HSA - How long is a doctor's note valid?

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GreenGrowTheDollars
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HSA - How long is a doctor's note valid?

Post by GreenGrowTheDollars » Thu Dec 06, 2018 12:53 am

I use artificial tears for dry eyes and reimburse from the HSA. The note my doctor provided doesn't have an end date and I'll likely need them for years. Do the notes expire from the IRS's perspective? I hate bugging docs to write these mother-may-I notes since it should be fairly obvious that nobody would be buying artificial tears if they didn't need them.

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southerndoc
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Re: HSA - How long is a doctor's note valid?

Post by southerndoc » Thu Dec 06, 2018 1:19 am

If the IRS follows conventional pharmacy prescribing, then the prescription is valid for one year.

joppy
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Re: HSA - How long is a doctor's note valid?

Post by joppy » Thu Dec 06, 2018 1:34 am

One way to handle multiple items for HSA is to print up a page of "regular OTC" items that you need and ask the doctor to sign the "HSA doctors OTC approval" page during your annual check-up. That way every year, you have a new "prescription" signed by the doctor for OTC meds, and it saves the doctor time as well.

- Joppy

RickBoglehead
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Re: HSA - How long is a doctor's note valid?

Post by RickBoglehead » Thu Dec 06, 2018 6:09 am

I used to get an annual note but stopped. If the IRS ever inquires, which they won't, I will get a retroactive note. It is in my chart every annual visit.

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Nestegg_User
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Re: HSA - How long is a doctor's note valid?

Post by Nestegg_User » Thu Dec 06, 2018 1:04 pm

we also got a note every year for DW parents showing their ADL limitations.... we recall reading that the IRS could claim a need to show cause for each year, even though it would be obvious that once they reached a certain limitation that they wouldn’t expect to improve.

fuzzball
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Re: HSA - How long is a doctor's note valid?

Post by fuzzball » Fri Dec 07, 2018 11:27 am

I want to piggy back off this thread - my dad has a couple of claims on his FSA, but was denied due to incomplete documentation.

His doc literally wrote a paper prescription w/ his name/DOB/device requested (in this case air purifier/HEPA filter). What would would as a "sufficient/valid" doctor's note?

Thanks!

curmudgeon
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Re: HSA - How long is a doctor's note valid?

Post by curmudgeon » Fri Dec 07, 2018 2:20 pm

For simple, low cost items with a clear purpose (like the OP), I would be comfortable treating my doctor's note as "good until cancelled". That is, I wouldn't fret about it and wouldn't worry about the IRS giving me grief. For something more expensive and less obvious (the all-day "massage therapy" at the spa, for example), I would be more careful to have clear and ongoing medical documentation.

FSAs are a different world, and you are subject to the CYA mindset of the administering organization. Anything other that straightforward medical bills are likely to be painful, but I don't have much experience there.

texasdiver
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Re: HSA - How long is a doctor's note valid?

Post by texasdiver » Fri Dec 07, 2018 3:51 pm

fuzzball wrote:
Fri Dec 07, 2018 11:27 am
I want to piggy back off this thread - my dad has a couple of claims on his FSA, but was denied due to incomplete documentation.

His doc literally wrote a paper prescription w/ his name/DOB/device requested (in this case air purifier/HEPA filter). What would would as a "sufficient/valid" doctor's note?

Thanks!
That's not an IRS issue, sounds like an unusually fussy FSA plan administrator. What you had from the doctor should have been more than sufficient. I would have complained/appealed to that person's supervisor because those claims were perfectly valid. When I had an FSA the administrator just rubber stamped anything that met the general criteria.

That said, when you use an HSA it is a little different. At least in my experience there is never anyone to review and approve/disapprove your spending decisions. You just swipe the HSA debit card wherever you want and keep the receipts for the IRS. It would only come up in the unlikely event that you were ever audited and this was the portion of your return that was audited.

mariezzz
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Re: HSA - How long is a doctor's note valid?

Post by mariezzz » Sat Dec 08, 2018 3:13 am

texasdiver wrote:
Fri Dec 07, 2018 3:51 pm
fuzzball wrote:
Fri Dec 07, 2018 11:27 am
I want to piggy back off this thread - my dad has a couple of claims on his FSA, but was denied due to incomplete documentation.

His doc literally wrote a paper prescription w/ his name/DOB/device requested (in this case air purifier/HEPA filter). What would would as a "sufficient/valid" doctor's note?

Thanks!
That's not an IRS issue, sounds like an unusually fussy FSA plan administrator. What you had from the doctor should have been more than sufficient. I would have complained/appealed to that person's supervisor because those claims were perfectly valid. When I had an FSA the administrator just rubber stamped anything that met the general criteria.

That said, when you use an HSA it is a little different. At least in my experience there is never anyone to review and approve/disapprove your spending decisions. You just swipe the HSA debit card wherever you want and keep the receipts for the IRS. It would only come up in the unlikely event that you were ever audited and this was the portion of your return that was audited.
Agree on this reply. If appealing to the supervisor in writing doesn't work: You can also complain to the people who oversee your insurance benefits in general - be sure to carefully read the IRS regulations, allowed items, etc.. This may not be feasible to many since it may require revealing personal details you don't want to reveal, or you may feel uncomfortable rocking the boat at work.

I had a situation where the administrator was clearly imposing an inappropriate level of documentation that wasn't required by the IRS. It was quite petty of them, and most importantly, they didn't provide any clear statement in advance of what they were demanding, so they just automatically declined all such requests.
Most people probably didn't appeal; I realized this and found it irksome that they were making it unnecessarily burdensome for people to get their FSA benefits paid.
At the time, I was working for a state agency, and insurance was overseen by a state office that oversaw insurance for all state workers. I complained (the item I wanted reimbursement for wasn't all that personal), and also made the point that the administrator's website was very inadequate - for this item, and many other things. End result: I got an apology; I got reimbursed, and the administrator's website was improved. The reimbursement in and of itself wasn't worth the effort I put into it - but my effort did improve things for all state employees.

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southerndoc
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Re: HSA - How long is a doctor's note valid?

Post by southerndoc » Sat Dec 08, 2018 7:29 am

fuzzball wrote:
Fri Dec 07, 2018 11:27 am
I want to piggy back off this thread - my dad has a couple of claims on his FSA, but was denied due to incomplete documentation.

His doc literally wrote a paper prescription w/ his name/DOB/device requested (in this case air purifier/HEPA filter). What would would as a "sufficient/valid" doctor's note?

Thanks!
For a device, you need type of device, instructions, and indication (generally an ICD-10 code).

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