USE IT OR LOSE IT!

Your Year-End Guide: All the Smart Ways to Use Your FSA/HSA Dollars

We are closing in on the end of the year and this is your nudge to log in to your medical savings accounts and look at your current balances, plan how to best spend those dollars and plan for next year's contributions. Reminder: FSA=Flexible Savings Account - these funds can disappear if not used, and HSA=Health Savings Account - acts like a savings account when not spent.

***2025 quick facts: Health FSA contribution limit is $3,300. If your plan allows carryover, you can roll up to $660 to the next plan year; otherwise, unused dollars are typically forfeited. HSAs roll over indefinitely. Always check your plan’s rules. (IRS)

Fast Checklist: Eligible Services & Appointments

• Chiropractic care:) You can use your HSA/FSA card in our office.

• Physical therapy, acupuncture (exam, treatment, and copays). (IRS)

• Dental: cleanings, fillings, crowns, periodontal care, orthodontia (including ongoing treatment plans, aka: braces). (IRS)

• Vision: eye exams, prescription glasses/sunglasses, contact lenses and supplies (saline, cleaners). (IRS)

• Mental health: psychologist/therapist visits. (IRS)

• Telehealth visits, lab tests, vaccinations and flu shots. (IRS)

At-Home Medical Devices & Supplies

• Orthotics & insoles (custom and OTC). (FSA Store)

• Braces/supports, slings, crutches, durable medical equipment, TRACTION BLOCKS! (FSA Store)

• TENS units and replacement pads. (FSA Store)

• CPAP machines & supplies (masks, tubing, filters, wipes). (FSA Store)

• Breast pumps & lactation supplies. (IRS)

• First-aid essentials (bandages, hot/cold packs), and PPE (masks, sanitizer, wipes). (IRS)

• Work at home accessories: Sit and Stand Desk, Ergonomic Chairs etc **we can provide a LMN if necessary.

Medications & Over-the-Counter (No Prescription Needed)

Thanks to federal changes, most OTC medicines are eligible without a prescription (pain relievers, allergy/cold meds, heartburn meds, acne treatments, etc.), and menstrual care products are eligible. (FSAFEDS)

• Smoking cessation: programs are eligible; OTC nicotine aids are generally covered (check plan notes). (FSA Store)

Women’s, Prenatal & Family Planning

• Menstrual care products. (FSAFEDS)

• Pregnancy tests & ovulation kits; prenatal vitamins (prenatal-specific). (IRS)

• Condoms. (IRS)

Skin, Sun & Eye Care (Often Forgotten)

• Broad-spectrum SPF 15+ sunscreen (including SPF lip balm and moisturizers that meet SPF criteria). (GoodRx)

• Backup prescription glasses or an extra box of contact lenses before year-end. (IRS)

Sleep & Respiratory

• CPAP/APAP devices, humidifiers used with CPAP, replacement supplies; Oxygen equipment when medically necessary. (FSA Store)

Travel & Getting to Care

• Transportation for medical care (including mileage at the IRS medical rate), parking, and tolls. Keep a mileage log/receipts. (IRS)

“Think Outside the Box” — Commonly Missed Uses

• Compression socks (medical-grade; plan may require Rx/LMN for higher compression). (FSA Store) ***If you frequently travel or having swelling in the ankles, I highly recommend compression socks.

• Posture supports/braces, kinesiology tape, foam rollers, hot/cold therapy packs used for a diagnosed condition (LMN may apply). (FSA Store) ***Yes, traction blocks do fall in this category.

• Massage therapy for treatment of a diagnosed condition (LMN). (FSA Store) ***I have a great massage therapist!

• Weight-loss programs when prescribed to treat a specific disease (e.g., obesity, hypertension)—not general fitness. (IRS)

• Stop-smoking programs (program fees are eligible; OTC nicotine meds may be covered per plan). (IRS)

• Service animals (including food, vet care) for qualifying disabilities. (IRS) ***DID YOU KNOW THIS???

• Capital/home modifications for medical needs (e.g., grab bars, ramps)—special rules apply; talk to your tax pro. (IRS)

• SUPPLEMENTS: Sometimes can be covered, depends on FSA and HSA rules.

Quick Tips to Avoid Forfeiting Funds

1. Book care now: November is a great time to annually schedule all of your Annual Exams: your physical, your teeth cleaning, getting your eyes checked etc. ***Its my birthday month, so it is easy for me to remember I am a year older and need to "do all of the things" :) Dermatologist, Gyno, blood work etc.

2. Stock up on eligible supplies you’ll use anyway (contacts, CPAP filters, bandages, sunscreen). (IRS)

3. Know your plan’s deadline and whether it offers a grace period or carryover (up to $660 if allowed). (IRS)

4. REMEMBER TO SAVE ALL OF YOUR DOCUMENTATION: ALL OF YOUR PAYMENT SLIPS AND RECEIPTS. (FSAFEDS) **I keep all of my receipts and file them in an accordion under Medical. However, I am training myself to take PICTURES of the receipts and I have a folder on my iphone NOTES, where I also store them and quickly tally them for my accountant at the end of the year.

For our AFCAZ Nerdy friends who would like to deep dive some more, check these out

• IRS Publication 502: what counts as medical care (last reviewed Dec 12, 2024). (IRS)

• IRS update on PPE (masks, sanitizer, wipes) as medical expenses. (GovDelivery)

• FSAFEDS eligible expenses & LMN guidance. (FSAFEDS)

• Orthodontia, CPAP, orthotics/TENS/compression socks consumer eligibility resources. (FSAFEDS)

• 2025 limits & carryover reminder. (IRS)

Small print

⚠️ Every plan can set its own documentation rules. Items marked LMN may require a Letter of Medical Necessity from one of your clinicians or myself for FSA/HSA reimbursement. (FSAFEDS

This guide follows federal rules (IRC §213(d)) but your plan’s SPD/administrator controls reimbursement. Some items require a prescription or LMN, and cosmetic/general-wellness items are typically excluded. (IRS)

~ Dr. C