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On Facial Hair and Flexible Spending Accounts

I have worn a beard for most of my adult life, and I appreciate a solid stand of men's facial hair. So I couldn't help noticing an article last week touting a growing industry in Turkey: Turkish mustache transplants. 

For a mere $5,000, the "follicly challenged" can have a cosmetic surgeon enhance their mustache or beard. The procedure is done under local anesthetic and takes only a few hours. In true medical tourism style, the procedures are being offered as part of "transplant packages" that may include additional amenities such as a beachside vacation on Turkey's Mediterranean coast.

If you're looking to boost your masculinity and catch a few rays in the process, this might just be the thing you've been waiting for.

That got me to thinking: This is bound to become wildly popular because - let's face it - who could resist a shot at the mustache of their dreams. Which means it's only a matter of time before we find an employee or two claiming reimbursement under a health FSA, HRA, or HSA for the cost of the procedure. It's medical, so it's covered - right?

Well, not so fast. 

To be reimbursed from a health FSA, HRA, or HSA, expenses generally must be for "medical care," and the tax code specifically excludes cosmetic surgery from the definition of medical care. What counts as cosmetic surgery? Any procedure that "is directed at improving the patient's appearance and does not meaningfully promote the proper function of the body or prevent or treat illness or disease."

But what if the procedure does treat illness or disease? Let's say a man is suffering from clinical depression over years of low self-esteem due to sub-par facial hair, and his physician prescribes the procedure to treat the depression. Now is it cosmetic? Maybe not.

Remember, however, that only the expenses associated with medical care could be reimbursed. So even if the transplant costs qualified for reimbursement, some of the related expenses - such as the cost to rent a beach villa for a week - might not.

Also, travel expenses related to medical care are always tricky. To qualify, the expense must be "primarily for and essential to medical care." The cost of traveling to Turkey might not be essential to obtaining the care, if the same care is available at other, closer locations.

Then again, where else could you expect to get an authentic Turkish mustache?



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Don Berner, the Labor Law, OSHA, & Immigration Law Guy
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Boyd Byers, the General Employment Law Guy
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Jason Lacey, the Employee Benefits Guy
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