Understanding Health Insurance and whether it covers personal training?
Big issues in America, health care, taxes, obesity, and Pythons in Florida. Three of these things can be used synergistically (four if you are super creative).
How you ask?
First you seduce the pythons into agreeing to a Bezos inspired tax evading offshore ponzi scheme located close to cheesecake factory……..No? Ok here is the second approach.
If you have a health plan through your job, you can use a Flexible Savings Account that allows you to pay for co-payments, deductibles, drugs (prescription, not recreational), and some other health care costs.
What exactly is an FSA? An FSA – Flexible Spending Account (or Flexible Spending Arrangement) is a non-taxable account that you put money into throughout the year to pay for some out-of-pocket health care costs. It can be used for medical expenses and typically have a maximum contribution of $2,500 per year that must be used by the end of your enrollment year.
Now seeing as no one enjoys paying taxes but it is unfortunately an unavoidable reality (unless you’re a billionaire) and we should all be happy and healthy enough to enjoy our lives, can we use an FSA to improve our health or at least provide access to the funds to do so?
The rules state that if you have a medical condition, such as obesity, and a doctor requires you to exercise, they can create a Letter of medical Necessity (LMN) for your benefits administrator that could allow you to cover these costs with your FSA.
For any product or service to be FSA-eligible, it must treat, cure, diagnose or prevent a disease or illness.
How can this be argued? Well if we look at the current (actually 99.9%) of the research, obesity is a disease that can be cured, treated and prevented with exercise prescription, therefore it should be eligible under this definition. The key words are treat and prevent. Exercise is a well established means to help prevent and cure a number of diseases that can affect us mere mortals and thus according to the definitions provided, personal training theoretically could be FSA eligible. All you need is an LMN.
How to submit a letter of medical necessity
If you and your doctor have identified a medical product or service that can aid the treatment of an injury or medical condition and it falls outside FSA eligibility, here’s what you need to do:
- Check with your benefits administrator to see if there is an official form to fill out for the expense to be approved.
- If your doctor is writing a letter on his/her own, the letter must outline: what medical condition is being treated, a description of the treatment (frequency, dosage), and how long the expense will be needed to treat the condition.
- A receipt or invoice must be submitted with the LMN for the full price to be reimbursed.
Let’s say you have visited the doctors and have been told you are at risk for type 2 diabetes. If you are already paying for a certain class/ session/ membership unrelated to this condition, then the costs won’t be covered retroactively. However, if you are not actively doing any of these things and the physician recommends say personal training to help with a specific condition, (in this example type 2 diabetes), they might submit a LMN on your behalf which allows you to use tax free funds to cover the cost of Personal training for a period of time until the doctor determines your treatment is complete (retest blood work).
In a perfect world, there should not be any difficulty getting reimbursed for your expense as long as you keep an open line of communication with your benefits administrator and ensure that your physician is as detailed as possible.
I highly recommend visiting your physician if you have any health conditions you would like help alleviating but may not have the finances to cover. Research the FSA and see if you are eligible. Not only will you save money on taxes, get discounted or even free personal training, you will have the opportunity to optimize your health and therefore life experience!
Then when you are fit, we can fly to Florida and tackle the python problem.
For more information on the FSA:
Disease: a disorder of structure or function in a human, animal, or plant, especially one that produces specific signs or symptoms or that affects a specific location and is not simply a direct result of physical injury.