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FSA, HSA Reimbursement

Can I use FSA/HSA for a Pediatric Sleep Coach?

general Apr 01, 2022

If you’ve been participating in your company’s FSA/HSA, you know that there are so many benefits it provides in your journey of parenthood.   From baby supplies to lactation support, FSA programs have provided reimbursement for these parenthood services.

 

So what about sleep consulting?  You may have already done the research and seen that your FSA isn’t specifically identified as a covered item or service in the program, but it is possible to gain eligibility under the health institute fee category.

 

What are health institute fees?

These fees are expenses are associated with many different categories including courses, workshops, room and board, wellness coaching, and could potentially cover sleep consulting. There is a huge range of offerings for general health that aren’t medically necessary or require a prescription.  

According to FSA STORE, “Health institutes go by many names including clinics, retreats, workshops, institutes, campuses, etc. but always are classified by the services they offer which do not typically diagnose, treat or alleviate a medical condition or disease. If there is a service that does directly treat, diagnose or alleviate a medical condition or disease, and it is prescribed, then it may be eligible for reimbursement with a consumer-directed healthcare plan and with appropriate documentation. It is possible, though unlikely, that this service would be prescribed to be performed at a health institute and covered by health institute fees (Internal Revenue Service).”

Under the health institute fees, sleep consulting can be covered with a letter of medical necessity (LMN).  This can be obtained from a medical professional.  But beforehand, make sure to check with your FSA administrator and make sure it’s required and that the fee and expense will be covered.

 

If you are looking into getting pediatric sleep support but would like to find ways to creatively cover some of the expense, it may be worthwhile to check with your FSA administrator and follow these steps:

 

  1. Call your FSA or HSA administrator and discuss with them the offerings and sleep training services and confirm whether it’s covered.  You may be able to reach out to your Human Resources can help guide you to the right contacts.  If it is covered, l ask what approvals are needed and the paperwork involved.
  2. If your FSA or HSA does cover these services and requires a Letter of Medical Necessity (LMN), you can reach out to your pediatrician’s office to discuss and obtain one.   
  3. After approval, you may need to prepay with FSA and then submit a receive for reimbursement, while you may be able to use your HSA debit card.

 

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