Can an employee be reimbursed for herbal medicines prescribed by a physician to treat a medical condition? My understanding is that vitamins, even if prescribed by a physician, are not reimbursable. Are herbal medications treated the same as vitamins?

The answer to your question is yes.Herbal medicines, if prescribed by a doctor are eligible.


[This message has been edited by Joe Priselac (edited 12-15-1999).]

[This message has been edited by Joe Priselac (edited 12-15-1999).]

One more note on this issue since herbal remedies are normally "prescribed" by a naturopath or acupuncturist, ect., according to the IRS informational letter on July 30,1999, medicines and supplies can only be excludable if prescribed by a "physican" as defined as a "doctor of medicine, osteopathy, dental medicine, optometry and chiropractor." A practitioner of alternative medicine or holistic healer would not meet this definition. Therefore, any prescribed remedies would NOT be reimburseable even if the professional services of the holistic healer are eligible for both MSAs and Medical FSAs.

Lisa. Can you cite this IRS informational letter please.I am also wondering how they would get chiropractor to write a prescription. Also FL, CA and HCFA among others allow alternative medicine doctors to write prescriptions under their Health Insurance laws, curious that the IRS would not, yet would accepts from those who are restricted by Federal Law.

This isn't really an IRS decision; they are bound by the statute. Health care expenses generally can be reimbursed through an FSA if the expenses would be deductible under section 213 of the Code. Section 213 limits deductibility of medicine and drugs to "prescribed drugs". Prescribed drugs are those drugs prescribed by a "physician" as defined in 42 USC 1395x®. A physician in 42 USC 1395x® means:

1. a doctor of medicine or osteopathy
2. a doctor of dental surgery or dental medicine
3. a podiatrist
4. an optometrist
5. a chiropractor.

A naturopath is not on the list. Therefore, drugs/remedies prescribed by a naturopath are not "prescribed drugs" under section 213 and are not eligible for reimbursement through a health FSA.

Note, however, that medical care provided by a naturopath for a specific condition or illness may be eligible for reimbursement even though drugs/remedies are not.

It is important to note that the regs say the drug has to be available ONLY by prescription. That way, someone cannot get around the restrictions by asking their doctor to write a prescription for an over the counter preparation. Anything that I can buy myself at a health food store or pharmacy without a prescription therefore cannot be pretaxed in a Cafeteria plan.