HSA vs FSA

Daily living costs certainly can add up. From home and foot expenses to everyday necessities and health care, everything adds up. 

Fortunately, when shopping, some footwear is considered eligible when using Health Savings Accounts (HSAs) or Flexible Spending Accounts (FSAs) — which can be a great cost-savings tool. Whether looking for athletic footwear or dress shoes, Dr. Comfort® offers a wide array of diabetic and therapeutic shoes for those with foot-health issues. 

Wondering how FSAs and HSAs work? Here’s a breakdown to help you understand what’s covered.

What's the difference between an FSA and an HSA?

FSA's and HSAs are pre-tax accounts you can use to pay for healthcare-related expenses, such as diabetic footwear. Usually, an HSA health-care plan has a high-paying deductible.1 

An FSA is like a line of credit. For example, if your account balance is $50 in January but you'd like to buy a $200 pair of prescription eyeglasses, you can as long as you're on track to save at least $200 by the end of the year. So you’re covered throughout the year. However, if you don't use it the funds you could lose it.

An HSA is a health savings account. So you can put money into a savings account that is only for healthcare. The money you save always stays in your account. Keep in mind you can only spend money you've already saved.

With both FSA's and HSAs, you can pay for things like co-payments, medical bills, and health-care expenses. And both accounts have benefits that can make managing your out-of-pocket medical expenses easier throughout the year.

Both have pros and cons. An FSA has a little less flexibility—and must be offered through an employer—while an HSA has a bit of flexibility, but an HSA may have more out-of-pocket costs.2 Regardless, both allow you to save for medical costs. Map out what you think your medical costs will be for the year and figure out how much you want to put away in your FSA or HSA to cover your expectant costs. Learn more about HSAs and FSAs here.

Can you use your HSA or FSA to purchase your Dr. Comfort shoes?

Dr. Comfort® shoes with A5500 HCPCS (Healthcare Common Procedure Coding System)3 are eligible. In order to get reimbursed for A5500 HCPCS shoes, you’ll be asked to submit the following documentation, but not limited to:  

1) Prescribing physician's detailed written order

2) Completed signed and dated statement from the certifying physician (physician managing the beneficiary's systemic diabetes condition) specifying that the beneficiary has diabetes and:

  • Previous amputation of the other foot, or part of either foot, or
  • History of previous foot ulceration of either foot, or
  • History of pre-ulcerative calluses of either foot, or
  • Peripheral neuropathy with evidence of callus formation of either foot, or
  •  Foot deformity of either foot, or
  • Poor circulation in either foot,

and is being treated under a comprehensive plan of care for his/her diabetes, and needs diabetic shoes.

3) Relevant medical records where the certifying physician either personally documented that the beneficiary met one or more of criteria 2a – 2f or obtained documentation from another clinician documenting the beneficiary met one or more of criteria 2a – 2f and the certifying physician indicated agreement with the information by initialing and dating the record

 4) Supplier in-person evaluation conducted prior to the selection of items that documents an examination of the beneficiary's feet with a description of the abnormalities that will need to be accommodated by the shoes/inserts/modification

 5) An in-person visit, at the time of delivery, which assesses the fit of the shoes and inserts with the beneficiary wearing them

6) Delivery documentation with the beneficiary's name and address and the description of the items provided

7) Any other pertinent records.

Relevant medical records consist of physician notes, non-physician clinical notes, and non-physician clinical evaluations that verify that the patient's condition meets coverage criteria for therapeutic shoes for persons with diabetes.  The source of these records may be a physician's office, hospital, nursing home, home health agency, wound clinic, etc. Evaluations used to determine coverage must have been performed and recorded prior to delivery and performed by a clinician who does not have a financial relationship with the supplier.3

Dr. Comfort® shoes are American Podiatric Medical Association (APMA) approved, meaning the shoes are constructed with technology, material, and craftsmanship to deliver comfortable and top-quality diabetic shoes. The designs and materials are made to help protect the feet and help prevent them from foot-health issues that are associated with diabetes and other foot health problems. 

From exploring the town and outdoor adventures to special occasions and work, your footwear can be considered a medical aid, which can help you save on your diabetic and foot-health costs. 

Shop A5500 HCPCS footwear.

Remember to speak with your health care provider and health insurance for more information. 

The contents of this blog were independently prepared, and are for informational purposes only. The opinions expressed herein are those of the author and are not necessarily indicative of the views of any other party. Individual results may vary depending on a variety of patient-specific attributes and related factors.

Sources

  1. https://www.nerdwallet.com/blog/health/employer-offers-hsa-fsa-whats-difference/
  2. https://www.healthinsurance.org/faqs/what-is-the-difference-between-a-medical-fsa-and-an-hsa/
  3. https://www.pedorthics.org/page/SERVSPECPREPAYREV/HCPCS-Codes-A5500-A5512-and-A5513--Service-Specific-Pre-pay-Review-.htm
  4. https://www.drcomfort.com/medicare
  5. https://www.cdc.gov/diabetes/library/features/save-money.html
  6. https://www.cigna.com/individuals-families/member-resources/hsa-fsa-hra-payments/eligible-expenses#Medicalaids