FSAFEDS will reimburse your Gym Memberships

Dear FSAFEDS Participant:
We will process gym membership claims differently beginning January 1, 2009. As you may know, gym memberships may be eligible expenses if prescribed by a physician and substantiated by his/her statement that treatment is necessary to alleviate a medical condition.
As a result of a recent clarification provided by the IRS, we must change how we currently process gym membership fees to remain compliant. IRS regulations stipulate that we cannot reimburse participants for services to be provided in the future, even if the provider requires payment in advance for the entire period.
What does this mean for you?

FSAFEDS and Gym Memberships

This means that FSAFEDS cannot reimburse you for gym membership fees in full even if you paid for an entire period upfront. If you submit a Letter of Medical Necessity for a gym membership and it is approved, you will need to submit your expenses AFTER the dates of service have passed. If you submit a claim that includes dates of service that have not yet occurred, we will pro-rate your claim. The portion that includes dates that have passed will be paid and the remaining portion will be denied. You would have to re-submit the denied portion(s) after those dates of service.
For example: If you submit a claim on February 1 for $500 to pay for membership from January 1 to May 31, we will pay $100 (January's service has taken place already) and deny $400 (February, March, April and May have not yet occurred).
How should I submit my gym membership claims if I pay for the full amount upfront?
For a gym membership to even be considered for reimbursement, you must first have an approved Letter of Medical Necessity (LMN) on file for a medical condition that requires exercise at a gym. If the LMN is approved, you have two options for submitting these types of claims. Please note that the IRS regulations stipulate that we cannot reimburse expenses that will be incurred in the future, even if the provider requires payment in advance for the entire period. This includes expenses such as gym memberships:
Here are your options:
1.    Submit expenses for a full month after that month has ended. Let's say you are billed monthly for gym membership, and paid for January 1 - January 31. On February 1, you would submit a claim form for January only, and include the receipt for January's membership that details the dates of service, provider name and cost.
2.    Submit the expense for a specific time period. Let's say you were asked to pay a fee upfront for a specified time period. For instance, in April you were asked to pay a $270 fee to cover gym membership for April through December. On May 1, you could submit a claim for $270 but we would pay a pro-rated amount of $30 ($270 divided by 9 months). On June 1, you could submit another claim and we would pay another $30. You could submit a claim each month thereafter with the appropriate documentation until you were reimbursed for the entire expense.
In summary, beginning January 1, 2009, if you have an approved Letter of Medical Necessity for a gym membership, you will only be reimbursed for eligible expenses AFTER the dates of service have passed. If a claim is submitted that includes future dates of service, the portion of the claim for dates of service that have not yet occurred will be denied.
We appreciate your understanding and cooperation as we implement IRS requirements. If you have any questions, please contact us at FSAFEDS@shps.com or toll-free at 1-877-FSAFEDS (372-3337), TTY: 1-800-952-0450, Monday through Friday, 9:00 a.m. until 9:00 p.m., Eastern Time.
Sincerely,
FSAFEDS