Paying for a testosterone test with an HSA or FSA

You may want to pay for a test from an HSA or FSA. The IRS rules help, but your account’s own rules decide. Here is what the IRS says and what to check.

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What the IRS says about lab fees

IRS Publication 502 says: “You can include in medical expenses the amounts you pay for laboratory fees that are part of medical care.” It describes medical expenses as the costs of diagnosing, treating or preventing disease (IRS Publication 502).

The same publication says medical care expenses must be primarily to alleviate or prevent a physical or mental disability or illness, and that expenses only beneficial to general health do not qualify. Whether a given test meets that standard for you is a question for your plan administrator or a tax adviser.

HSA rules

• To contribute to an HSA you must be covered under a high deductible health plan (IRS Publication 969).
• Distributions from an HSA used to pay qualified medical expenses are not taxed.
• Expenses incurred before you set up your HSA are not qualified medical expenses.
• You must keep records showing the money was used only for qualified expenses was not paid from another source, and was not taken as an itemized deduction. You do not send these records with your tax return.

FSA rules

• A health FSA is an employer-established plan that reimburses employees for medical expenses. The plan specifies which expenses qualify.
• FSAs are generally use-it-or-lose-it. A plan may offer a grace period of up to 2 1/2 months or a limited carryover, but not both, so check your plan’s rules.
• The IRS says you must give your FSA a written statement from an independent third party that the expense was incurred and its amount, plus your own statement that no other health plan paid it. Cards issued by your employer may simplify this.

Before you order

1. Ask your plan administrator whether a self-ordered lab test is an eligible expense, and what paperwork they want.
2. At checkout, see whether your HSA or FSA card works. If it does not, you can pay another way and submit for reimbursement, if your plan allows.
3. Keep the order confirmation, the receipt and the lab order.
4. Remember that your plan, not this guide, makes the final call.

This is general information, not tax or legal advice.

The cheapest test that fits

Using pre-tax money does not change which test you need. See the test finder or the testosterone test guide to choose the smallest test that answers your question. For the steps after you order, see how walk-in lab testing works.