No, Pediasure is not a universally eligible Flexible Spending Account (FSA) or Health Savings Account (HSA) expense.
Why Is Pediasure Not FSA/HSA Eligible?
Pediasure is generally not eligible for reimbursement through a Flexible Spending Account (FSA) or Health Savings Account (HSA) because it is classified as a nutritional supplement intended to support general health and growth in children.
According to IRS Code Section 213(d) and SIGIS guidelines, FSA and HSA funds can only be used for products that diagnose, treat, or manage specific medical conditions. Pediasure, when used as a general dietary supplement, does not meet these criteria.
When Can Pediasure Be Eligible?
Pediasure may qualify for FSA/HSA reimbursement if it is prescribed by a healthcare provider to address a specific medical condition, such as:
Failure to Thrive: For children who are underweight or have difficulty maintaining a healthy weight.
Nutritional Deficiencies: To supplement the diet of children with diagnosed deficiencies or dietary restrictions.
Chronic Illness or Recovery: As part of a treatment plan for children recovering from surgery, illness, or with conditions requiring supplemental nutrition.
In these cases, a Letter of Medical Necessity (LMN) from your doctor is required to confirm the medical purpose of Pediasure. The LMN should detail the condition being treated and explain why Pediasure is necessary.
How to Purchase Pediasure With FSA/HSA Reimbursement
If your healthcare provider determines Pediasure is medically necessary, follow these steps:
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Obtain a Letter of Medical Necessity (LMN):
Consult your doctor and request an LMN. The letter should specify the diagnosis and explain why Pediasure is essential for treatment.
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Verify Approval With Your FSA/HSA Provider:
Submit the LMN to your FSA or HSA administrator to confirm that Pediasure qualifies for reimbursement under your plan.
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Make the Purchase:
Use your FSA or HSA card to buy Pediasure at a retailer that accepts these payment methods.
If the retailer does not accept FSA/HSA cards, pay out-of-pocket and retain the receipt.
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Submit a Reimbursement Request:
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If you pay out-of-pocket, provide the following documentation to your FSA/HSA administrator:
A copy of the LMN.
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The receipt showing:
Name of the retailer or provider.
Date of purchase or service rendered (must be within the FSA plan year).
Description of the product purchased.
Itemized details with UPCs, if applicable.
Total purchase amount.
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Maintain Documentation:
Retain copies of the LMN and receipts for your records in case additional verification is required.
By ensuring the purchase is tied to a specific medical need and providing proper documentation, you can use your FSA or HSA funds to cover Pediasure when it is medically necessary. Always confirm eligibility with your plan administrator before making a purchase.
