Using Your FSA or HSA
for Dermatology Care

Yes, you can use a flexible spending account (FSA) or health savings account (HSA) to pay for medical dermatology care. Visits to diagnose or treat a skin condition, skin cancer screenings, biopsies, Mohs surgery, prescription medications, and broad-spectrum sunscreen with SPF 15 or higher are all eligible expenses. Cosmetic treatments are not. Most FSA balances must be used by December 31, so the last quarter of the year is a good time to schedule the visit you have been putting off.

What Is the Difference Between an FSA and an HSA?

Both accounts let you pay for qualified medical expenses with pre-tax dollars, but they work differently at year-end.

• A flexible spending account (FSA) is offered through your employer. You choose an amount at open enrollment, it is deducted from your paycheck before taxes, and you must use it within the plan year. Most plans end on December 31. Employers may offer either a grace period of up to two and a half months (usually through March 15) or a limited carryover of unused funds into the next year, but not both. Anything beyond that is forfeited, which is where the phrase “use it or lose it” comes from.
• A health savings account (HSA) is paired with a high-deductible health plan. The money is yours, it rolls over every year, it stays with you if you change jobs, and there is no deadline to spend it. You can also pay out of pocket now and reimburse yourself from the HSA later, as long as you keep the receipt.

Not sure which you have? Your benefits card or your employer’s human-resources portal will say, and your plan administrator can confirm your balance and deadline.

Which Dermatology Services Are FSA and HSA Eligible?

The IRS defines eligible expenses as the costs of diagnosing, treating, or preventing disease. For dermatology, that means medical care is eligible and cosmetic care is not.

Eligible Over the Counter, No Prescription Needed

Since 2020, over-the-counter medicines and products are eligible without a prescription. For skin, that includes:

• Broad-spectrum sunscreen with SPF 15 or higher, including mineral sunscreens and SPF lip balm.
• Acne treatments with benzoyl peroxide, salicylic acid, or adapalene.
• Hydrocortisone cream, antifungal creams, antihistamines, and wart removers.
• First-aid supplies.

Our over-the-counter product guide lists the categories our providers recommend most often.

How Do FSA Deadlines Work at Year-End?

• The date of service is what counts. Care you receive on or before your plan’s deadline is eligible even if the bill arrives in January.
• December 31 is the deadline for most calendar-year plans. Check whether yours offers a grace period (often through March 15) or a carryover.
• Claims have their own deadline. Many plans give you until March 31 to submit receipts for the prior year. Submit early rather than waiting.
• December appointments fill quickly because everyone has the same deadline. Booking in October or November gives you the most choice of dates and providers.
• HSA funds never expire, so there is no year-end rush. Scheduling before the end of the year still makes sense if you have already met your deductible.

How to Use Your FSA or HSA at Belaray

• Bring your FSA or HSA debit card. It works like any other debit card for copays and balances at either office, and you can also use it to pay your bill online.
• Pay for cosmetic services with a different card so your account stays clean.
• Ask for an itemized receipt at checkout, or request an itemized statement later by phone or text. Your insurer’s explanation of benefits (EOB) also documents the visit.
• If you need a letter of medical necessity, for example for Botox to treat hyperhidrosis, ask your provider at the visit.
• Keep copies of receipts with your tax records. HSA withdrawals in particular should be backed by a receipt in case of an audit.

Dermatology Visits Worth Scheduling Before Year-End

If you have an FSA balance to use, these are the visits patients most often leave for last:

• Your annual full-body skin exam, especially if you have a history of sunburns, tanning, or skin cancer in the family.
• A mole or spot you have been watching. See the ABCDE guide for the warning signs.
• Follow-up visits for acne, eczema, psoriasis, or rosacea, and prescription refills.
• Patch testing for a rash that keeps coming back, or an evaluation for excessive sweating.
• A pediatric visit during the winter school break.
• Sunscreen for the family. It is eligible, and the year-end supply carries you into spring.

Both offices are open through December. Hicksville (358 S Oyster Bay Road, Hicksville, NY 11801) sees patients Monday and Wednesday 7 am to 7 pm, Tuesday 7 am to 4 pm, Thursday 9 am to 4 pm, and Friday 7 am to 3 pm. Stony Brook (2500 Nesconset Hwy #20B, Stony Brook, NY 11790) is open Monday through Thursday 8 am to 4 pm and Friday 8 am to 2 pm. Both offices are closed on weekends, and holiday hours may vary.

Frequently Asked Questions

Can I use my FSA or HSA to see a dermatologist?

Yes. Office visits to diagnose or treat a skin, hair, or nail condition are qualified medical expenses, including copays, deductibles, and coinsurance. That covers annual skin exams, skin cancer screenings, acne, eczema, psoriasis, rosacea, rashes, warts, and similar concerns. Purely cosmetic visits are not eligible.

Is sunscreen FSA or HSA eligible?

Yes. Broad-spectrum sunscreen with SPF 15 or higher is an eligible over-the-counter expense, and since 2020 it no longer requires a prescription. SPF lip balm and mineral sunscreens qualify as well. Products whose main purpose is cosmetic, such as makeup or tinted moisturizer that happens to contain SPF, are usually not eligible.

Is Botox FSA or HSA eligible?

Only when it treats a medical condition. Botox for hyperhidrosis (excessive sweating) is a medical treatment and is generally eligible, although many plans ask for a letter of medical necessity from your provider. Botox or Xeomin for frown lines, crow’s feet, or other wrinkles is cosmetic and is not eligible.

Are cosmetic dermatology treatments FSA or HSA eligible?

No. The IRS excludes procedures that improve appearance without treating disease or a deformity. Fillers, Kybella, laser hair reduction, BBL and IPL photofacials, laser resurfacing, RF microneedling, PRP for hair growth, and cosmetic removal of moles or skin tags are not eligible. A treatment that is cosmetic for one patient can be medical for another, for example laser treatment of a disfiguring scar, so ask your plan administrator before you schedule.

When does my FSA expire?

Your plan sets the deadline, and for most calendar-year plans it is December 31. Some employers add a grace period of up to two and a half months or allow a limited carryover into the next year, but not both. What counts is the date you receive care, not the date you are billed. HSA funds never expire.

Is Mohs surgery FSA or HSA eligible?

Yes. Mohs surgery for skin cancer is medical care, so your copays, deductibles, coinsurance, pathology fees, and the reconstruction performed after the cancer is removed are all eligible expenses. Wound-care supplies you buy afterward, such as petroleum jelly, gauze, and bandages, are eligible as well.

What receipt do I need for an FSA or HSA claim?

An itemized receipt showing the provider name, the date of service, a description of the service, and the amount you paid. Your insurer’s explanation of benefits (EOB) also documents the visit. Belaray can print or email an itemized statement on request. Keep copies with your tax records, especially for HSA withdrawals.

Related reading: annual skin exams, insurance plans we accept, our over-the-counter product guide, and paying your bill online.