Changes to HSAs

The Patient Protection and Affordable Care Act includes a number of changes to the rules that currently apply to Flexible Savings Accounts (FSAs), Health Reimbursement Accounts (HRAs), and Health Savings Accounts (HSAs). 

Effective January 1, 2011
Beginning in 2011, the definition of a “qualified medical expense” will be altered to no longer include over-the-counter medications unless they are prescribed by a physician.  Therefore, items such as aspirin will no longer be considered as a “qualified medical expense,” and therefore will not be reimbursable from an FSA or HRA or be treated as a non-taxable medical expense under an HSA, unless pursuant to a prescription.  The following lists provide examples of medications that may now require a doctor’s prescription in order to be considered an IRS eligible qualified medical expense.

Acid controllers                                          
 Allergy and sinus                                        
Antibiotic products                                     
Anti-diarrheal                                             
Anti-gas                                                     
Anti-itch and insect bite                              
Anti-parasitic treatments                             
Baby rash ointments and creams                 
Cold sore remedies
Digestive aids
Hemorrhoid preps                                    
Laxatives
Motion sickness pills
Pain relief such as aspirin
Respiratory treatments
Sleep aids and sedatives
Stomach remedies

Items such as bandages, home health-aids and other over-the-counter items may still be qualified medical expenses.  For example, the following items will remain available without a physician’s prescription.

Artificial teeth                                                                                              
Birth control                                               
Braces and supports                                   
Braille books and magazines                       
Catheters                                                   
Contact lens supplies and solutions              
Denture adhesives                                      
Diagnostic tests and monitors                      
Elastic bandages and wraps
Band-Aids and other first aid supplies
Hearing aids and batteries
Insulin and diabetic supplies
Ostomy products
Oxygen and oxygen-equipment
Pregnancy test kits
Reading glasses
Wheelchairs

In addition, beginning in January 2011, the penalty for using HSA funds for nonqualified medical expenses will increase from 10% to 20%. 

Effective January 1, 2013
Beginning in 2013, individuals will only be able to contribute $2,500 a year to their FSA.  This amount will be indexed for inflation in subsequent years.

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