Leveraging your Health Savings Account (HSA) or Flexible Spending Account (FSA) may make the ORBERA Weight Loss Balloon more affordable than you were expecting. Leveraging your HSA or FSA could help you save up to 31% of the total cost. You may be eligible to leverage the benefit of a pre-tax healthcare account for the ORBERA gastric balloon procedure and follow-up case if you meet some key requirements.
Benefits of your HSA
You can use an HSA to cover most of the costs of ORBERA® Weight Loss Program.
You are able to claim tax deductions for contributions that you, or someone other than your employer, makes to your HSA.
You can exclude contributions made by your employer from your gross income.
You can reimburse yourself from an HSA for expenses as you add funds to your account, provided that the HSA was established before the expense was incurred
Your contributions will roll over to the next year, if unused.
Benefits of your FSA
You can use an FSA to be reimbursed for most of the costs of ORBERA® Weight Loss Program.
FSA contributions decrease your taxable income.
You determine the amount that you would like to contribute to your employer-sponsored account, allowing you to pay for eligible medical expenses on a pre-tax basis.
FSA contributions are not subject to any payroll taxes.
How much could you save?
Eligible Expenses
15% Tax Bracket
28% Tax Bracket
31% Tax Bracket
$6,000
$900
$1,680
$1,860
$7,000
$1,050
$1,960
$2,170
$8,000
$1,200
$2,240
$2,480
Your specific saving will depend on your tax bracket.
HSA / FSA Eligibility for some ORBERA® costs?
Individual plans may vary. Please verify eligibility with your HSA / FSA administrator and your tax advisor.
A physician must document that the ORBERA® is provided as a treatment that is a qualified medical expense for a specific diagnosed disease (including obesity, hypertension, heart disease).
Qualified medical expenses are those incurred by you, your spouse, or in most cases dependents you claim on your tax return. There are a few exceptions such as when:
The person filed a joint return,
The person had gross income of $4,000 or more, or
You, or your spouse if filing jointly, could be claimed as a dependent on someone else’s 2018 return.
Your child over the age 26 at the end of your tax year.1
Take these steps to make a small investment for the rest of your life:
Step 1: Connect with an ORBERA® Specialist who will determine if this procedure is right for you. Find a Specialist [https://www.orbera.com/find-a-specialist]
Step 2: Consult with your HSA or FSA plan administrator prior to accessing funds as outlined through your employer and the IRS rules governing the use of HSA and FSA funds to pay for medical services. Below are a few tips to help guide you through the process.
HSA Tips
HSA holders can choose to save up to $3,350 for an individual and $6,750 for a family (HSA holders 55 and older get to save an extra $1,000 which means $4,350 for an individual and $7,750 for a family); and, these contributions are 100% tax deductible from gross income.
HSA funds may be used to cover many of the costs associated with ORBERA including Physician fees, dietitian consults, and gastric balloon placement / removal procedures.
HSA funds may be used for prescription medications associated with your treatment and for over-the-counter medications with a prescription from your physician.
HSA funds may not be used for meal replacements or shakes; and, funds cannot be used for in most cases for insurance premiums.
Funds are typically distributed after submission of all required documentation to Health Savings Account Trustee managing your funds. Your HSA policy guidelines determine if the funds are paid directly to the service provider or to you. Be sure to check with your administrator on card usage.
FSA Tips
The maximum FSA contribution for 2019 will remain at $2,550.
FSA funds may be used to cover deductibles and co-payments, as well as physician fees, dietitian consults, placement and removal procedures. FSA funds may not be used for insurance premiums, meal replacements, or shakes.
FSA funds may be used for prescription medications associated with your treatment and may be used for over-the-counter medications with a prescription from your physician.
FSA debit cards, credit cards, and shared value cards issued by an employer may be used to pay for approved medical expenses.
Some plans require submission of a statement from an independent third party (such as a provider) stating that the medical expense has been incurred and the amount of the expense. You must also submit a personal statement indicating that the expenses have not been reimbursed through any other health plan coverage. Be sure to check with your administrator on card usage.
Please remember to retain all documentation, including receipts for all transactions for tax purposes, as you will be required to produce the documentation in the event of an audit. For information on establishing an HSA / FSA and complete federal tax regulations, please visit https://www.irs.gov/publications/p969/ar02.html#en_US_2015_publink1000204185. For comprehensive HSA and FSA medical and dental coverage explanations, please visit (https://www.irs.gov/pub/irs-pdf/p502.pdf. For specifics on managing your plan, please contact your benefits administrator or your HSA account trustee.
References
