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Last time, I shared my experience of being diagnosed with a BRCA1 mutation -- a genetic condition that makes me more susceptible to breast and ovarian cancer. The doctors I spoke with recommended prophylactic surgery to remove my breasts, ovaries and Fallopian tubes.
Until I get the surgeries, I'm supposed to get a blood test, vaginal ultrasound and breast MRI every six months. The cost of these screening tools can be expensive, especially if you have a high-deductible health plan (HDHP) like I currently do. The average cost of an MRI is $2,000, whereas the ultrasound is several hundred dollars. Even the CA-125 blood test can cost $200.
I didn't have to worry about the cost of the procedures immediately. My husband and I somehow qualified for reduced expenses through our medical insurance, so everything from the consultations to the MRIs would be covered for now. But I also knew we had plans to move out of state in a few months, meaning I'd lose that affordable coverage.
Even before I found out my BRCA results, I knew I would want to get the preventative surgeries as soon as possible. I'm an anxious person by nature, so the idea of cancer hanging over my head was enough to give me panic attacks.
Some women are comfortable with surveillance and regular screening, but not me. Every doctor I spoke to recommended surgery as soon as possible since I'm not interested in having kids.
A major life decision
Not all women go that route. Many are scared of having surgery and believe they can detect cancer early enough. That may be true for most breast cancers, but ovarian cancer is different. Symptoms of ovarian cancer are vague and can be confused with PMS or stomach problems. I don't like the idea of freaking out every time I'm bloated or feel discomfort in my abdomen.
Of course my HSA should be there to help. Right now I'm maxing out the family contribution limit of $6,900. We have an HDHP right now, but plan to sign up for a gold plan next year with lower premiums. And it's the right move for us today -- we'll save approximately $4,000 by doing so, but it means we won't be able to contribute to an HSA. That's why I'm planning to save as much as possible this year.
I also won't be able to open an FSA because my husband and I are both self-employed. Currently we are a partnership according to the IRS and plan to transition to an S-corp next year. Neither of those is eligible for an FSA. If I were able to open an FSA, then I would contribute to that account as well to pay for any other outstanding costs that insurance wouldn't cover.
Right now I'm hoping my HSA will have enough money in it to cover the costs of surgery. There might even be some left over in case I need follow-up appointments the year after.
If I wasn't getting surgery next year, I would keep my high-deductible plan and save more money in my HSA to pay for the costs of screening. There are no right answers when it comes to this situation, but approaching the financial side with a level head has helped me to feel more confident for the future.
No one can ever be emotionally prepared for this news, not even someone who's researched so much about breast and ovarian cancer. Some days I still wake up angry at my diagnosis. Some days I think maybe screening is better than surgery. But I always come back to my decision.
Thankfully, the financial aspect of BRCA is easier to swallow. Setting up my budgeting for success means I'll only have to worry about recovery and not how I'm going to pay the hospital bill.
Portable health needs
MedAngel ONE Wireless Thermometer
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Whether you budget week-to-week, or plan to use your FSA for bigger things, our weekly Real Money column will help you maximize your flex spending dollars. Look for it exclusively on the FSAstore.com Learning Center. And for the latest info about your health and financial wellness, be sure to follow us on Facebook, Instagram and Twitter.
Gene research is at the cutting edge of medical science. Researchers are realizing that genes can tell a lot about your body - from the most effective ways to exercise, to the best way to manage your diet, to which diseases and conditions you're more likely to develop.
With that in mind, I decided to take a test in 2017 to determine whether or not I had a mutation on the BRCA gene. In short, such a mutation would put me at a severely increased risk for certain types of cancers. Shortly after submitting the test, I received a positive result.
Here's my story: How I found out, what I did to address it, and how I plan to pay for it all.
How I found out
Almost a year ago, I read an article in the New York Times about the BRCA gene, which is responsible for suppressing tumors that can cause breast and ovarian cancer. If you think you've heard of it before, it was probably in 2013 when Angelina Jolie wrote an essay about her decision to have a preventive double mastectomy because of her BRCA mutation. When I tell people I have a BRCA mutation, I usually preface it by asking if they remember Jolie's decision.
The Times article said that Jewish women had a one in 40 chance of having a mutation on the BRCA gene, and therefore being more susceptible to these types of cancers. I'm Jewish on both sides of my family, and the news hit home for one important reason - my grandmother died of ovarian cancer at 42.
I also used to work at a cancer agency. I learned how deadly ovarian cancer can be, and how difficult it was to go through treatment for even comparatively "mild" types of cancer. Every day I saw people suffering physically, mentally and financially, with no assurance that things would ever get better.
After reading the article, I asked my doctor about getting tested for the mutation. She didn't think I had enough family history to qualify, despite coming from a Jewish background, so she denied my request for a referral. I have very little family history to begin with, so this distinction seemed odd to me even at the time.
One testing option...
A few months later I discovered Color, an at-home DNA testing kit similar to 23andMe. Color offered a BRCA specific test for only $100. I'm a frugal person by nature and hated the idea of spending $100 out of pocket. Because my doctor didn't recommend the test, I couldn't even use tax-free funds to pay for it.
Providers only consider DNA tests as qualified medical expenses if a doctor recommends them. Usually, if the doctor suggests a BRCA test, it has to be done at their office. They can also write a letter of medical necessity if you want to purchase a DNA test for home use using FSA funds.
A few weeks after submitting my saliva sample to Color, I got my results: I had a mutation on my BRCA1 gene. In short, that means I have an 81% lifetime risk for breast cancer and 54% lifetime risk for ovarian cancer.
My head started spinning and my stomach sank. Thankfully, I was on the phone with one of Color's professional genetic counselors. She told me my next steps were an appointment with a clinical geneticist, who would then refer me to an OB-GYN and breast surgeon.
She also said I'd need a breast MRI, vaginal ultrasound and a specific blood test every six months until I got my surgeries. Most BRCA-positive women get their ovaries and Fallopian tubes out once they're finished having kids, or before age 35.
That may sound extreme, but ovarian cancer currently has no effective screening method. A vaginal ultrasound will usually only pick up cancer once it's advanced, and the blood test has a high false-positive and false-negative rate. In short, by the time you get diagnosed it might be more severe than expected.
The testing was only the beginning of my BRCA journey. Next, I had to figure out how to pay for all the additional tests I would need - and especially how to cover the cost of surgery. Be sure to check back to see how this journey is affecting my health and financial planning for the next year.
Eligible testing and diagnostics
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Whether you budget week-to-week, or plan to use your FSA for bigger things, our Real Money column will help you maximize your flex spending dollars. Look for it every Tuesday, exclusively on the FSAstore.com Learning Center. And for the latest info about your health and financial wellness, be sure to follow us on Facebook, Instagram and Twitter.
If you have any prescription medications you take on a regular basis, you probably have a routine - go to the pharmacy, wait in line, hand over your insurance card and pay for the prescription with your debit or credit card.
Even with your insurance chipping in, chances are you end up paying a decent chunk of the bill out-of-pocket. If you're battling a chronic condition, those costs can really add up over time. But what if you could get that medicine at a cheaper price without using your insurance card?
It might sound crazy, but billing your insurance isn't always the most cost-effective option. Here's what you should know about the alternatives, and how your FSA card can save you even more.
Pay for prescription medicine instead of using insurance
A recent investigative report from The New York Times and ProPublica found that 40 common prescriptions were cheaper using GoodRx, a prescription discount card, than billing insurance.
GoodRx is the most common type of prescription discount card, and it's completely free. Blink Health, SingleCare and WellRx are some of the other cards available. All you have to do is print one out or have it mailed to you.
These discount cards only apply if you don't bill the prescription to your insurance. Here's how it works: You fill the prescription at a pharmacy, present the GoodRx or similar discount card and then pay for the remainder with your FSA card. Some pharmacies will even have the cards sitting out for anyone to use.
Discount prescription services list their prices before you buy, so you can see if it will be cheaper than using insurance and which pharmacy has the best price. As with most cost-saving measures, shopping around is a step toward saving the most money.
Pay for over-the-counter medicine
You can use your FSA card to pay for over-the-counter (OTC) medicine if a qualified professional has prescribed it (note that OTC items which do not contain an active medical ingredient will not require a prescription and you can shop for thousands of qualified items here). The prescription must be written before you buy the drug and generally within the FSA plan year in which you purchase it. .
You can use your FSA card when you buy the item at the drugstore. You can also pay with a regular debit or credit card and then request reimbursement from your FSA provider. Keep the receipt and the prescription to prove it's a qualified medical expense.
Pay for prescription medicine after insurance
If billing your insurance is still the cheapest way to buy a prescription, you can use your FSA card to save even more money.
When you fill the prescription, give the pharmacist your insurance card. They'll run the prescription and bill you for any leftover amount. You can pay for that directly with your FSA card or use a debit or credit card and then file a claim with your FSA provider. And of course, keep the receipt to prove it was an FSA-eligible expense.
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New to FSAs? Need a refresher course in all things flex spending? Our weekly Flex-Ed column gives you a weekly dose of FSA Living 101, offering tips for making the most of your tax-free funds. Look for it every Thursday, exclusively on the FSAstore.com Learning Center.
Divorce is never easy. Learning to disentangle two lives can be exhausting, frustrating and full of confrontation - especially if you have children. Health care can be especially tricky, as many families share insurance plans and medical savings accounts. If you're divorcing, have children and use a flexible spending account (FSA) or health savings account (HSA), here's what you need to know.
Divorced and using HSAs and FSAs with children
HSA holders can spend money on themselves and anyone who is a qualified tax dependent. If your spouse claims your son on her tax return, you can't claim them - that means you can't use HSA money for their medical needs.
FSA rules are more lenient when it comes to children and eligibility. If you have a child, you're allowed to spend FSA funds on them even if you don't claim them on your taxes or pay for their health insurance. This applies to children up to the age of 26.
If your child isn't under your health insurance plan and don't share that plan with a new spouse, you can only contribute the individual maximum amount to your HSA and not the family max.
Splitting HSAs and FSAs
If you're getting divorced and have a significant sum of money in an HSA, you and your partner will have to decide how those are divided. There's no set rule regarding how FSA and HSA funds have to be split up, so it all depends on your divorce agreement. You and your lawyers can decide how to divide that up, either 50/50 or in another arrangement.
Divorce is considered a qualifying event, so you can also change your health insurance plan once the divorce is finalized. During that time you can remove a spouse from your plan if you previously held a family membership.
If you're getting divorced and contributing to an HSA for the maximum family contribution limit, you'll have to change your contribution schedule as soon as the divorce is finalized. The contribution limit will remain the family limit for the months you were married, but will be prorated for the year. Talk to a financial adviser to make sure you don't contribute more than the maximum if you're unclear about your personal limits.
If you're divorced and still want to pay for your ex-spouse's medical bills with an HSA, those will be considered an ineligible withdrawal and be subject to income tax and a 20% fine. If you use your FSA for your ex-spouse's expenses, you may be asked to pay the plan back by your administrator. So even if your divorce agreement includes you paying for his or her medical bills, you can't use HSA or FSA funds to do so.
From FSA basics to the most specific account details, in our weekly Asked and Answered column, our team gets to the bottom of your most-pressing flex spending questions. It appears every Wednesday, exclusively on the FSAstore.com Learning Center. And for the latest info about your health and financial wellness, be sure to follow us on Facebook, Instagram and Twitter.
Figuring out how much to contribute to your FSA is a bit like deciding how much food to bring on a backpacking trip. Once you get out in the wilderness, you're stuck with the rations you've brought - if you packed too much, you may have to toss it along the way. If you packed too little, you'll have to end the trip early.
Because you can't change FSA contributions mid-year unless you have a qualifying event, like changes in marital or work status, it pays to contribute the right amount. Contribute too little and you may end up with some hefty out-of-pocket expenses.
Contribute too much and you'll be faced with a dilemma - roll over up to $500 to the next year or try to spend the remaining balance in the first two and a half months. Everyone has a magic number for how much they should contribute to their FSA. Here's one way to find yours.
Go through last year's expenses
The best way to decide how much to save for health care expenses is to look at how much you spent the previous year. Log on to your insurance account and see if you can find the total amount you paid, not including monthly premiums.
Include how much you spent for all medical expenses, such as glasses and contacts, prescriptions, counseling and therapy visits, medical devices, dental visits and more. Then, examine those expenses and determine how common they were. If your only visits to the doctor were because of ordinary problems like the flu or sinus infection, you can probably estimate this next year will be the same.
If you ran into a major health problem, you should evaluate if next year will be similar. Some issues, like diabetes or asthma, require more-frequent doctors' visits. Others, like appendicitis, happen once a lifetime.
If you had a costly medical emergency, consider the likelihood that it will occur again and whether or not to include that figure in your estimate.
Compare health insurance plans
Even if you're signing up for a similar health insurance policy, the deductibles, copays and coinsurance rates might change from year to year. Compare the figures to see if you'll be paying more and adjust your FSA contribution accordingly.
For example, if your health insurance copay is increasing from $40 a visit to $60, add up how many visits you made last year and multiply them by $20.
Think ahead about major procedures
Sometimes you know about major operations and procedures ahead of time, so you can plan ahead. If you know this is the year when you're going to get LASIK surgery or finally get your knees replaced, call the insurance company to get an estimate of those costs.
Most of the time you can get an accurate idea of the expenses you're facing. If the insurance company can only guess what your costs might be, go with the higher end of the estimate. This way, you'll be covered in case you end up paying more.
What if you picked the wrong number?
If you end up saving more than you needed, ask your HR rep about the company's rollover policy. Most will either let you roll over $500 or give you a grace period of 2.5 months to spend the remainder. If you saved too little, try upping your contributions next year to maximize your tax-free benefits.
Finding your FSA magic number is essentially, a guessing game. Don't be surprised if you estimate too much or too little the first time you do it. It's all about taking charge of your finances and making the most educated guess possible.
From FSA basics to the most specific account details, in our weekly Asked and Answered column, our team gets to the bottom of your most-pressing flex spending questions. It appears every Wednesday, exclusively on the FSAstore.com Learning Center. And for the latest info about your health and financial wellness, be sure to follow us on Facebook, Instagram, YouTube and Twitter.
As time marches on, trends go in and out of fashion. Slim-fitting pants are in, knee-length shorts are out. Natural hair is in - bushy perms are out. Healthy skin is in - tanning is out.
People are starting to realize that no tan is worth the risk of skin cancer. Beyond just the safety risk, tanning is also associated with an increase in wrinkles and other signs of premature aging. If you want to look your best into old age, a healthy approach to sun exposure is the best route.
But even people trying to avoid UV damage might not realize the truth - the sun can still cause damage on a cool, cloudy day. Here's what you need to know.
Why "tanning" isn't always what you think
Most people associate tanning with a long day at the beach or a Fourth of July BBQ. But you can get tanned - or burnt - even on a cool day. The temperature has no effect on the sun's rays.
According to the Skin Cancer Foundation, clouds and rainy weather don't prevent all UV rays from penetrating. That means you still need to wear sunscreen if you're hiking or visiting the beach on a cloudy day.
Eating and drinking outside
Now that it's spring, more people are opting to sit outside at their favorite restaurant or bar. If you grab a table outside, apply sunscreen a few minutes before sitting down. Even if you're not burning up, you're still at risk of sun damage.
If you plan a long day of sitting at the beer garden with your friends, remember to reapply the sunscreen every two hours. A hat and sunglasses will also offer important sun protection.
Early spring is a volatile time for many parts of the country. It might be rainy and sunny or cold and hot in the same day.
No matter what the outdoor temperature is like, you should still cover up when puttering around in the garden or taking a walk in the park. If possible, wear a wide-brim hat, cover your arms and legs and put sunscreen on any exposed skin. Avoid outdoor activities in the afternoon if possible.
Snow and winter sports
If you're going skiing or snowboarding, you probably remember to pack your gloves, hat and other winter gear. Another important accessory to bring? Sunscreen.
Getting sunburned on the slopes is common, because you're closer to the sun at high altitudes. The sun reflecting off the snow is also more powerful than people realize.
If you're going skiing, remember to apply sunscreen before you hit the lifts and reapply every few hours. You should also use sunglasses and lip balm with SPF to protect your eyes and lips.
How to use your tax-free funds
Sunscreen is both HSA- and FSA-eligible, and you don't need a prescription to buy it with your funds. You can buy any kind of sunscreen, including lotion, spray or powder, as long as it's broad-spectrum and SPF 15+ (and allowed by your plan, of course). You can't use HSA or FSA funds on sunglasses, unless they're also prescription glasses. Hats and clothes with SPF also are not eligible.
Now that the calendar has flipped to June, chances are you're spending a lot more time outdoors. And that means you need to start thinking about cooling off, inside and out.
We've all been there. You're working in the garden or playing a game of pick-up basketball when you start to feel off. You're sluggish, dizzy and maybe even a little irritable (okay, a LOT irritable). Dehydration has snuck up on you again, and you never even saw it coming.
We associate dehydration with a feeling of thirst, but the two don't always go hand-in-hand. Thirst is your body's way of alerting you to low hydration levels, but you can easily get dehydrated before your body sends out the signal. By the time you feel thirsty, you're often already experiencing some of the early symptoms of dehydration.
Now, we're not doctors, but we are fans of sunny days. This summer, don't let dehydration get the best of you. Always check with a doctor before making changes to your diet and routines, but here are some tips we use to prevent dehydration, and how your tax-free funds can help.
Common causes of dehydration
As the weather gets warmer, the risk of dehydration increases. Dehydration can be a mild problem - sometimes a cold glass of water can take care of it - but it can also become an extremely serious condition that requires urgent medical care.
Common causes of dehydration include:
- Working outdoors in the sun
- Drinking too much alcohol (and not enough water)
- Exercising outside or in hot environments
- Driving in a hot car without air conditioning
If you're already sick with a fever, vomiting or experiencing diarrhea, you may become dehydrated if you're not drinking enough to replenish your fluids.
How to avoid dehydration
You can avoid dehydration by drinking water, wearing weather-appropriate clothes and taking breaks. Sip water or a sugar-free sports drink at regular intervals and avoid being outside during the hottest parts of the day. Check the temperature ahead of time and try to do as much in the shade as possible.
Believe it or not, with a prescription, you can use your FSA to prevent dehydration with electrolyte replacement drinks. But don't try to sneak in some fruit punch without authorization -- you'll need a prescription from the doctor for those to be eligible with your FSA. If you often work outside and find yourself getting dehydrated, tell your doctor and they may be willing to write a prescription.
Some first-aid kits also have electrolyte solutions, which you can dissolve in water to create your own drinks on the go. These are useful to keep in the car or bring with you if you're hiking or going on a long road trip.
No matter how you pack your kit, the important thing is to have one, and have it handy, with everyone in your family educated on how to use it in case of an emergency.
How to get ahead of dehydration
The good thing is that despite the extreme circumstances that can result from dehydration, relieving it can often be a simple process. Try to drink some water or a sports drink with electrolytes if possible. Find a cool place to sit or lie down. Take a break from whatever you're doing or stop for the day if possible.
If you're dehydrated, you could also be overheating. Use the same cold packs you'd put on a swollen knee or hurt back to cool yourself down. Popsicles or ice are also good for both dehydration and overheating.
If you're still struggling, feeling weak, dizzy or confused, seek immediate medical help. Anyone with a fever over 103 degrees should be immediately taken to a hospital.
You can use your FSA to cover a visit to urgent care, the emergency room or your primary care doctor. If they prescribe something or run tests to determine the severity of your dehydration, those will also be covered.
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, YouTube and Twitter.
Glasses and contacts are so commonplace, it's easy to forget that optometry is a medical issue. When you're prescribed eyewear by an eye doctor, you're essentially being prescribed medicine to treat a vision disorder. In the United States, over 61% of the adult population need some kind of corrective eyewear.
So how do eyewear expenses fit in with your FSA? Do contacts fall under the same rules? What about accessories and other related products? Read on for a few things you might want to know.
Most people know they can use their FSA card to purchase prescription glasses, but they might not be aware of one key fact - there's no limit on what kind of prescription glasses you can buy with an FSA.
All glasses are FSA-eligible, even if you buy $300 frames (yes, that includes those Gucci or Louis Vuittons you've had your eye on the last few months). As long as you're buying prescription glasses, you can use your FSA card to pay for them. You can also use your FSA to purchase eyeglass repair kits, for when those high-end frames inevitably get damaged.
Sunglasses are essential for protecting your vision while outdoors, but FSA eligibility surrounding sunglasses is complicated. If you're just buying regular sunglasses for personal use, you're not allowed to use an FSA.
Prescription sunglasses, however, are FSA-eligible. You may or may not need a prescription from your eye doctor to buy prescription sunglasses. As long as the glasses you buy help your vision, your FSA will likely cover them (when in doubt, always ask your FSA administrator for help).
Consumers who prefer to wear contacts instead of, or in addition to glasses can use their FSA to purchase contacts. Even if your vision insurance company doesn't cover contacts, you can still use your FSA to pay for them. Contact solution and contact lens cases are also FSA-eligible (and things you shouldn't overlook when going through those receipts for reimbursement).
Note: You can't use an FSA for color contacts that don't have any vision correcting qualities. So no, you probably won't be getting reimbursed from those party store expenses.
Reading glasses correct farsightedness, a problem that affects most adults after age 40. If you have to squint to read the words on this screen, chances are you need them too.
Reading glasses don't have to be as individually specific as regular glasses, so you don't need a prescription. You can buy them at grocery stores, drugstores or online. Reading glasses are also FSA-eligible, and you don't need a prescription to make them yours with FSA funds.
People who also have nearsighted issues need to buy bifocals, which address both types of eye problems. These glasses are often expensive, but your FSA can help offset the additional costs of this more-complicated eyewear.
Putting your FSA to work for better vision
Honestly, it's easy -- like any other eligible purchase, you can use your FSA card when buying contacts, glasses or prescription sunglasses from your optometrist, retail eye clinic or online store. (Need to find one? Well, stop looking.)
You can also pay for the item with your regular debit or credit card and then reimburse yourself from your FSA. No matter which option you choose, keep the receipt and upload it in a cloud or other virtual storage space. You'll want to have proof in case your FSA administrator questions the purchase.
New to FSAs? Need a refresher course in all things flex spending? Our Flex-Ed column gives you a dose of FSA Living 101, offering tips for making the most of your tax-free funds. Look for it every Thursday, exclusively on the FSAstore.com Learning Center.
With the rise of natural and organic remedies and the change in public perception surrounding cannabis, it's no surprise that CBD has become increasingly popular in the last few years. You'll see its benefits touted by everyone from professional athletes to the arthritic elderly, promoting it as a milder alternative to prescription pain medication.
But the legality surrounding CBD is still undefined by the IRS, which has implications for FSA eligibility. Regardless, here's what you might want to know about CBD (after speaking with your doctor, of course).
What is CBD?
CBD or cannabidiol is extracted from a specific variety of cannabis, usually hemp. Hemp plants contain little to no traces of THC, the psychoactive element found in marijuana.
A common misconception is that since CBD is related to marijuana, it will get you "high." But because most forms of commercial CBD have no THC in them, you won't feel that traditional sense of high after ingestion.
CBD is technically legal in all 50 states as long it's derived from hemp. THC-derived CBD is legal in the following states: Alabama, Georgia, Indiana, Iowa, Kansas, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee, Texas, Virginia, Wisconsin and Wyoming.
Of course, there are experts with more details on the subject. The National Organization for the Reform of Marijuana Laws (NORML) has more information on what CBD products are legal in your state.
What is CBD used for?
Proponents of CBD claim its benefits include reduced anxiety, inflammation, arthritis and overall pain relief. Unlike prescription medication, there are few adverse side effects from CBD. Patients generally cannot become addicted to CBD, which can make it preferable to traditional pain pills. In 2018, the FDA approved a CBD-based drug to treat seizures for people with a rare type of epilepsy.
CBD usually comes in a few different forms, including oil, tablets and creams. Many veterinarians even sell CBD products for animal anxiety.
Where to find CBD
You can find CBD products anywhere from gas stations to health food stores. Unfortunately, regulation of CBD products can be lax in many states, leading to questions about the quality and purity of individual products.
To find quality CBD products, some people suggest buying products manufactured in Colorado, where regulation is stricter. You can also look up a CBD product's certificate of authenticity to make sure it's been properly tested.
(Again, we're not medical professionals - always speak with your doctor before making any changes to your medical routine.)
So, can you use an FSA for CBD?
CBD products are probably not considered HSA- or FSA-eligible, though there hasn't been any formal guidance from the IRS on the matter. This is similar to medical marijuana, which is also not HSA or FSA-eligible even if you're taking it for a diagnosed disorder or to reduce the effects of chemotherapy.
While medical marijuana is legal in 33 states and the District of Columbia, including the 10 states where both recreational and medical marijuana are legal, it is not yet federally legal, and therefore not eligible for reimbursement. It appears that CBD products -- even if they're not derived from marijuana -- are being categorized similarly.
As of today, if you use your HSA for medical marijuana or CBD, you'll pay income tax and an extra 20% penalty on any forbidden distributions from your account. If you use an FSA, you'll likely be asked to pay back your account. Because of this, remember to always buy CBD products with your regular debit or credit card to avoid any confusion and penalties.
From FSA basics to the most specific account details, in our Asked and Answered column, our team gets to the bottom of your most-pressing flex spending questions. It appears on Wednesdays, exclusively on the FSAstore.com Learning Center. And for the latest info about your health and financial wellness, be sure to follow us on Facebook, Instagram and Twitter.
Most people think of using their HSA and FSA funds on medical treatment and material goods. That's usually the case, but medically eligible expenses can also include something a little more lively - namely, your service animal. If your furry friend is part of a medical treatment strategy, there's a good chance that some of your associated expenses will be eligible.
But as with many healthcare costs, there are certain requirements that must be met in order to use your HSA or FSA on a service animal. Before you go buy a new frisbee for Fido with your card, read below for the important details.
When it's okay to use FSA funds for service animals
A service animal provides necessary medical assistance, such as a seeing eye dog for the visually impaired or a pet that senses blood sugar changes in a diabetic. Service animals are legally recognized and protected against housing and business discrimination.
To use your HSA or FSA for a service animal, your medical professional typically has to write a Letter of Medical Necessity (LMN). This letter must show that you require an animal for your medical needs and that its primary function is for your health and not companionship.
What eligible items you can buy
According to the IRS, you can use your FSA for any expenses associated with your service animal, including food, training and veterinary costs. Costs paid for by the FSA must help the animal do its job. A harness that says "Service Dog" may be eligible, while a new doggie bed may not. You can also use your FSA to pay for a new service animal.
You can pay for those expenses directly with your FSA card, or use a different debit or credit card and reimburse yourself from your FSA. As with any expense, keep your receipt in case your FSA administrator requires documentation.
Does this apply to emotional support animals?
Emotional support animals (ESA) refer to two types of service animals - those that help people with a mental illness like anxiety or depression, and therapy or comfort animals that help people going through a hard time.
ESAs that help patients with PTSD or other mental illnesses may be HSA-eligible or FSA-eligible, especially if your doctor can write a LMN proving how the animal will help you more than medication or other forms of treatment.
Comfort or therapy animals are different. These are primarily animals that offer support to those in hospice, retirement homes or undergoing cancer treatment. If you care for an animal that you bring with you to a nursing home, you can't count it as an ESA or use tax-free funds to pay for its care.
The animal must be part of your own or a dependent's medical treatment, not anyone else's. It would be like paying for a friend's prescription with your FSA.
From FSA basics to the most specific account details, in our weekly Asked and Answered column, our team gets to the bottom of your most-pressing flex spending questions. It appears every Wednesday, exclusively on the FSAstore.com Learning Center. And for the latest info about your health and financial wellness, be sure to follow us on Facebook, Instagram and Twitter.
Kids are awesome. But that awesomeness can be expensive. A 2018 report found that raising a child until age 18 will cost $233,610. Thankfully, you have roughly 18-26 years to balance those payments. But be ready -- some of the biggest expenses come early, starting with childcare.
Since most parents work these days, childcare isn't just a "nice to have" anymore -- it's a necessity. Daycare can run up to $1,000 a month, depending on where you live. But we're not here to point out problems, so let's get to a potential solution for offsetting those costs.
Our old friend, the dependent care FSA
Like a traditional FSA, a dependent care FSA is sponsored by your employer who will automatically withhold contributions from your paycheck. But, unlike a traditional FSA or HSA, you have to pay for the expenses with your regular checking account or credit card and then apply for reimbursement through the proper procedure.
If you choose to go this route, you'll enjoy a $5,000 annual contribution limit for parents/guardians married or filing jointly and $2,500 per person if married and filing seperately. But budget smart -- like a traditional FSA, you can only use the funds within the contribution year or deadline extension period if applicable.
If you saved $2,500 in 2018, you have to use that money in 2018. It won't roll over to the next year. For most parents, this is simple because they can easily estimate their childcare costs throughout the year.
But childcare goes beyond daycare. In addition to standard costs, your dependent care FSA can also cover some lesser-known expenses that come with raising children.
Work doesn't always end when school does. Meaning parents have to find other ways to care for their kids before punching out for the day. The cost of after-school care is reimbursable. The only "catch" is that the primary purpose has to be for the care of the child and not for education.
In other words, don't try passing off the piano teacher or math tutor as an "after-school caretaker." It's not the same thing.
If there aren't organized after-school care programs available, the cost of a babysitter, in or out of the home, is reimbursable. The cost of the babysitter must be for taking care of a child while you're working, not for personal reasons like a party or a dinner date.
One nice touch is that generally, amounts paid to a relative for qualified child care are reimbursable. Of course, exceptions apply, but as long as your child is being cared for by a qualified adult, money spent for this purpose is generally eligible.
The cost of day camp, including specialized day camp (soccer camp, art camp, etc.) is also reimbursable. And, when provided by the caregiver, the cost of transporting the qualifying person to and from the care location is also eligible for reimbursement.
But this is just for day camp -- overnight or sleepaway camps aren't eligible, even if they're serving the same purpose during your workday.
This might be the biggest boost for parents looking to enter (or re-enter) the workforce. If you're going on job interviews, the costs are reimbursable, as long as the following conditions are met:
- The person looking for work must have earned SOME income for the year.
- If married, the other spouse must be gainfully employed, looking for work, a full-time student or mentally or physically incapable of self-care.
Dependent care FSAs are a big win for people with childcare expenses. Not only do they give parents or guardians a little more freedom to do their jobs without worrying about childcare expenses, but they could potentially save them hundreds (or even thousands) in taxes when used the right way.
Please note, administrators may have specific requirements as to when an expense will be qualified and covered, and in call cases they should speak with their dependent care FSA administrator before electing and/or using their funds.
Whether you budget week-to-week, or plan to use your FSA for bigger things, our weekly Real Money column will help you maximize your flex spending dollars. Look for it every Tuesday, exclusively on the FSAstore.com Learning Center. And for the latest info about your health and financial wellness, be sure to follow us on Facebook, Instagram and Twitter.
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.