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Can Medical FSA reimburse medical service provided by relative?


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Guest RichelleHJ
Posted

Can a Medical FSA reimburse for a medical service that was provided by relative? The insurance company denied the claim (following their document) but I don't find anything that would disallow this for a Flex Plan - in the Flex document or in the code. But my gut instinct is that it doesn't seem right - is there something in the tax regs I'm missing that disallows this reimbursement?

Guest JerseyGirl
Posted

Is the relative a licensed medical practitioner? Does the documentation provided seem legitimate? Is it a reasonable fee for a reasonable service? I work for a TPA and adjudicate claims on a daily basis. We have a participant whose wife is an MD, and we have approved claims for prescriptions written for him, by her, for medications that were not covered by their health insurance. If the answers to my 3 questions are all *yes*, I can see no reason to prevent reimbursement.

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