Yes, Ozempic is eligible for reimbursement with a Flexible Spending Account (FSA) or Health Savings Account (HSA).
Why Is Ozempic FSA/HSA Eligible?
Ozempic is eligible for reimbursement under a Flexible Spending Account (FSA) or Health Savings Account (HSA) because it is a prescription medication designed to treat specific medical conditions. Primarily prescribed for managing Type 2 diabetes, Ozempic (semaglutide) is a glucagon-like peptide-1 (GLP-1) receptor agonist that regulates blood sugar levels by enhancing insulin release and slowing glucose absorption. It is also increasingly used as part of weight management programs for individuals with obesity or weight-related health conditions.
IRS Code Section 213(d) allows reimbursement for prescription medications used to treat recognized medical conditions. Ozempic’s dual purpose in addressing Type 2 diabetes and assisting with weight loss in eligible patients aligns with these guidelines, making it a qualifying medical expense.
When used for weight loss, Ozempic helps regulate appetite and reduces calorie intake, which supports sustainable weight management. It is often prescribed for patients with weight-related medical concerns, further reinforcing its classification as a medically necessary treatment rather than a general wellness product.
For FSA/HSA reimbursement, you may need a Letter of Medical Necessity (LMN) from your healthcare provider, especially if your prescription is for weight loss rather than diabetes management. This documentation highlights the medical purpose of the medication, ensuring compliance with FSA/HSA requirements.
How to Purchase Ozempic With an FSA/HSA
Since Ozempic is a prescription medication, you must order it through your primary healthcare provider. The best way to pay using your Flexible Spending Account or Health Savings Account is to pay out of pocket and submit a receipt to your FSA/HSA provider for reimbursement later.
It is best to have a Letter of Medical Necessity (LMSN) from your doctor if their office doesn’t submit a claim directly to your medical insurance provider.
Make sure the distributing pharmacy or clinic provides the following information with the purchase receipt:
Name of the provider
Date of purchase/service rendered (note that for services, they must be rendered within the plan year for FSAs)
Description of items/services rendered
Itemized list of products purchased with UPCs (if purchasing items at a retailer that doesn’t accept FSA/HSA cards or if using a regular credit card)
Total amount of purchase
What Other Weight Loss Drugs Are FSA/HSA Eligible?
Several other prescription medications for weight loss may also be eligible for reimbursement with a Flexible Spending Account (FSA) or Health Savings Account (HSA). These medications are typically prescribed to treat obesity or weight-related medical conditions and must be deemed medically necessary by a healthcare provider. Some common weight loss drugs that qualify include:
Wegovy (semaglutide): Like Ozempic, Wegovy is a GLP-1 receptor agonist designed specifically for chronic weight management in adults with obesity or weight-related health issues.
Saxenda (liraglutide): A medication approved for weight management, Saxenda helps regulate appetite and caloric intake, supporting long-term weight loss.
Qsymia (phentermine and topiramate): This combination drug suppresses appetite and is prescribed for weight management in patients with obesity or overweight conditions and related health risks.
Contrave (naltrexone and bupropion): This medication helps manage appetite and cravings and is often used in weight loss programs.
Plenity: An FDA-cleared medical device in pill form that expands in the stomach to promote a feeling of fullness and reduce calorie intake.
Adipex-P (phentermine): A short-term appetite suppressant prescribed to help initiate weight loss in conjunction with diet and exercise.
These medications are eligible under FSA/HSA guidelines when prescribed by a healthcare provider to treat obesity or weight-related conditions. To ensure coverage, it is recommended to obtain a Letter of Medical Necessity (LMN) from your doctor. Always check with your FSA/HSA provider for specific eligibility requirements and additional documentation needs.
