May 23, 2024
May 23, 2024
Eddie Zepeda

Can Your FSA Help Cover Prosthetics? Let's Talk Healthcare Benefits

Eddie Zepeda
Eddie Zepeda

Prosthetics can make a huge difference for people who have lost limbs or have conditions that affect how their limbs work. They don't just help with physical abilities, they can also boost confidence and let people live more independently. This article is all about how your Flexible Spending Account (FSA) or Health Savings Account (HSA) might be able to help pay for prosthetic devices, giving you important financial support.

Understanding FSA and HSA Basics

Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs) are special ways to save money on qualified medical expenses. FSAs are set up by employers, and you can put aside pre-tax income to cover health costs insurance doesn't. HSAs are for people with high-deductible health plans (HDHPs), and they also offer tax benefits plus the option to save money for future medical needs.

What about HRAs? Health Reimbursement Arrangements (HRAs) are another way employers can help. With an HRA, your employer reimburses you for out-of-pocket medical expenses and insurance premiums. It's important to know that HRAs are completely funded by employers, and money usually doesn't carry over between years.

Program Tax Benefits Eligibility Rollover of Funds Funding Source
Flexible Spending Account (FSA) Contributions made with pre-tax dollars, reducing your taxable income. Offered by employers to their employees. Funds must generally be used within the plan year or forfeited ("use it or lose it"). Employer
Health Savings Account (HSA) Contributions are tax-deductible, earnings grow tax-free, and withdrawals for qualified medical expenses are tax-free. Available to individuals enrolled in a High Deductible Health Plan (HDHP). Funds roll over year after year, allowing for long-term savings. Individual
Health Reimbursement Arrangement (HRA) Reimbursements for qualified medical expenses are tax-free. Established by employers as part of their benefits package. Funds typically do not roll over and must be used within a specified period. Employer

All About Prosthetics

Prosthetics are amazing devices that can help replace missing body parts, whether they were lost due to an injury, health issue, or congenital conditions. These devices come in all shapes and sizes, from artificial limbs to replace arms or legs, to even replacements for parts like breasts or eyes. The main goal of a prosthetic is to improve daily life, give people more independence, and help them get back to all the things they love to do.

For people with above-the-knee or below-the-elbow amputations, prosthetic limbs can make a huge difference in getting around and doing daily tasks. Each prosthetic is specially made to fit the person using it and help them live their best life.

Good News! Your FSA or HSA Can Help Pay for Prosthetics

Because prosthetics are so important for daily life, most healthcare plans (including FSAs and HSAs) consider them a medical necessity. That means you might be able to get some or all of the cost covered! The IRS has rules about what you can use your FSA for – it has to be something that helps prevent or treat a physical or mental issue. Prosthetics totally fit the bill because they replace a missing body part that's important for getting around and doing daily tasks.

Good News! Your FSA or HSA Can Help Pay for Prosthetics

What Kinds of Prosthetics Are Covered?

However, cosmetic prosthetics that are not medically necessary might not be covered. It's important to check with your FSA provider for any specific restrictions or conditions that might affect the coverage of prosthetic devices.

FSAs and HSAs usually cover all sorts of helpful prosthetics for upper limbs and lower limbs, including artificial arms and legs! Here are some examples of what your FSA or HSA might be able to help pay for:

  • Prosthetic Sleeves: These make your prosthetic more comfortable and help protect your skin.
  • Prosthetic Socks & Shrinkers: Also for better fit and comfort!
  • Prosthetic Liners: These make the fit of your prosthetic even better.
  • Prosthetic Leg Braces: For extra support and stability.
  • Skin Protectants: To keep your skin healthy when wearing a prosthetic.
  • Amputee Equipment: Special tools and items that make life with a prosthetic easier.

Important Note: Prosthetics that are just for looks and not medically necessary might not be covered. It's always best to double-check with your specific FSA provider to be sure about what they will and won't cover.

How to Use Your FSA or HSA for Prosthetics

Here's a simple guide to using your Flexible Spending Account (FSA) or Health Savings Account (HSA) to cover the cost of a prosthetic:

  • Talk to your doctor: Your doctor can write you a prescription for a prosthetic, explaining why it's important for your health and daily life.
  • Certificate of Medical Necessity: Sometimes, your FSA or HSA provider may ask for this form. Don't worry; your doctor can help you get this to prove your prosthetic is medically necessary.
  • Find the right provider: Choose a reputable company that makes prosthetics and is happy to work with your FSA or HSA.
  • Keep your receipts! Once you buy your prosthetic, hang on to the receipt and any other paperwork your FSA administrator asks for.
  • Submit for reimbursement: Follow the instructions for your FSA to get your money back. It's that easy!
How to Use Your FSA or HSA for Prosthetics

Limitations and Exclusions

FSAs and HSAs are great for covering prosthetics, but sometimes there are limits on how much they'll pay or certain types of devices they won't cover. Make sure to double-check your plan's details or ask an FSA/HSA administrator if you have any questions.

Tips for Getting the Most Out of Your FSA and HSA

Maximizing Your FSA or HSA Benefits for Prosthetic Needs

To maximize the benefits of your FSA or HSA:

  • Plan ahead! Talk to your doctor early about the kind of prosthetic you might need and how much it will cost. That way, you can set aside enough money in your FSA or HSA.
  • Save those receipts! Keep track of everything you spend on your prosthetic. This paperwork is super important for getting your money back and staying on top of your account.
  • Stay up-to-date: FSA and HSA rules can sometimes change. Make sure you know the latest info so you can make the most of your benefits.

Get the Help You Need to Reach Your Goals

Prosthetics can make such a huge difference for people with missing limbs, helping them get back to doing what they love. Your FSA is there to help with the cost! Be sure to talk to your FSA administrator about exactly what kind of prosthetics are covered and how much they'll pay. That way, you can plan ahead and make the most of your benefits.

The PrimeCare Orthotics & Prosthetics team is here to help make the whole process easier – in both Las Cruces and Albuquerque! We truly care about giving you the best possible experience and helping you find the perfect prosthetic solution. Reach out today, and let's get started!


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A grandfather with a prosthesis walks with his grandchildren.