When Your Wallet and Your Health Collide: A Tale of FSAs and HSAs and their use

Use pretax dollars to your health benefit

Created by Jacqueline Caffrey, Physician Assistant

January 2nd 2025

Alright, picture this: It’s December 31, and you’re in a full-blown panic. You’re feverishly Googling, “What can I buy with my FSA money before it disappears?” You’re teetering on the edge of a mental breakdown, convinced that buying 9,000 Band-Aids in bulk is your only salvation. Then, suddenly, you pause. Is there a better way to handle this whole health savings thing?

Spoiler alert: Yes, yes there is. And I’m here to tell you all about it—so grab a cup of tea (or a heating pad—FSA eligible, baby) and let’s dive into the magical world of FSAs and HSAs, and how FlexUp Wellness PLLC can help you save the day. On average for pretax dollars, most people save around 30%!!!

Not financial advice—just a passion project I hope gets you thinking.

What in the World Are FSAs and HSAs?

Okay, let’s start with the basics, because I know a lot of us are secretly Googling "What is an FSA again?" in the middle of a crisis. FSAs and HSAs are financial tools that let you spend pre-tax money on health-related expenses. Think of them like your health savings Avengers—only with fewer spandex suits. But here’s the catch: FSAs and HSAs aren’t the same thing.

They’re more like distant cousins who vaguely understand each other but don’t exactly hang out at family reunions. Let’s break down the differences:

Flexible Spending Account (FSA)

What it is: A “use-it-or-lose-it” account your employer provides. You contribute a set amount of money for the year, and that money can be used for medical expenses. Save on average 30% off whatever you use the funds with.

Key Facts:

• Contribution limit (2025): $3,300

• Funds usually have to be spent by the end of the year (unless your employer lets you roll over a generous $610 or gives you a grace period)

• If you change jobs, you can’t take the money with you

  
  

Health Savings Account (HSA)

What it is: This is the cool, flexible cousin tied to a high-deductible health plan (HDHP). You contribute pre-tax dollars, and your money rolls over every year.

Key Facts:

• Contribution limit (2025): $4,300 for individuals, $8,550 for families

• Funds roll over every year

• You can invest the money and grow it tax-free. It's called a triple tax advantage. See other blogs by Flexup Wellness and learn how to use it like a Boss

  
  

Big Difference:

FSA = funds expire at year’s end, like milk

HSA = funds roll over and grow, like a savings account with biceps

So, What Can You Actually Buy With These Accounts?

You might be thinking, “Okay, okay, this all sounds good, but can I really buy anything with this money?” Well, let’s take a look at what’s actually covered (and, of course, what’s not).

It’s not just doctor visits and prescriptions.

12 Health Costs Your FSA/HSA Will Cover:

1. Doctor co-pays and prescriptions

2. Over-the-counter medications

3. Vision care (glasses, contacts, and eye exams)

4. Dental work (cleanings, braces, and dentures)

5. Hearing aids and batteries

6. First-aid supplies

7. Chiropractic care

8. Birth control and fertility treatments

9. Mental health therapy

10. Acupuncture

11. Smoking cessation programs

12. Breast pumps and lactation supplies

    
    

    ...kinda lame if you ask me

    
    

12 Health Costs Your FSA/HSA Won’t Cover (Usually):

1. Gym memberships (nope, no CrossFit for you...yet).

2. New mattress (seriously, health isn’t about comfort and good night sleep?).

3. Home gym equipment (I’ll just keep staring at that Peloton I definitely need).

4. Vitamins and supplements (unless your doctor says you need them, but doesn’t that defeat the purpose?).

5. Yoga classes (again, unless they’re prescribed).

6. Massage therapy (unless it’s medically necessary—then YES).

7. General wellness apps (no, you can’t cover your “Nerva” or meditation app...yet).

8. Personal trainers (Usually cash paid...and super worth it).

9. Cold plunges

10. Probiotics

11. Air filtration systems (because allergies are totally not medical).

12. Red light therapy (I mean, it’s red, but...).

Enter FlexUp Wellness PLLC: Your Health Savings Hero

Now, you might be realizing that a lot of your health-related spending isn’t typically covered—but here’s the good news: there’s a way to change that. As stated before that’s where FlexUp Wellness PLLC swoops in like a superhero who knows how to make magic happen.

Here’s the thing: Some of those “ineligible” expenses can actually become eligible with a little help from the pros. FlexUp Wellness can help you get a Letter of Medical Necessity (LMN), which basically says, “Hey, this thing you want to buy? It’s medically necessary.”

So, suddenly, that fancy therapeutic mattress you’ve been eyeing? It’s eligible.

That gym membership for $600/yr? Boom, 30% of it covered saving $180. That green supplement or mushroom coffee billed monthly? Oh yes, you can write those off now. (AG1 is $1,200/yr and you would save $360). Spend $1,000/yr or more on supplements? Now you could have $300 of savings for the cute dress you've been eyeing. Massages? Need a sauna or cold plunge? Personal trainer?!?

How It Works:

1. Fill out a health evaluation: FlexUp Wellness will ask you about your health, and a licensed nurse practitioner will review it to see if you qualify for an LMN (most do).

   
   

2. Get your LMN: You’ll receive a letter outlining why that gym membership or supplement is actually good for your health, good for 12 months.

   
   

3. Submit to your FSA/HSA: Submit the letter to your administrator and—bam—you can get reimbursed 30% the cost. If you use an HSA like Fidelity, just make the purchase and keep the receipt. (See the HSA blog for more details for a large tax free purchase or a tax free vacation)

   
   

Final Thoughts

So, there you have it: FSAs and HSAs don’t have to be intimidating. With a little knowledge (and help from FlexUp Wellness PLLC), you can make your health savings work for you.

When December rolls around, you’ll be ready.

And don’t forget: FlexUp Wellness is here to help you navigate the maze of health savings with their magical letters of medical necessity.

Make 2025 the year you conquer health savings like a pro—and maybe even get a medically necessary massage. You deserve it.