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Top 10 ways HSAs and FSAs support reproductive health and family planning

4 min read

NOTE: This post was published on July 27, 2022. For additional information on the Dobbs decision and how people can use pre-tax benefits for reproductive healthcare and family planning, read our previous post.

Workplace benefits and family planning are in the news lately. Businesses are looking for ways to support employees—whether it’s answering questions about coverage or creating customized plan options. And, if you’re an employee, you’re likely looking for ways to both understand your coverage options and get the most from your benefits.

Many ways pre-tax benefits support you

The good news is that Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) already support members by providing resources to manage a range of issues related to family planning and reproductive healthcare. Both accounts let you use tax-free money1 to pay for qualified medical expenses. Thousands of items and services are eligible. It’s a long list, so here’s our top 10 ways HSAs and FSAs support family planning and reproductive healthcare.

1. OB-GYN care

Your HSA and FSA can help you pay for all doctor visits and consults before meeting your deductible. This includes labor and delivery at the hospital or birthing center.

2. Menstrual care products

As of 2020, over-the-counter (OTC) medications and products related to menstrual care—including pads, tampons, cups, liners—are on the list of eligible medical expenses.

3. Prescription birth control

Birth control and other contraceptives (including “Plan B” / “Morning After Pill”) count as eligible medical expenses with a prescription unless otherwise restricted by the employer’s plan documents.

In states where abortion services are legal, you may use your HSA and FSA to pay for the services, including prescription(s) related to such eligible medical care.

5. Transportation and lodging for healthcare

Sometimes healthcare needs require travel to another state or another country. In many cases, your HSA can help you pay for those transportation expenses, provided you’re traveling exclusively (or primarily) for medical care.

This can include:

  • Car and rental car expenses
  • Bus, taxi, rideshare
  • Train, plane, and ferry fares
  • Parking fees and tolls
  • Ambulance services

Rental car expenses are limited to the portion attributable to the medical appointment or other care. Instead of actual car expenses, a standard mileage rate (18 cents per mile for January 1, 2022–June 30, 2022, and 22 cents per mile beginning July 1, 2022) for use of a car to obtain medical care is allowed. We encourage you to consult a tax advisor before making travel plans.

6. Vasectomy (and reversal)

Not planning to have children or finished having kids? Your tax-advantaged accounts can cover the costs associated with a vasectomy. They can also pay to reverse a previous procedure.

7. Gear for nursing

You can use your HSA or FSA to pay for breastfeeding supplies like eligible breast pumps, pads, storage bottles and bags, lanolin, and more.

8. Doula services and midwife treatment

Some families use midwives and doulas (also called birth attendants) during pregnancy and labor for medical care. Both types of services are eligible with a Letter of Medical Necessity.

9. In vitro fertilization (IVF) treatment

IVF, including egg and sperm storage, is potentially considered an eligible medical expense. Fees for temporary storage qualify, but only to the extent necessary for immediate conception. For example, storage fees for undefined future conception probably aren’t considered medical care. And, while “temporary” is not defined, one consideration might be whether it is stored and used within the same year. For these reasons, it’s important to verify your specific plan coverage by talking with your benefits team.

10. Fertility monitors and pregnancy tests

You can also use your HSA or FSA to pay for home pregnancy tests and fertility monitors like ovulation tracking tools.

Not sure if your planned expenses are covered?

Check out our searchable list of eligible medical expenses. It’s not exhaustive, but it’s a great place to start. You can also visit the HSA Store.2 There you can search and buy eligible expenses using your HealthEquity healthcare debit card.3

If you’re at a store, try the barcode scanning tool in the HealthEquity Mobile app.4 Just scan an item and the app will tell you if the item is eligible for reimbursement. As always, if you have any questions, visit our Help Center.

More resources for employers and benefits advisors

Looking to provide more support for your people? Explore our family planning resource page.

And make plans to attend our upcoming free webinar: Using workplace benefits to support reproductive health and family planning. You can join the panel discussion to understand how consumer-directed benefits support reproductive health and family planning.

HealthEquity does not provide legal, tax or financial advice. Always consult a professional when making life-changing decisions.

1 HSAs and FSAs are never taxed at a federal income tax level when used appropriately for eligible medical expenses. Also, most states recognize HSA and FSA funds as tax-deductible with very few exceptions. Please consult a tax advisor regarding your state’s specific rules.

2 HealthEquity and the HSA Store are separate, unaffiliated companies and are not responsible for each other’s policies or services.

3 This card is issued by The Bancorp Bank; Member FDIC, pursuant to a license from Visa U.S.A. Inc. Your card can be used everywhere Visa debit cards are accepted for eligible expenses. This card cannot be used at ATMs and you cannot get cash back, and cannot be used at gas stations, restaurants, or other establishments not health related. See Cardholder Agreement for complete usage restrictions.

4 Accounts must be activated via the HealthEquity website in order to use the mobile app.

COBRA/Direct Bill Employer login

Please refer to your Client Welcome email for the URL of your specific COBRA/Direct Bill Employer login page.