Doctor Fees: HSA Eligibility

Doctor fees are eligible provided that the medical care was actually received. Doctor fees reimbursement is eligible with a flexible spending account (FSA), health savings account (HSA) or a health reimbursement arrangement (HRA). Doctor fees reimbursement is not eligible with a limited care flexible spending account (LCFSA) or a dependent care flexible spending account (DCFSA).

What are doctor fees?

Doctor fees can vary greatly based on what type of specialty or geographic area a physician falls under, but by and large, most physicians will outline their own fee schedules which will list the fees that the doctor wishes to be paid for his/her services. This takes on two forms: first, this fee schedule creates a price tag for every service offered by a doctor, and for insurance companies, a fee schedule is a list of the amounts the insurance will allow in payment for the physician's services. On the patient side, doctor fees are typically covered by the patient's insurance policy with a copayment (or coinsurance payment) that will cover the full cost of the treatment.

However, it's important to note that doctor fees are only reimbursed if the amounts are paid for the diagnosis, cure, mitigation, treatment or prevention of a disease. For instance, if doctors require an additional fee to belong to a specific medical practice (concierge fees), this would not be eligible for reimbursement with consumer-directed healthcare accounts as this is viewed as an extraneous charge to participate in a boutique practice.

However, if a doctor ordered tests from a diagnostic facility, this would be considered a fee that will be billed to the patient's insurance or covered by the patient. But, in this case, it would be eligible for reimbursement through a consumer-directed healthcare account because it directly related to the treatment of a patient's medical condition. The total charge of doctor fees is largely determined by the patient's insurance plan, the doctor's fee schedule and the treatment being conducted, but as long as services are rendered to alleviate a medical issue, they will be eligible for reimbursement with consumer-directed healthcare accounts.

Eligibility Table

Flexible Spending Account (FSA) Limited Care FSA Dependent Care FSA Health Savings Account (HSA) Health Reimbursement Account (HRA)

Eligible

Eligible with Rx

Eligible with LMN

Not Eligible

Specifically Not Covered

Fees to belong to a specific medical practice, such as a concierge facility, are not eligible as no care has actually been received.

 


AZ-PROD-WEB01 11/21/2017 4:08:55 AM