Reimbursable expense?

[Guest rachd]

Would sunglasses that clip on to regular prescription glasses be reimbursable under a FSA?

The participant would be saving money by purchasing the clip on instead of buying a whole new set of prescription sunglasses yet the clip-on's by themselves are not technically medically necessary.

Opinions??

Thanks,

Rachel

[Guest MSMA]

We've paid these in the past because they really can not be used for any other purpose...it's not like the person could wear them all on their own.

[Guest kimb]

The matrix we use says that if the clip on sunglasses are not corrective then they're not reimbursable under the Cafeteria plan. We never reimburse for clip ons. It would be like reimbursing for regular sunglasses, which we know is not a reimbursable item either.

[Lisa Hand]

I would agree with MSMA that since the clip ons are used only with the prescription glasses, they would meet the "but for" requirement of an item not being personal use since it would not be used but for the specific medical condition, in this case prescription glasses.

This seems to be similar to the discussion we had recently on remote control devices for hearing aids. It has no other purpose but to work with a prescription device.

Also there could be cases where regular sunglasses could be medically necessary and prescribed by a practioner, such as after eye surgury or injury. Those cases would require proper documentation from the provider.

[Sandra Pearce]

I would not allow reimbursement in our 125 plan due to the fact that the clip on could be used by anyone and could not be construed as intended for the use of the participant.

[Lisa Hand]

Don't you have participants sign a claim which includes a statement verifying the expenses are for themselves or their dependents (along with other appropriate legalize) and documentation verifying the expense?

[Guest MSMA]

In regards to that they could be "used by anyone" argument....the same could be said for saline solution and other maintenance items for contact lenses....and like Lisa mentioned, our claim forms do have a statement on them regarding expenses and eligible people.