Why aren't diet and health foods FSA-eligible?

A few months back, we talked about maintaining healthy seasonal activity. But that article has continued to bring about deeper questions about food, diet and overall health
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We know that eating well and maintaining a healthy weight can reduce the risk of many conditions like diabetes, heart disease, and even strokes. Since eating well is such an essential component of overall health, some people with FSAs believe that health or diet foods are (or should be) eligible for reimbursement. But a good chunk of diet and health food items are not FSA-eligible expenses.

Why aren't these items eligible expenses?

For an item to be eligible, it needs to be necessary to diagnose, treat, cure, or prevent a disease or condition. In most cases, food doesn't fall into any of these categories. Because of this, the IRS doesn't allow diet or specialty foods to qualify, because they're just a substitute for what is normally eaten to satisfy nutritional needs. This includes everything from diet shakes to fruits and vegetables.
The thinking is this: Everyone needs to eat to be alive and well and anything you do on a regular basis to stay healthy, such as eating or exercise, isn't considered a medical expense.

For example, someone struggling with obesity might need a special diet low in calories but rich in nutrients to assist with weight loss and overall health. But the foods that are needed also fulfill normal nutrition requirements that everyone needs on a daily basis. The food itself does not treat, cure or prevent obesity - monitoring diet and activity levels and making healthy choices does.

In the same vein, nutritional supplements and meal replacements aren't eligible for reimbursement because they typically aren't used to diagnose, treat, cure or prevent conditions, either. People traditionally use supplements when they aren't getting the recommended dose of vitamins and minerals from their typical diets, or because they're interested in the benefits of various natural extracts and oils.

Are there any exceptions?

In most cases, food is (pardon the pun) off the table. But there are certain medical conditions that require specific formulas and nutrients in order for the patient to live symptom-free.

As an example, when people have Celiac Disease, they might suffer from an upset stomach and abdominal discomfort when they consume gluten. In a case like this, a gluten-free diet is necessary for the person to live without those symptoms.

In some cases, the person can speak with their physician and obtain a Letter of Medical Necessity which would outline what kind of food is necessary and how it would help treat the condition. But even if you get an LMN, the full cost of the food isn't eligible for reimbursement - only the increased cost of the specialty food over what a non-specialty food would cost.

In some cases, nutritional supplements may also be eligible expenses with a prescription or LMN. These special cases would also be instances where a specific condition requires the addition of a specialized nutrient or vitamin to treat and prevent symptoms.

But since food and nutrition items don't typically qualify, it's important to first discuss the potential of reimbursement with your FSA administrator and physician.

Source: Tabitha Jean Naylor of FSAStore.com

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