Using Your FSA or HSA for Hormone or Weight-Loss Care Before Year-End

Peak Medical Wellness accepts HSA and FSA cards. We aren't tax advisors, and your plan administrator has the final word on what your specific plan reimburses. The rules below come from IRS Publication 502 and are the ones most plans follow.

• A flexible spending account (FSA) is funded through your employer and, in most plans, runs on a calendar year. Money you don't use by the plan deadline is forfeited. Some plans soften this with either a grace period of up to two and a half months (often through March 15) or a carryover of up to $680 from a 2026 plan year into 2027. A plan can offer one of those or neither, never both. Your plan documents or HR say which applies to you.
• A health savings account (HSA) is yours. The balance rolls over every year, so there's no December deadline. The 2026 contribution limits are $4,400 for self-only coverage and $8,750 for family coverage, and unused room doesn't carry forward, so some people choose to spend down or top up before year-end for tax reasons. That's a conversation for your tax advisor, not us.

The 2026 health FSA contribution limit is $3,400. If you set aside that much in January and haven't used it, December is the month to check your balance.

IRS Publication 502 lists these among medical expenses, which is the standard FSA and HSA plans use:

• Visits with a licensed provider for diagnosis and treatment.
• Laboratory fees that are part of medical care.
• Prescribed medicines and drugs. A prescription filled by a compounding pharmacy is still a prescription for this purpose; what matters is that a licensed provider prescribed it for a medical condition.
• A weight-loss program when it is treatment for a specific disease diagnosed by a physician, such as obesity, hypertension or heart disease. Some plan administrators ask for documentation from the treating provider before they reimburse weight-loss care; ask your plan what it requires before you book.

At Peak Medical Wellness, provider visits, labs drawn in our office, and prescribed treatment for hormone care or medical weight loss are what patients typically pay for with these cards. Whether a specific visit or prescription is reimbursable under your plan is your plan's decision, not ours.

• Diet food, meal replacements or beverages, even if a program recommends them.
• Gym, health club or fitness memberships.
• Over-the-counter supplements without a prescription.
• Anything cosmetic rather than medical.
• Care that isn't tied to a diagnosed condition. The IRS says a weight-loss program whose purpose is improving appearance, general health or sense of well-being doesn't count.

If you're unsure whether a specific service is reimbursable under your plan, ask your administrator before you book; it's a two-minute call and it avoids a denied claim.

One practical note about “spend by”: most FSA plans count the date of service, not the date you pay. A visit on December 30 counts toward 2026 even if the card runs the next week. A visit booked for January 3 does not.

1. Check your FSA balance and your plan's deadline and grace or carryover rules (your benefits portal shows all three).
2. Ask your plan administrator what documentation, if any, it needs for the care you're planning.
3. Book your visit for a date before the deadline. Peak Medical Wellness sees patients Wednesday through Saturday, and the last two weeks of December fill early; booking in November is the safe play.
4. Bring your FSA or HSA card to the visit. If your plan reimburses instead of paying directly, ask the front desk for an itemized receipt with the date of service and the provider's name.
5. Keep the receipt. Plans can ask for documentation months later.

If you'd rather spread the cost of care over time, payment plans are available too.

If your employer's open enrollment is in October or November, it's worth estimating next year's hormone or weight-loss care when you choose your 2027 FSA amount. Ongoing care with regular labs and follow-up visits is predictable, which is exactly what an FSA is good at.