Concierge physicians office, with regular blood test, covid test, sick visits, skin checks, and diet and nutrition advice. All of these things can be paid for using a benefit many companies offer, the Flexible Spending Account. This is an employer sponsored benefit that many people do not take full advantage of.
In the US, the IRS allows employers to offer an FSA to employees as a way to help provide for medical coverage. They can be used to “reimburse you for qualified medical expenses you incurred during the period of coverage.” The key is to understand what is considered a “qualified medical expense”. Not surprisingly, many personal health and wellness trackers qualify.
Tools that help monitor your health and are offered over the counter can be paid for entirely out of his account. That does not make them free, since you still have to fund an FSA. Instead the FSA is funded with money that is not taxed, so in effect you can get these trackers at a a discount that is equal to your marginal tax rate which can be up to 37%. That means all these products and services suddenly can be had for almost half price!
What Should I Spend My FSA On?
The official list of what you can spend an FSA on is buried within some hard to decipher IRS documents (link). At the end of the day the list is just a set of guidelines and the interpretation is mostly left up to individual plan providers to determine what they will reimburse. Amazon has an entire portion of the store dedicated to pre-approved products for which it will automatically accept an FSA debit card (note, that this site is supported by commissions on this and other similar links).
A complete list spans everything from baby products to connected smart devices. Generally though all of these things have a single thing in common, they are designed to help with your health. Sadly though, this description does not apply as you would interpret as some items that are very clearly designed to help with health still are not covered. If you are spending your FSA though, it is best to focus on services and products that:
- Take advantage of preventive care services: One of the best ways to use a flexible spending account to improve your health is to take advantage of preventive care services. These services can be used to identify and prevent potential health problems before they become serious. Depending on your specific plan, preventive care services may include physicals, vaccinations, and other screenings.
- Stock up on necessary medical supplies. With a flexible spending account, you can purchase necessary medical supplies that can help you maintain your health. This includes items like bandages, braces, gauze, and other supplies. It can also include over–the–counter medications and vitamins that are recommended for your specific health needs.
- Invest in alternative therapies: Depending on the type of flexible spending account you have, you may be able to use your funds to invest in alternative therapies that can help improve your health. This could include acupuncture, massage, and other forms of alternative medicine.
- Seek professional help: A flexible spending account can also be used to seek professional help from a doctor or therapist. You can use your funds to pay for doctor appointments, physical therapy sessions, and other professional services that can help you improve your health.
- Purchase health and exercise equipment that is covered. Not everything counts, but there are a number of fitness type products that fall within FSA guidelines.
Is an FSA Use It or Lose It?
Yes, by default you should consider the money in your FSA to be use it or lose it. That said, there are some limitations to this. The IRS forms note that:
A health FSA may allow participants to carry over unused benefits from a plan year (to one more year).
A health FSA may extend the grace period for using unused benefits for a plan year after the end of the plan year.IRS – Unused FSA
A health FSA may allow an individual who ceases participation in a health FSA during calendar year to continue to receive reimbursements.
If you are reading this and wondering, “Hey, that’s not clear”. We agree. The best way to solve this is to actually read the fine print of you plan to see how it interprets the rules. Generally speaking though at least a majority of your FSA dollars will expire worthless within a few months of your plan year end, and all of your dollars will expire after twelve months.
Spend your FSA money to improve your health!
There are dozens of interventions that can be preventive, but are often forgotten about. One of the best resolutions we’ve heard of when it comes to improving your health is to actually invest in it. Many people focus on the behavioral changes required, but sometimes the mental aspect of spending a few dollars can be the push to make sure those changes stick. Forward had helped me lower my blood pressure, Cue Health can be paid for with and FSA and used to learn about Covid status or get access to a doctor.
There are limits to how much you can fund an FSA with. That was $2750 for the year 2021 but has since increased to $3050 for 2023. That money can go a long ways. Let’s look at some areas where you can spend that money to see how much it can be used to improve your health. Of course, if you have doctor’s bills, those are almost always able to be reimbursed from the account. But for now we’ll assume you have avoided the doctor and their bills and just want to pro actively spend your FSA on improving your health and understanding of your body. I am not a lawyer or an accountant, so always do your own research and confirm coverage and reimbursements of your exact situation.
Using a flexible spending account the right way can make a big difference in your wellness goals.
Blood Pressure Cuff
If you have any reason to track your vital statistics, and we all do, a simple blood pressure cuff is refundable under an FSA. This is a great device to have in the house, along with other staples like a thermometer, a pulse oximeter, otoscope (ear checker!), and a first aid kit. All of these also typically fall under the definitions covered by the guidelines for FSA eligible expenses. Especially if you have a remaining balance in your account, which expires annually, picking up these staples beats losing the money. You can always load up on these one time, or just stock up on common non-perishable covered items like bandages.
Connected Scales
Just like the above, scales very often fit the definition of eligible FSA products. Especially easy to justify are those that track multiple readings (heart rate, body fat) that further support their medical rationale.
Technically most basic scales would have to also be medically required, which might mean discussing a weight management plan with your doctor. For most adults this should be a part of a standard discussion since even if you are a healthy weight, big sudden changes can indicate a number of issues so it’s good to have a sense of things outside of the doctors office.
Food Sensitivity and Allergy Tests
Over the counter available allergy and genetic screenings also are FSA eligible (always check to verify!). Most of them are at home kits that make you spit in a tube, or use an included finger prick to take a simple blood sample, which is then sent to a lab. The results get delivered a few weeks later and can be eye opening. Friends who have also taken one of the allergy tests have been thrilled at the results as they can often uncover unknown food sensitivities.
Removing simple foods with high reaction can drastically change how you feel day to day. Sadly this might mean altering some of your favorite dishes, say you are a fan of Italian food but trying to cut out garlic! Even so, eliminating the food is not required but knowing the sensitivity can help you determine when and how much to have and plan for the results.