Millions of people participate in weight-loss programs every year, and many seek ways to offset the costs. A Flexible Spending Account (FSA), Health Savings Account (HSA), or Health Reimbursement Arrangement (HRA) can be used to pay for certain health care, vision, and dental costs. This article explores the eligibility of various weight loss products and services under these accounts.
Understanding FSAs, HSAs, and HRAs
- Health Reimbursement Arrangement (HRA): You can use your HRA to pay for eligible medical, dental, or vision expenses for yourself or your dependents enrolled in the HRA. Your employer determines which health care expenses are eligible under your HRA.
- Flexible Spending Account (FSA): A flexible spending account (FSA) can help you save money on healthcare expenses for you and your family.
Both FSAs (Flexible Savings Accounts) and HSAs (Health Savings Accounts) allow you to set aside pre-taxed dollars from your paycheck to use for eligible medical expenses. You could save an average of 30 percent based on state and federal tax rates.
Weight Loss Programs and FSA/HSA Eligibility
Weight-loss programs should have a long run focus to ensure you keep the weight off for good. While it is best to focus on diet and exercise, these changes can be supplemented with drugs. Commercial programs offer advice on diet and exercise regimens as well as provide online tools for tracking your weight and food consumption. Some even sell prepared foods and diet aids. Clinical programs are typically provided through a doctor's office or hospital clinic. They offer a more comprehensive program including diet, exercise, and behavior-modification.
WeightWatchers
You may be eligible for up to 100% reimbursement on your WeightWatchers membership with FSA/HSA funds. Benefits include saving money by using pre-tax dollars and the potential for full reimbursement of eligible expenses.
What may be eligible for reimbursement:
- Any WeightWatchers membership costs, including access to the app and Workshops
- Registered dietitian visits
Steps for Reimbursement:
- Sign up for WeightWatchers.
- Check with your insurance provider.
- Get a copy of your receipt through the WeightWatchers app (Settings > Billings).
- Submit your receipt and a letter of medical necessity (if required) to your FSA/HSA provider.
A letter of medical necessity from your doctor that recommends weight loss for a specific condition (including but not limited to obesity, overweight, hypertension, or heart disease) may be required for reimbursement of Points and Workshops memberships. Check with your provider for specific requirements.
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Prescription Weight Loss Medication
The full amount of your GLP-1 injectable or oral weight loss medication kit is considered a medical expense eligible for reimbursement through your FSA (Flexible Savings Account) and HSA (Health Savings Account).
GLP-1 injections: Personalized treatment plans with GLP-1 injections taken daily or weekly to help you lose weight.
Oral Medication Kits: Custom oral medication treatment, taken daily to help curb cravings and suppress your appetite.
General FSA/HSA Eligibility Guidelines
The IRS rules surrounding LMNs are complex and limited to individual facts and circumstances. Qualified medical expenses (QMEs) are designated by the IRS and include medical, dental, vision, and prescription expenses. QMEs are subject to change by the IRS at any time. It is the member's responsibility to verify that expenses incurred are designated by the IRS and by the plan sponsor as a QME.
Common FSA Eligible Items (Alphabetical List)
- Acupressure: Eligible; may require a Letter of Medical Necessity (LMN) in some cases.
- Acupressure mat: Eligible
- Acne medicine: Eligible
- Alcoholism and drug abuse - Medical expenses paid to a treatment center for alcohol or drug abuse are reimbursable.
- Alcoholism treatment: Eligible; some administrators may require a Letter of Medical Necessity (LMN).
- Allergy medicine: Eligible
- Aloe Vera creams and ointments: May be eligible with a Letter of Medical Necessity (LMN).
- Alternative healer: Eligible (provided the service is eligible). Some benefits administrators may require documentation to support that treatment from the alternative healer was primarily used to treat a specific medical condition.
- Alternative treatment: Eligible. Some benefits administrators may require documentation to support that treatment from the alternative healer was primarily for the treatment of a specific medical condition and not for general health.
- Ambulance and emergency room: Eligible, including air lifts and flights to hospitals.
- Analgesics (painkillers): Eligible
- Anesthesia: Eligible
- Ankle braces: Eligible
- Anti-bacterial hand sanitizer to prevent COVID-19 (with at least 60% alcohol): Eligible.
- Anti-diarrheal medicines: Eligible.
- Anti-embolism socks: Eligible if used to treat a medical condition; may require a Letter of Medical Necessity (LMN).
- Anti-fungal treatment: Eligible
- Anti-gas medicine: Eligible
- Anti-inflammatory treatments: Eligible
- Anti-itch cream or lotion: Eligible
- Anti-Snore Guards: Eligible
- Antibiotic ointments: Eligible
- Antibiotics: Eligible with a prescription.
- Antidepressants: Eligible with a prescription.
- Antihistamines: Eligible as over-the-counter (OTC) medicines.
- Antipyretics: Eligible as over-the-counter (OTC) medicines.
- Antiseptics: Eligible
- Arch support: Eligible
- Arm sling: Eligible
- Arthritis glove: Eligible
- Arthritis medicines: Eligible
- Artificial insemination: Eligible
- Artificial limb: Eligible
- Artificial reproduction: Eligible
- Artificial teeth: Eligible, unless for a cosmetic purpose.
- Aspirin: Eligible as an over-the-counter (OTC) item.
- Asthma medicine: Eligible with a prescription.
- Asthma oxygen flow monitor: Eligible
- At-Home COVID-19 Test: Eligible, provided the full cost has not been covered by a health plan.
- At-home drug test: Eligible
- Athletic bandages and braces: Eligible
- Athletic mouth guards: Eligible
- Athletic tape: Eligible
- Athletic treatments: Eligible, such as braces, bandages, etc.
- An automated external defibrillator (AED): Eligible
Limitations and Exclusions
- Cosmetic Procedures: Medical expenses for cosmetic procedures are reimbursable only if the procedure is necessary to improve a deformity arising from, or directly related to, a congenital abnormality, a personal injury resulting from an accident or trauma, or a disfiguring disease. However, medical expenses paid for other cosmetic procedures are not deductible medical expenses under Code Section 213(d), and thus are not reimbursable. This applies to any procedure that is directed at improving the patient's appearance and does not meaningfully promote the proper function of the body or prevent or treat illness or disease. For example, face lifts, hair transplants, hair removal (electrolysis), liposuction, teeth bleaching and dental veneers are generally not deductible.
- Clothing: The cost of clothing - even if prescribed - that substitutes for normal clothing is not deductible.
- COBRA premiums: COBRA premiums that you pay for yourself or your eligible dependents are not reimbursable under a Health FSA. However, COBRA premiums are reimbursable under an HSA, and may be reimbursable under an HRA. Your employer determines which health care expenses are eligible under an HRA.
- Conference: Amounts paid by an individual for admission and transportation expenses to a medical conference relating to the chronic disease of the individual or individual's eligible dependent are deductible if the costs are primarily for and essential to the medical care of the chronic disease. The cost of meals and lodging while attending the conference are not deductible as medical expenses.
- Herbs: The cost of herbs taken for general well-being are not reimbursable. However, the cost of herbs taken to alleviate a specific medical condition are reimbursable.
- Household help: The cost of household help, even if recommended by a doctor, is prohibited. However, certain expenses paid to an attendant providing nursing-type services are reimbursable.
- Insurance premiums: Premiums for any health plan are not reimbursable under a Health Care FSA.
- Marriage counseling: Expenses for marriage counseling services do not qualify as medical expenses.
- Personal use items: Items that are ordinarily used for personal, living, and family purposes are not reimbursable unless they are used primarily to prevent or alleviate a physical or intellectual disability or illness. For example, the cost of a wig purchased for the mental health of a patient who has lost all of his or her hair from disease is reimbursable.
Navigating FSA/HSA Reimbursement
- Check Eligibility: Always verify that expenses are designated by the IRS and the plan sponsor as Qualified Medical Expenses (QMEs).
- Letter of Medical Necessity (LMN): Some items and services may require an LMN from a medical professional for reimbursement.
- Documentation: Keep detailed records and receipts of all expenses.
- Plan Guidelines: Adhere to the guidelines and terms/conditions of your specific FSA/HSA plan.
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