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Confused by the health insurance alphabet soup? Don’t worry. In this article, we’ll break down everything you need to know about FSAs, HSAs, and how to check your coverage for common fertility testing and treatment services like sperm testing, in vitro fertilization, and sperm freezing.
Perhaps you remember seeing the terms “HSA” or “FSA” while you were signing up for your health insurance or looking into payment options for a healthcare service, but you don’t exactly remember what they are or what they stand for. Let’s get some definitions sorted first.
Flexible spending accounts (FSAs), also sometimes referred to as flexible spending arrangements, are accounts into which you deposit money from your paycheck. You can then use this money to pay for certain out-of-pocket healthcare expenses. One benefit of FSAs is that the money put into these accounts are not taxed, saving you some money. You can deposit up to $3,050 of untaxed income into your FSA account.
Depending on where you work, some employers may also contribute to your FSA as an added benefit. Generally speaking, there’s a cap of $500 for employer FSA contributions. That means you could have up to $3,550 in your FSA by the end of the year.
The money in FSAs can be used to pay for a range of expenses including deductibles, copayments, prescription and over-the-counter medications, medical equipment, and dental expenses. You cannot, however, use FSA funds to pay for insurance premiums.
Similarly, health savings accounts (HSAs) are savings accounts in which the contributions are not taxed and can be used to cover a range of approved medical expenses. Paying deductibles, copayments, coinsurance, and other medical purchases with an HSA can lower your healthcare costs.
Only individuals with a high deductible health plan (HDHP) — generally considered health plans (including a Marketplace plan) that only cover preventive services before the deductible — are eligible to contribute funds to an HSA.
The maximum contribution for individuals is $3,650 annually and up to $7,300 for those who have children or partners on their health plan.
Fertility testing and treatments include a range of technologies and procedures that are used to diagnose infertility and aid conception. These include:
Many fertility tests and treatments — including those listed above — are eligible to be paid for or reimbursed from an FSA or HSA, according to the Internal Revenue Service (IRS). These services must be directly attributed to the account holder or a qualified dependent, and may require documentation from a healthcare provider.
You usually sign up for an FSA once a year during open enrollment. During this time, you may estimate your healthcare expenses for the upcoming year and decide on the amount you would like to deposit into the account. With FSAs, the total amount is available on day one, even though the payments are withheld from your paychecks throughout the year.
There are two ways to use your FSA: pay for services with accounts funds directly, or pay for services on your own and submit receipts for reimbursement.
The funds in an FSA are typically “use it your lose it.” The deadline to spend the funds in your FSA is the end of the year (December 31), or by March 15 of the following year if your account has a grace period. After this time, all unused funds are returned to your employer; FSAs do not rollover. You should confirm with your employer to confirm if your FSA has a grace period, and if so, what the deadline is to use the funds, so that you don’t lose any money.
The funds in an HSA, on the other hand, roll over each year if they are not used, and collect interest.
Coverage for fertility-related care varies widely among insurance plans, especially from state to state. In some states, larger employers are required to cover IVF or even fertility preservation, such as sperm freezing, in the case of certain diagnoses. Learn more about fertility insurance coverage in the US.
The best way to understand whether your insurance plan covers fertility care is to look at your explanation of benefits (EOB) or contact your plan administrator. Your EOB should specify exactly which fertility tests or treatments are covered — some plans cover only the testing required to get a diagnosis of infertility, some cover certain types of care (such as IUI or medication), and some cover everything, including IVF or cryopreservation.
Some employers may provide fertility-related coverage separately, through a fertility benefits provider such as Carrot, Progyny, or WINFertility. The best way to know if you have access to these benefits is to contact your HR department.
Legacy offers a range of at-home testing and freezing options, including:
Sperm testing, STI testing, sperm freezing, and temporary frozen sperm storage may be FSA- and HSA- eligible.
You can use your FSA/HSA card at checkout to pay for your kit or file for reimbursement with your plan provider. We can provide an itemized receipt for reimbursement. Contact email@example.com for more information.
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