FlexSpend for baby's medical expenses/doula/nursing expenses?

[Anonymous]

Hi, I need to tell our HR department how much to put aside for flexspend, and am having trouble estimating the amount. I'm due in July. Does anyone know if doulas are an eligible expense? How about expenses connected with nursing such as a lactation consultant, breast pump rental through hospital?

Apparently co-pays for baby's pediatrician visits are covered.

Sadly, diapers are not covered. Childcare expenses are eligible through a dependent care savings account.

I know this varies a lot person by person but would love to hear what has worked for others. Thanks!

[Anonymous]

I have heard that doulas and breast pumps are eligible only under limited circumstances. Doulas, I believe, have to have some sort of certification (DONA not enough) and you'll need some sort of note from a doctor that you need a breast pump (not just for milk expression to feed baby while you're gone). I've only heard this second-hand from others.

[Anonymous]

we have Aetna FSA and unfortunately our doula is NOT covered. neither is the breast pump. but our childbirth classes were - so check into that.

[Anonymous]

[op here] wow...childbirth classes covered? that's pretty cool. i wonder if a bradley class would be covered or if i'd have to go through the hospital. thanks for the tips!

[Anonymous]

Bradley classes are 12 weeks so you'd better sign up quickly if you plan to go that route. I didn't know they took so long so signed up for hypnobirthing instead (5 weeks). Fortunately, I'm happy with what I've learned in hypnobirthing.

[Anonymous]

op here...yes, my bradley class started already. like the class--8 sessions, which is still a lot.

[Anonymous]

Also - depending on what hospital you will be delivering at:

If you have the option of a private room (therefore you pay extra) that is a covered expense. For example, Sibley private rooms. Of course you don't know whether you'll have 2 or 4 nights.

If you have a c-section, there will be a neonatalogist present. Under my health insurance, that was not a covered maternal cost, but a deductible child-cost. A few hundred bucks that is covered.

[Anonymous]

You should have 30 days after the birth to enroll in the FSA. I believe it's the IRS rule, so don't let your HR push you into signing up earlier if you don't need to. By 30 days after birth, most (hopefully all) of your providers will have billed your insurance and you should know how much you will owe in copays etc. You can also call your insurance right now and they should be able to tell you how much you will be responsible for.

Breast pump rental may be covered under your insurance, so check on that. You may need a doctor's note but again, I would check into that with your insurance ahead of time.

I also had a c-section, and there was no neonatologist present for the birth that I can recall or that I got billed for. The hospital's pediatrician who did the initial exam/assessment was billed under my name too. My daughter did end up in the NICU, and the charges for the facility and the doctors there got billed under her name. It didn't matter under my insurance (no deductible) but I guess if your insurance has different deductible for individuals that may matter.

Good luck!

[Anonymous]

bradley classes are DEFINITELY covered by insurance

[Anonymous]

i meant bradley classes are definitely covered by FSA. any organized form of childbirth ed. is covered by FSA.

[Anonymous]

SAHM now but former HR person. I'm guessing the OP is currently going through open enrollment. Not all companies do this in the fall for the next calendar year. If that is the case she does need to make an election at this time.

Once you have the baby it is a "qualifying event" which allows her to have 30 days to add the new dependent child and to make changes to her FSA and DCA expenses. This year I put aside $500 in my FSA during open enrollement and depending on what I have to pay for the birth will make adjustments at that time. In fact, I'm in the process of gathering up all my deductible expenses thus far for 2008 to submit right now so I have an accurate balance for when the baby is born.

The easiest way to check which expenses are deductible/non-deductible is to reference Publication 502 which is put out by the IRS. Here is the link:

http://www.irs.gov/pub/irs-pdf/p502.pdf

Good luck. I know this is confusing but FSA's are a wonderful benefit and it is unfortunate that more people don't take advantage of them. I think "use it or lose it" scares a lot of people but depending on your tax bracket, you can actually forfeit a significant amount and still come out ahead. For what it's worth I have participated for over 10 years now and the most I have ever forfeited is $20.

Good luck with the rest of your pregnancy. I'm ready to pop!

[Anonymous]

I am a doula and several of my clients have had my services covered under their FSA's. I did not need to provide them with any proof of certification or training -- all they needed from me was a receipt. Childbirth classes are also frequently covered. OP, you would probably have the best luck with just calling your particular FSA company and asking them specifically which of these things are allowable expenses.

If you hire a doula, it will cost anywhere from $800-$1200. A postpartum doula could cost anywhere from $500-$2000. A Bradley Method or Lamaze childbirth class will cost you $300-$400. A breastpump rental could cost about $70/month (though you could just buy one for $250). An in-home consultation with a lactation consultant would cost $100 - $120, and if you are a first time mom I might allow for two lactation consultations. Hope this helps get a feel for how much these sorts of things cost. Also, have you hired your doula yet? Most doulas I know are already full for July. Obviously you should make sure you have a doula before you set aside any money in your FSA for one.

Good luck with your delivery and new baby!

[Anonymous]

14:25 - i don't see how it's helpful to have a general link. it depends on your specific FSA. Aetna FSA DOES NOT COVER DOULAS. i called and asked, after reading it pretty plainly in the manual.

[Anonymous]

I never said Doula's were covered. This link is the IRS's guidelines. Yes it is on the most general level but it is a great starting point. If your plan's documents are more specific that is great.

I was not able to submit birthing classes, doula, breast pump purchase price, etc. Some insurances allow it but it is really up to that individual insurance plan. FSA's are still goverened by the IRS how individual insurance plans decide to interpret the laws/guidelines is up to them.

[Anonymous]

Okay, I'm a Federal employee who participates in FSAFEDS. I'm reading from the eligibility expenses "juke box," as they call it.

Breast pumps are listed as potentially eligible. "Routine use of a breast pump is not an eligible expense. If the nursing mother or baby has a meedical condition that can be relieved through use of a breast pump, the extense of your breast pump can be reimbursed."

Childbirth classes are eligible expenses. "Does not include Breasfeeding classes; newborn or new infanct care classes; parenting classes."

Doulas are listed as potentially eligible. "If the douola is a licensed health care professional who render medical care, his or her fees can be reimbursed."

A DONA certified doula is absolutely not a health care professional rendering medical care. That would be contrary to the DONA code of ethics, as I understand it.