A Simple Guide to Using Your HSA/FSA for Vitamins and Supplements

What’s the difference between FSA and HSA coverage?

Flexible spending accounts (FSAs) and health savings accounts (HSAs) both allow you to use pre-tax dollars to pay for healthcare-related expenses. Both can be used for doctor visits, prescriptions, coinsurance, first aid monitoring supplies, over-the-counter medications, feminine hygiene products, massages and chiropractic visits, glasses and contact lenses, fertility and maternity treatments, children’s healthcare expenses, and so on. You get the idea. Beyond that, though, some differences emerge.

How does FSA coverage work?

FSAs are available only through employers; you can’t sign up for one as an individual. In other respects, they’re quite similar to HSAs. Here are the essentials to know:

• FSAs have contribution limits – in 2022, that meant you could contribute up to $2,850 to an FSA.
• You typically can’t carry the money over into a new year; this is a key difference between FSAs and HSAs. Sometimes employers will select a rollover option, though. Check with your employer about the particulars of your plan.
• Your FSA funds come out of your paycheck pre-tax. FSAs are typically pre-funded, however, which means that the full contribution amount that you’ve selected will be available from the start of the year.
• Employers are allowed to contribute, but the majority of them will not.

How does HSA coverage work?

HSAs are only available to those of us who have what’s called a high-deductible health plan (HDHP). To give you a frame of reference: In the year 2022, such an HDHP would be any plan with a $1,400 deductible for an individual or $2,800 for a family; maximum out-of-pocket spending for these plans would be $7,050 and $14,100, respectively. If you have such a plan – and it’s your only plan – you’re eligible for an HSA. (You can’t be eligible for Medicare or claimed as a dependent on someone’s tax return.) Here are some of the other essentials to know about HSA coverage:

• You can take an HSA with you even if you get a new job.
• Your HSA will have a contribution limit – in 2022, that meant that folks with individual health insurance could allocate up to $3,650 to their HSA, while folks with family coverage could allocate up to $7,300.
• The contributions you make to an HSA are pre-tax or tax-deductible.
• HSA funds roll over into the next year.
• If you’re an HSA-holder, you may not spend more than the funds that you’ve deducted from your paycheck. However, you can file for a reimbursement later in the year.
• As with a 401(k) plan, many employers offer to contribute to HSAs, which can help you cover those higher deductibles or go toward future costs.

What makes a vitamin eligible?

FSA and HSAs won’t cover a vitamin supplement geared toward general health and wellness. A vitamin is eligible for coverage by an FSA or HSA only if that vitamin has been recommended by a medical professional for the treatment or prevention of a specific disease or condition.

While prescriptions are not strictly required, it’s a good idea to get your doctor’s recommendation in writing.

Which vitamins are HSA and FSA covered?

If a vitamin is prescribed to you for a specific medical condition, that vitamin may be eligible for HSA/FSA coverage. If you’re buying a vitamin over-the-counter to promote general wellness, it’s unlikely that that vitamin will be covered.

Prenatal vitamins can sometimes be an exception to this rule. Here at Care/of our Prenatal is eligible for FSA/HSA/HRA reimbursement. While they’re available over-the-counter and not designed to treat a specific condition, they’re still helpful for the health of pregnant people and fetal development. If you want to have coverage for your prenatal vitamins, it’s still best to get a letter from your healthcare provider.

You want to be careful when trying to buy vitamins with your FSA or HSA. They are not always deemed a qualified expense. If your vitamins are not prescribed by a doctor or used to treat a specific condition, your purchase most likely won’t be FSA or HSA eligible.

HSA/FSA coverage for prenatal vitamins

HSA/FSA coverage is often available for prenatal vitamins. You can use your card as a form of payment or submit a receipt of your purchase for reimbursement.

To be safe, your healthcare provider can write you a prescription for prenatal vitamins. You can also find FSA- and HSA-eligible items by checking prenatal vitamin labels. It’s important to contact your account administrator to be sure your purchase qualifies.

When you need a letter of medical necessity

There may be times when the HSA or FSA administrator doesn’t automatically approve the vitamins recommended by your doctor. In such cases, you may need to ask your doctor for a letter of medical necessity (LOMN). An LOMN is basically a document that confirms for the HSA/FSA that your vitamin purchase is associated with a specific treatment. An LOMN should include your name, the treatment you need, the length of the prescribed treatment, and a signature from your doctor. It should be printed on your provider’s prescription pad, letterhead, or discharge papers. The letter is also required by the Internal Revenue Service for certain eligible expenses.

How to use an HSA to purchase vitamins

You can either use your HSA card or submit a claim for reimbursement. Check with your HSA guidelines first.

How to use an FSA to purchase vitamins

You use an FSA the same way you use an HSA: Use your card to buy the vitamins or submit a claim for reimbursement. Check with the FSA guidelines first.

Key takeaways

FSAs and HSAs are similar in some ways and different in others. For example, FSAs are only available through employers, while HSAs are available for purchase by individuals and families. They both help provide tax savings for health expenses. When it comes to purchasing vitamins, though, they won’t do you much good. For a vitamin to be eligible for HSA/FSA coverage, the vitamin must be prescribed by a doctor to treat a specific medical condition. Your doctor may need to write a letter of medical necessity to establish this. Prenatal vitamins are an exception to this rule; they don’t treat a specific condition, but are typically covered by FSAs and HSAs. Check the guidelines of your HSA/FSA plan to learn more.