FSA and HSA Coverage of Fertility and Pregnancy Products

Wondering which fertility and pregnancy products are covered by your FSA or HSA? Everything you need to know is in this guide.

Let’s face it. No one is a big fan of paying the bills—especially when it comes to paying for healthcare expenses. Even with a great insurance plan, medical care can be expensive. In an effort to reduce your personal healthcare costs, it may be valuable to investigate if you qualify for an FSA or HSA account. Both government-established programs, FSAs and HSAs exist to ease financial burdens and promote the affordability of healthcare. 

What Is An FSA or HSA? 

Flexible Spending Arrangements (FSA) and Health Savings Accounts (HSA) are tax-advantaged accounts that are commonly offered as fringe benefits to employees as part of an insurance plan. [1] These accounts are part of federally funded government programs and can often be used in conjunction with qualified insurance plans to help cover eligible healthcare expenses.

What Is the Difference Between an HSA and FSA?

While both FSAs and HSAs can aid in reducing healthcare costs, it is important to take note of the fundamental differences between accounts in order to understand how an HSA or FSA may apply to you.

An HSA is a medical savings account available to those who have enrolled in a high-deductible insurance policy. Unlike an FSA, self-employed taxpayers with high-deductible insurance policies may also create an account. Additionally, funds placed into an HSA account may roll over from year to year, while FSA funds will not. Please note that if you are eligible for Medicare or Medicaid, or are claimed as a dependent on another’s tax return, an HSA will not be available to you. 

An FSA is an employer-established benefit plan. This means that this type of account is only available when offered to employees by their employer. This account is owned by the employer, and the allotted funds do not roll over from year to year. [1] 

What Is Covered By FSA / HSA?

HSAs and FSAs are meant to cover “qualified medical expenses” as defined by the IRS. [2] This includes copayments, deductibles, and other health-related eligible expenses, including condoms, sunscreen, bandages, and heating pads. When it comes to fertility and pregnancy-related expenses, the following are included as HSA/FSA eligible items according to the IRS [2]:

• Breast pumps and supplies
• Diagnostic devices
• Pregnancy tests
• IVF and other fertility procedures
• Ovulation Tests
• Prescribed medicines
• Vasectomies
• Vitamins "recommended by a medical practitioner as treatment for a specific medical condition" (e.g. if your OBGYN recommends Prenatal Vitamins or Iron)
• Weight-loss programs

Here is a comprehensive list of qualified medical and dental expenses covered by FSA and HSA. [2] 

Which Natalist Products Are Covered by FSA/HSA?

Natalist offers many different products that are covered by most FSA/HSA programs, including:

• Natalist’s Prenatal Daily Packets
• Pregnancy Tests
• Ovulation Tests
• The Test Strip Pack
• Women's Fertility Test Bundle 

In addition to these products, other offerings may be eligible with a Letter of Medical Necessity (LMN) with a flexible spending account (FSA), health savings account (HSA), or a health reimbursement arrangement (HRA). Examples include:

• The Lube
• Iron
• Prenatal for him
• Fiber

You can either use your FSA/HSA debit card when checking out on our site or file for reimbursement (more on that below).

Note: While some bundles such as The Get Pregnant Bundle contain items that do not qualify as an FSA/HSA eligible expense, upon request, we can provide you with an itemized receipt for qualifying items in your bundle so you can log them for reimbursement if needed!  

How to Get Reimbursed From HSA / FSA

Reimbursements are simple and generally don't require claim forms. Each health plan may vary in the documentation required for reimbursement, but most just require a receipt of purchase of the qualifying item (email confirmation or paper receipt). Occasionally, you may also be required to provide an itemized receipt of your purchase along with a medical letter of necessity. We suggest logging into your provider's online portal (or calling them) for specific instructions.

When purchasing from Natalist, you can either use your FSA/HSA debit card or use the itemized receipt (which will be in your inbox after you make a purchase). If you have any questions or specific requests regarding your HSA/FSA-eligible Natalist purchases, please contact us at support@natalist.com.

Timing Guidelines for FSA /HSA Reimbursement

For FSA reimbursements, we recommend filing as soon as possible. Time limits may vary with individual plans, and some plans only give you until the end of your plan year. [1] We recommend reviewing your plan for personal time constraints or grace periods.

On the contrary, because HSA plan accounts may roll over from year to year, there is no time limitation on when reimbursement claims must occur. [1] It is important to note that you can not reimburse yourself for eligible expenses that occurred prior to opening your HSA account. Regardless, make sure to save your receipts in the rare case of an IRS audit.

Stay Organized 

While dealing with healthcare and medical expenses can be a pain (sometimes, quite literally), generally speaking, most FSA/HSA reimbursements should be a breeze as long as you take the proper steps to utilize your funds within the designated time frames and be sure to double-check for any limitations in your individual plan.

Once again, we strongly recommend that you keep any purchase receipts and documentation for qualifying expenses that you may be charged out of pocket

Common Questions Regarding FSA/ HSA Coverage

It’s normal to have a lot of questions and concerns regarding medical care expenses, especially when it relates to fertility and pregnancy. Here are some questions we see frequently regarding FSA/HSA coverage for reproductive health services and products. 

Are Prenatal Supplements FSA Eligible?

According to the FSA store, prenatal vitamins are eligible for reimbursement with FSA accounts, HSA accounts, and HRA accounts. Prenatal vitamins are not eligible for reimbursement with dependent care flexible spending accounts and limited-purpose flexible spending accounts (LPFSA). [3] 

Does HSA Cover Fertility Supplements?

There is a bit of a gray area when it comes to FSA/HSA coverage for supplements. Some supplements don’t fall under the IRS requirements while others do. In short, vitamins or supplements must have proven value in treating or preventing specific needs and conditions. [2-3] Prenatal vitamins are a great example of this, as they have been shown to prevent birth defects and support healthy fetal development. That being said, general multivitamins and most other supplements don’t qualify. If, however, your healthcare provider can write a letter of medical necessity explaining how a certain supplement is necessary for your care plan, you may be able to get a reimbursement. [3] If you are taking any specific supplements to support fertility, such as CoQ10 or Vitamin D, you should speak to your provider and benefits administrator about documentation. 

Are Home Fertility Tests Covered by FSA?

Many home fertility tests are covered by FSA, HSA, and HRA accounts. Some examples include pregnancy tests, ovulation tests, fertility trackers, fetal dopplers, and others. [2-3] Check your account terms or visit the FSA/HSA website for specific information. 

Do HSA/FSA Funds Cover Fertility Services?

Another big question many have is whether fertility treatments are covered by FSA/HSA. The good news is that many fertility treatments, including in vitro fertilization (IVF) are eligible for reimbursement. Additionally, donated embryos and sperm may also be considered a form of fertility treatment! [3] 

Keep in mind that eligibility can differ depending on your plan and circumstances, you should always check the terms of your account specifically for the most accurate and up-to-date information on eligible expenses. 

References:

1. The Difference Between A Flexible Spending Account (FSA) And A Health Savings Account (HSA). National Institutes of Health, Office of Management. Accessed December 2023. https://hr.nih.gov/about/news/benefits/difference-between-flexible-spending-account-fsa-and-health-savings-account-hsa 
2. Publication 502 (2022), Medical and Dental Expenses. IRS.GOV. Feb 2023. https://www.irs.gov/publications/p502#en_US_2019_publink1000178851 
3. 2023 FSA Store Inc. https://fsastore.com

Originally published on August 22, 2019. Updated for accuracy and relevancy on December 14, 2023.