FSA

Like many Americans, I choose to participate in a Medical Flex Spending Account program offered through my employer. This allows me to set aside a certain amount of money each year that is excluded as taxable income and can be used on eligible health related expenditures.

Until recently, the caveat of such a program was that any unused funds did not carry over from year to year. So it was truly a “use it or lose it” system. This meant that during the last month of my plan year I would spend days scouring the FSA literature for eligible expenses so as not to see my paycheck garnished in vain.

The IRS provides a detailed list as to what is considered an “eligible medical expense” and what is not. While glancing through this list, I found some rather peculiar entries:

Breast pump (for a lactating woman) – This particular entry seem to carry an unnecessary classification. I can certainly understand excluding the purchase of such a device for, say, a non-lactating man; but as the purchase required no other documentation I was unsure exactly how the confirmation process worked.  

Dancing lessons (for treatment of a medical condition) – The site was unclear on the nature of qualifying medical conditions or the type of dance instruction covered. For instance, Waltzing for West Nile might be perfectly acceptable while Stanky-legg for Psoriasis could require a special exception.  Either way, if embarrassing my wife on the dance floor is a medical condition I am pretty sure I could get 100% reimbursement.

Does Not Cover Illegal operations or substances – I felt like this was a good catch-all parameter for the FSA program. It was very considerate of them to clarify this up front in case your heroin dealer just got an updated point-of-sale system and could now take your FSA MasterCard.

Listening therapy – I am not sure what this is, but I do know that it is covered and that it is in my best interest that my wife never finds out. I can only hope that the course is available on audiobook…

Swimming lessons (for treatment of a medical condition) – It remained unclear whether or not “inability to swim” was classified as a medical condition although “hydrophobia” generally covers a fear of drowning. This has always been confusing to me since “phobias” are defined as “irrational fears” and to my knowledge no one has been revived on the side of a pool only to request that they be thrown back in so that they can “get another taste of that action.”

Dyslexia treatment (requires a letter) – I can only assume that our Federal Government is not cruel enough to require the patient to author and submit said letter. If I found myself in that position I would probably overthink it and worry that if the letter was correctly worded and free of errors, they would suspect I did not suffer from the condition I sought treatment for. On the other hand, if the letter was malformed in some way, they might reject my reimbursement based on the incomprehensibility of my letter.

Magnetic therapy (over-the-counter) – While I am unfamiliar with this particular line of treatment; I could not help but wonder what differentiates “over-the-counter” magnetic therapy from “prescription strength” magnetic therapy? Is it considered prescription strength when you are asked to remove your credit cards or only if your pacemaker stops? To be fair, coverage does require a letter.