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Using your FSA or HSA to pay for fertility testing and treatment

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

Key takeaways

  • HSAs and FSAs cover qualified medical expenses that are related to the prevention, treatment, or diagnosis of a condition, physical disability, or mental illness.
  • Both HSAs and FSAs are tax-advantaged accounts, allowing the owner to save some money on healthcare spending.
  • FSA funding does not rollover, and must be used by the deadline — the end of the year (December 31), or March 15 for those with an extension.

What is an HSA or FSA?

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)

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.

Health savings accounts (HSAs)

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.

What fertility testing and treatments are FSA- or HSA-eligible?

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.   

Using an FSA or HSA to pay for care

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.

  • Paying directly with FSA or HSA funds: Your FSA or HSA may come with an associated debit card. FSA/HSA cards have made it easy to buy eligible healthcare products and services in-store and online.
  • Reimbursement: If you purchase qualifying products and services with a personal credit or debit card, you can submit your receipts to your plan’s administrator to receive 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.

Does insurance cover fertility testing or treatment?

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’s FSA- and HSA-eligible services

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 for more information.

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