Can You Use an FSA for Fertility Treatments?

A Flexible Spending Account (FSA) provides a tax-advantaged way to pay for eligible healthcare expenses, allowing individuals to set aside pre-tax money from their paycheck. These accounts can offer financial relief by covering out-of-pocket medical costs that accumulate throughout the year. For many, fertility treatments represent a significant healthcare expenditure, and utilizing an FSA can help manage these costs effectively.

Eligible Fertility Treatment Expenses

The Internal Revenue Service (IRS) outlines specific criteria for what qualifies as an eligible medical expense, generally defining them as costs for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for affecting any structure or function of the body. This broad definition, detailed in IRS Publication 502, extends to many fertility-related services. Fertility treatments are generally eligible for reimbursement if they are performed on the account holder, their spouse, or eligible dependents.

Many common fertility procedures are considered eligible expenses:

• In vitro fertilization (IVF), which involves procedures like egg retrieval, fertilization, and embryo transfer, along with associated diagnostic tests such as blood work and ultrasounds.
• Intrauterine insemination (IUI), a less invasive procedure, and ovulation induction.
• Prescription medications, including hormones and injectables, when used as part of fertility treatment.
• Consultations with fertility specialists.
• Certain surgical procedures.
• Temporary storage of eggs or sperm.

Not all fertility-related costs qualify for FSA reimbursement. Expenses for general health or cosmetic purposes are not eligible. Costs for surrogacy, when incurred by the surrogate, or for donor eggs/sperm, when incurred by the donor, are not eligible. Adoption fees are also not considered eligible medical expenses for FSA purposes. Long-term storage of eggs and sperm may not be covered as it might not be viewed as an immediate medical need.

Required Documentation for Reimbursement

Record-keeping is important for successful FSA reimbursement. Before submitting a claim, individuals must gather and retain specific documentation to substantiate their expenses. This ensures compliance with IRS regulations and the requirements of FSA administrators.

Itemized receipts are required and must contain specific information. Each receipt needs to clearly show the date the service was rendered, a detailed description of the service or item purchased, the amount paid, and the name of the healthcare provider or vendor. Credit card statements or canceled checks alone are insufficient.

When health insurance is involved, an Explanation of Benefits (EOB) statement is necessary. The EOB details how much of the expense was covered by insurance and the remaining amount for which the patient is responsible. This document helps the FSA administrator verify the out-of-pocket portion of the cost. For certain treatments or services that may require additional justification, a Letter of Medical Necessity (LOMN) from a doctor can be essential. This letter confirms that the treatment is medically necessary for the diagnosis, cure, mitigation, or treatment of a medical condition. For prescription medications, documentation should include clear prescription details to confirm eligibility.

Submitting Your FSA Claim

Once all necessary documentation has been gathered, submitting an FSA claim is the next procedural step. Most FSA administrators offer multiple convenient methods for claim submission. Common options include online portals, mobile applications, mail, or fax.

To submit a claim, log into your FSA administrator’s online platform or mobile app and navigate to the claim submission section. Here, basic information about the claim is entered, such as the date of service, the healthcare provider’s name, and the total amount of the expense. The previously collected documentation, including itemized receipts and Explanation of Benefits statements, is then uploaded or attached electronically. Review all submitted information for accuracy, then finalize and send the claim for processing.

Following submission, individuals receive a confirmation of receipt from their FSA administrator. The processing timelines can vary, but reimbursements are issued either via direct deposit to a linked bank account or by check. Note that the FSA administrator may request additional information or documentation to substantiate the claim. Responding promptly to such requests helps avoid delays in reimbursement.

Important Rules and Considerations

Each year, the IRS sets a maximum contribution limit for FSAs. For the 2025 plan year, individuals can contribute up to $3,300 to their health FSA. This limit applies to eligible healthcare expenses, including fertility treatments.

FSAs operate under the “use it or lose it” rule, meaning funds must be used within the plan year or by a specific deadline. Employers can offer flexibility through either a grace period or a carryover option, but not both. A grace period allows an additional period, up to two and a half months after the plan year ends, to incur and claim new expenses. Alternatively, a carryover provision permits individuals to roll over a limited amount of unused funds into the next plan year; for 2025, this maximum carryover amount is $660. This carryover does not affect the maximum amount an individual can elect for the new plan year.

The timing of fertility expenses within the FSA plan year is a consideration. FSA elections are generally irrevocable for the plan year, but certain qualifying life events may allow for mid-year changes. These events include changes in marital status, the birth or adoption of a child, or changes in employment status that affect benefit eligibility. Note that fertility treatments fall under a Health Care FSA, distinct from a Dependent Care FSA, which covers childcare expenses. Retaining copies of all submitted claims and supporting documentation is advisable for personal records and future reference.