The Complete Guide to HSA/FSA and Bone Health Assessments

Your HSA or FSA Can Cover Your Bone Health Assessment

If you have a Health Savings Account (HSA) or Flexible Spending Account (FSA), you already have a powerful tool for investing in your bone health -- and many people do not realize it. Bone health assessments, including The Full Picture Assessment offered by HALLĒ, are eligible expenses under both HSA and FSA plans.

This means you can use pre-tax dollars to pay for a comprehensive bone density and bone quality evaluation. Depending on your tax bracket, this can effectively reduce your out-of-pocket cost by 20-35% compared to paying with after-tax income.

Here is everything you need to know about using your HSA or FSA for bone health.

What Are HSA and FSA Accounts?

Both HSAs and FSAs are tax-advantaged accounts designed to help you pay for qualified medical expenses. While they share a common purpose, they work differently in important ways.

Health Savings Account (HSA)

An HSA is available to individuals enrolled in a High Deductible Health Plan (HDHP). Key features include:

• Triple tax advantage: Contributions are tax-deductible, growth is tax-free, and withdrawals for qualified medical expenses are tax-free.
• Funds roll over: Unlike FSAs, unused HSA funds carry over from year to year indefinitely.
• Portability: Your HSA belongs to you, not your employer. If you change jobs, the account goes with you.
• 2025 contribution limits: $4,300 for individuals, $8,550 for families, with an additional $1,000 catch-up contribution for those 55 and older.
• Investment potential: Many HSAs allow you to invest funds in mutual funds or other vehicles for long-term growth.

Flexible Spending Account (FSA)

An FSA is offered through your employer as part of your benefits package. Key features include:

• Tax savings: Contributions are made pre-tax, reducing your taxable income.
• Use-it-or-lose-it: Most FSA funds must be used within the plan year. Some employers offer a grace period (up to 2.5 months) or allow a carryover of up to $640 into the next year, but unused funds beyond that are forfeited.
• 2025 contribution limit: $3,300 per year.
• Immediate availability: Your full annual election amount is available on the first day of the plan year, even though contributions are deducted from your paycheck throughout the year.

How The Full Picture Assessment Qualifies

The Full Picture Assessment by HALLĒ is a wellness assessment that evaluates bone density and bone quality using Echolight REMS (Radiofrequency Echographic Multi-Spectrometry) technology. It is performed by or under the supervision of a licensed healthcare provider and produces clinically actionable diagnostic results.

Under IRS guidelines, HSA and FSA funds can be used for medical expenses that are primarily for the diagnosis, cure, mitigation, treatment, or prevention of disease. Bone health assessments -- including bone density and bone quality measurements -- fall squarely within this definition.

Why It Qualifies

• It is a diagnostic medical procedure ordered or performed by a licensed healthcare provider.
• It produces clinical measurements (BMD values, T-scores, Fragility Scores) used for medical decision-making.
• It is used for the diagnosis and prevention of osteoporosis and osteopenia -- recognized medical conditions.
• It is consistent with the IRS definition of a qualified medical expense under IRC Section 213(d).

Step-by-Step Guide to Using Your HSA/FSA

Using your health account to pay for The Full Picture Assessment is straightforward. Here is how to do it:

Step 1: Verify Your Account Balance

Log into your HSA or FSA portal (or check your most recent statement) to confirm you have sufficient funds available. The Full Picture Assessment is $325.

Step 2: Book Your Assessment

Schedule your appointment through HALLĒ's website or by phone. You do not need a physician referral to book, though your primary care provider may recommend the assessment.

Step 3: Pay at Your Appointment

You have two options for payment:

• Pay directly with your HSA/FSA debit card: Most HSA and FSA accounts issue a debit card. Simply present it at the time of your appointment, just as you would a regular debit or credit card.
• Pay out of pocket and reimburse yourself: If you prefer, you can pay with a personal credit or debit card and then submit a claim to your HSA/FSA administrator for reimbursement.

Step 4: Keep Your Documentation

Retain the following for your records:

• Your receipt showing the provider name (HALLĒ), date of service, and amount paid
• A description of the service (bone health assessment / bone density evaluation)
• Your assessment results report (which serves as medical documentation of the procedure)

HSA and FSA administrators may request documentation to verify that an expense is a qualified medical expense. Having these records readily available ensures a smooth reimbursement process if needed.

Step 5: Submit for Reimbursement (If Applicable)

If you paid out of pocket and are submitting for reimbursement:

1. Log into your HSA/FSA administrator's portal
2. Select "Submit a Claim" or "Request Reimbursement"
3. Enter the date of service, provider name, and amount
4. Upload your receipt and/or assessment documentation
5. Submit the claim

Most claims are processed within 3-5 business days, though processing times vary by administrator.

Eligible vs. Ineligible Expenses: What You Need to Know

Not everything related to health and wellness qualifies as an HSA/FSA expense. Here is a quick reference:

Typically Eligible

• Bone density and bone quality assessments (including The Full Picture Assessment)
• Doctor visits, specialist consultations, and diagnostic tests
• Prescription medications
• Physical therapy and rehabilitation
• Certain over-the-counter medications and health products (including calcium and vitamin D supplements with a Letter of Medical Necessity in some cases)
• Lab work and blood tests

Typically Not Eligible

• General fitness programs or gym memberships (unless prescribed for a specific medical condition)
• Cosmetic procedures
• Health insurance premiums (with limited exceptions for HSAs)
• General wellness retreats

Note: Eligibility rules can vary by plan administrator. When in doubt, contact your HSA/FSA provider for confirmation.

Maximizing Your Year-End FSA Funds

If you have an FSA, the use-it-or-lose-it rule creates a powerful incentive to spend remaining funds before your plan year ends. Many people scramble to find eligible expenses in the final months of the year. A bone health assessment is one of the most valuable ways to use those funds.

Why a Bone Health Assessment Is Ideal for Year-End FSA Spending

• Clinically valuable: Unlike some year-end FSA purchases (do you really need another pair of prescription sunglasses?), a bone health assessment provides genuinely important medical information.
• Actionable results: You receive same-day results that can guide health decisions for years to come.
• Fixed, predictable cost: At $325, The Full Picture Assessment is a known, one-time expense that is easy to plan for.
• No referral needed: You can book directly, making it easy to schedule before your plan year deadline.

If your FSA plan year ends on December 31, consider booking your assessment in November or early December to ensure availability.

Why Bone Health Is a Smart HSA Investment

An HSA, with its ability to roll over funds and grow tax-free, is often described as one of the most powerful savings vehicles available. Using it for proactive bone health screening is a strategic investment that can yield significant long-term returns -- not in dollars, but in avoided costs and preserved quality of life.

The Cost of Inaction

Consider the financial comparison:

• The Full Picture Assessment: $325 (one-time cost for a comprehensive evaluation)
• Average cost of a hip fracture: $30,000-$50,000 in direct medical costs (hospitalization, surgery, rehabilitation), according to data from the National Osteoporosis Foundation
• Long-term care costs after hip fracture: Up to 20% of hip fracture patients require long-term nursing home care. The average annual cost of a semi-private nursing home room exceeds $90,000, according to Genworth's Cost of Care Survey.
• Lost income and productivity: Fractures result in missed work, reduced mobility, and in many cases, permanent disability.

A $325 assessment that identifies bone loss early enough to intervene is not an expense -- it is one of the highest-return health investments you can make.

Financial Planning for Bone Health

If you are thinking strategically about your health spending, consider building bone health monitoring into your annual HSA/FSA budget:

• Year 1: Baseline Full Picture Assessment ($325) to establish your bone density and bone quality measurements.
• Years 2-3: Implement nutrition, exercise, and any medical interventions based on your results.
• Year 3 or 4: Follow-up assessment ($325) to measure changes and evaluate the effectiveness of your interventions.
• Ongoing: Continue monitoring every 2-3 years, adjusting your approach based on objective data.

Over a decade, this amounts to approximately $975-$1,300 in total assessment costs -- a fraction of what a single fracture would cost, and all payable with pre-tax dollars through your HSA or FSA.

Frequently Asked Questions

Do I need a doctor's referral to use my HSA/FSA?

No. You do not need a physician referral to book or pay for The Full Picture Assessment with HSA/FSA funds. However, if your plan administrator requests a Letter of Medical Necessity, your primary care provider can provide one.

Will my HSA/FSA card work at the appointment?

Yes. HALLĒ accepts HSA and FSA debit cards as a form of payment at the time of your appointment.

What if my claim is initially denied?

In rare cases, an HSA/FSA administrator may request additional documentation. If this happens, provide your receipt and assessment report, which clearly document the medical nature of the service. If you need a Letter of Medical Necessity, your healthcare provider can supply one.

Can I use my HSA/FSA for family members' assessments?

Yes. HSA and FSA funds can be used for qualified medical expenses for your spouse and tax dependents. If you are concerned about bone health in your family, you can use your account to cover assessments for eligible family members.