A flexible spending account, or FSA, allows individuals to pay for eligible expenses with pre-tax dollars. Certain items, like a medically necessary adjustable overbed table, may require a letter of medical necessity from your doctor in order to be eligible for reimbursement.
Accessibility products and those that support the healthy function of the body are usually considered medically necessary when they help patients with ALS, MS, arthritis, surgery recovery, or mobility issues. However, because these products can be purchased by anyone, FSA programs consider them dual-purpose items, which are reimbursable if the individual provides the necessary documentation.
What Expenses Are Eligible for FSA Reimbursement?
The rules that determine what is an eligible expense for your specific FSA plan are a combination of IRS requirements and your employer-specific conditions. For exact answers, always contact your plan provider with your questions.
In general, an HSA or FSA plan will cover expenses like:
- Medical care
- Co-pays and deductibles
- Services that diagnose or prevent a disease or illness
- Products that cure, mitigate, or treat an existing medical condition like blood pressure monitors
- Prescription drugs and medications, including those for pain relief or cold and allergy symptoms
- Transportation exclusively for health care
FSA funds may not be used to cover items an individual would have purchased whether they had a medical condition or not—like bedsheets. Contact lenses may or may not be covered, depending on your plan.
What Is a Dual-Purpose Item?
Dual-purpose medical expenses are those items that promote general wellness and health for everyone but are also used to treat specific medical conditions. These types of items may be covered by your FSA with a letter of medical necessity when a doctor suggests them:
- Vitamins or minerals
- Nutritional supplements
- Chiropractic care
- Massage therapy
- Durable Medical Equipment
Over-the-counter medications can be covered by FSA if the doctor writes a prescription for them. Insulin does not require a prescription for reimbursement if purchased over the counter, and it is covered for those with diabetes under IRS Code Section 213(d).
What Is a Letter of Medical Necessity?
In order for dual-purpose items like overbed tables to be qualifying medical expenses, a letter of medical necessity (LMN) is required when submitting the receipt and expense paperwork. This letter follows a specific format and outlines the following:
- The specific medical condition creating the necessity
- A description of the treatment plan, including frequency and dosage if applicable
- The length of time the item or expense will be needed
For example, your doctor might provide you an LMN for an overbed table if you:
- have limited mobility, and will state the underlying issue
- describe that the overbed table will help prevent falls, improve quality of life, etc.
- identify the length of time your mobility will be limited
Submitting a Dual-Purpose Expense for Reimbursement
Submitting an expense for assistive devices and equipment is easy. There will be a standard claim form for your FSA provider, and the LMN is submitted along with the receipt as usual. Depending on your plan, you might have your payment within a week, but contact your provider for details and additional information.
Many patients with mobility issues can benefit from a convenient overbed table at home, just like the ones in the hospital but with even more features for recovering, working in bed, or helping to prevent falls. The atHand® Overbed Table System is an eligible dual-purpose item with a doctor’s recommendation, letting you enjoy integrated electrical and USB outlets, LED lighting, and complete adjustability while you rest or recover.