosamine/chondroitin supplements are extremely popular at FSAstore.com and HSAstore.com because of their proven benefits for treating arthritis.

Because the above exceptions have proven value in treating specific needs and conditions, they can be purchased with tax-free health dollars, and without any written approvals from physicians. However…

"Is there any chance they'll make an exception?"

We obviously can't answer that here. But as many Americans know, working with the IRS is not nearly the nightmare people used to claim. And if a doctor determines your body needs a specific vitamin supplement -- even if it falls outside of regular FSA or HSA parameters -- then a Letter of Medical Necessity might do the trick.

Chances are, the letter will need to be detailed in explaining why these specific products will benefit you, and how long the expected use will be (such as the duration of specific treatment). It's not a guarantee by any means, but a well-presented case made to your benefits administrator can go a long way toward getting the supplements you need, on a tax-free basis.

Glucosamine Chondroitin

Cushion bones and lubricate joints by taking glucosamine chondroitin daily.

Prenatal Vitamins

Keep mom and baby happy and healthy with daily prenatal vitamins for pregnant and nursing mothers.

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Eligibility

What vitamins are FSA/HSA eligible?

One of the most common questions we receive in our FSA Learning Center from our customers is related to the eligibility of daily multivitamins and supplements. Traditionally, multivitamins are used to fill in the nutritional gaps that a person is lacking in his/her diet, but certain supplements can also help to alleviate a nutritional deficiency that may be caused by an underlying health problem. When it comes to FSA/HSA eligibility, vitamins seem to fall into a gray area, but we hope to clear up the confusion!

What determines vitamin eligibility?

A product/service's FSA eligibility is dictated by the Internal Revenue Service (IRS), which adheres to IRS 213(d). This regulation states that all FSA eligible expenses must conform to the IRS's definition of medical care:

"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."

While this seems straightforward, vitamins are a prime example of a product that can be considered necessary for "general health" or is considered "dual purpose." This means that while the product/service may have a medical basis, they are used primarily to promote one's general health and do not have a direct role in treating a specific medical condition. For instance, a toothbrush or dental floss are considered dual purpose items as they have both a medical and non-medical purpose.

What vitamins are FSA/HSA eligible?

With this IRS definition in mind, while daily multivitamins are not FSA/HSA eligible, there are some types of vitamins that are eligible with consumer-directed healthcare accounts and others that may be eligible with proper documentation from a physician. For instance, prenatal vitamins are FSA/HSA eligible, as they help prevent birth defects and support fetal development, while glucosamine/chondroitin supplements are also eligible when used to treat arthritis.

However, in some cases, doctors may prescribe a specific vitamin supplement to treat a medical condition that falls outside of FSA regulations. In this case, your benefits administrator may require a Letter of Medical Necessity (LMN) to show that these vitamins are necessary for the treatment of a medical condition. The letter will typically need to outline how these products will be used to aid the treatment process, and how long the treatment will last. If you are considering a specific vitamin for treatment of a medical condition, talk to your FSA/HSA benefits administrator to determine what types of documentation may be required.

Glucosamine Chondroitin

Lubricate joints and cushion bones with FSA-eligible glucosamine chondroitin.

Prenatal Vitamins

Keep mommy and baby happy and healthy with prenatal vitamins.

Eligibility

Are vitamins covered by my FSA?

Are vitamins FSA eligible? Lots of questions about vitamin eligibility come up when it comes to FSAs, and it can be tricy. Learn more in our post.

Have you recently enrolled in a flexible spending account (FSA) through your employer's health insurance plan? Congratulations! This is a fantastic way to save money on yearly healthcare expenses, but FSAs come with a bit of learning curve to understand what is/isn't FSA eligible. While we have plenty of great resources at FSAstore.com like our FSA Learning Center or FSA Eligibility List to help you get started, specific products like vitamins and supplements are items customers ask about frequently.

The Internal Revenue Service (IRS) sets the rules for FSA eligibility, and every product/service that is considered eligible falls under regulation IRS 213(d):

"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."

Are vitamins FSA eligible?

Yes...to a point. While one could make the argument that taking daily multivitamins can help ward off future health problems, they generally fall outside IRS regulations for FSA eligibility as they are products used to support one's "general health," and not used to diagnose, cure, mitigate, treat or prevent a legitimate medical condition.

However, if a vitamin or supplement is prescribed to treat a major medical issue, it could be eligible for reimbursement through an FSA. For instance, glucosamine and chondroitin are FSA eligible without the need for a prescription or Letter of Medical Necessity (LMN) from a physician, as they are known to support joint health and prevent the breakdown of cartilage. Additionally, prenatal vitamins are also FSA eligible, as they have been proven to cover nutritional gaps in a mother's diet and reduce the risk of birth defects.

Lastly, if an FSA holder's doctor suggests a specific type of vitamin supplement to treat a medical condition, such as common treatments like biotin for enhanced metabolism or melatonin to improve one's sleep cycle, these will typically require a Letter of Medical Necessity (LMN) from a doctor. This letter must outline how an account holder's medical condition necessitates a vitamin supplement, how the treatment will be used to alleviate the issue and how long the treatment will last. If the treatment plan exceeds the current plan year, another LMN will have to be provided to the benefits administrator to cover the duration of the treatment.

For questions regarding your FSA and to shop the web's largest selection of FSA eligible items, visit FSAstore.com! We make it easy for you to maximize the potential of your employee benefits and support the wellness of you and your loved ones.

Have another question? Browse our Learning Center or ask our team of Experts!

Mason Natural Glucosamine Chondroitin

Cushion bones and lubricate joints with glucosamine chondroitin.

CVS Health Prenatal Vitamins 

Keep mommy and baby happy with prenatal vitamins.