Can I use a Lifestyle Spending Account (LSA) for fertility counseling?

Fertility counseling can be a deeply personal and emotional journey, and you may be wondering if your employer-provided Lifestyle Spending Account (LSA) can help cover the costs.

LSAs are a flexible benefits solution that allows you to spend on a wide range of wellness and lifestyle expenses, tailored to your unique needs and goals.

In this article, we'll explore what LSAs are, how they work, and whether fertility counseling is an eligible expense under these accounts.

What is a Lifestyle Spending Account (LSA)?

A Lifestyle Spending Account is an employer-funded benefit that provides you with a set amount of money to spend on wellness and lifestyle expenses. Unlike traditional health insurance or pre-tax accounts like HSAs or FSAs, LSAs offer more flexibility and choice in how you use your benefits.

The specific eligible expenses and contribution amounts vary by employer, but the goal of LSAs is to support your overall well-being across physical, mental, financial, and professional dimensions. This holistic approach recognizes that everyone's needs and priorities are different.

Examples of LSA-eligible expenses

LSA-eligible expenses are determined by your employer, but they commonly include a wide range of wellness and lifestyle categories. Some examples are:

• Fertility counseling and family-forming support
• Mental health services like therapy or counseling
• Gym memberships, fitness classes, and exercise equipment
• Financial planning, coaching, and education
• Professional development courses and certifications
• Childcare and eldercare services
• Home office setup and ergonomic furniture

Can fertility counseling be covered by a Lifestyle Spending Account?

Yes, fertility counseling can be an eligible expense under an LSA if your employer explicitly includes it in their LSA program design. LSAs are customizable employer-funded benefits that allow companies to reimburse you for a wide range of wellness and lifestyle expenses, including family-forming support.

Key Considerations for LSA Coverage

1. Employer Discretion: LSAs are not tax-advantaged accounts, so employers have broad flexibility to define eligible expenses. Fertility counseling may fall under categories like:
2. Family planning (e.g., adoption, surrogacy, fertility treatments)
3. Mental health services (e.g., therapy for stress related to infertility)
4. Specialized LSA programs (e.g., HealthEquity's "Family Support" category or Lively's "New Chapter" LSA, which explicitly cover fertility counseling).
5. Tax Implications:Reimbursements from LSAs are taxable income for you. This differs from HSAs/FSAs, which cover fertility counseling as a tax-free expense if it's medically necessary.
6. Documentation Requirements:Your employer may require proof of service, such as receipts or a letter from a licensed fertility counselor. For example, Lively's LSA mandates documentation for expenses like "fertility nutrition counseling."

Examples of Employers Offering Fertility Counseling via LSAs

• HealthEquity includes "family support" expenses like surrogacy and infertility treatments in LSAs, with 21% of their LSAs covering reproductive health services.
• Lively's "New Chapter" LSA explicitly lists fertility counseling, genetic testing, and fertility medication as eligible expenses.
• CHG Healthcare offers LSAs that reimburse for mental health services, which could include fertility-related counseling.

How LSAs Compare to Other Accounts

Account TypeFertility Counseling CoverageTax TreatmentLSA✅ If employer allowsTaxable incomeHSA/FSA✅ With medical necessityTax-freeHRA❌ Employer-dependentTax-free

Steps to Confirm Eligibility

1. Review your employer's LSA guidelines for listed eligible expenses (e.g., "mental health services" or "family planning").
2. Submit a pre-approval request if the expense is unclear.
3. Provide documentation from a licensed fertility counselor or clinic.

For example, ASRM-certified counselors offering services like "implications counseling" or "crisis intervention" for fertility patients are often eligible.

Employer Trends

• 34% of employers now offer adoption/family-forming benefits via LSAs, with contributions averaging $14,831+.
• Companies like American Express reimburse up to $35,000 for adoption/surrogacy costs through LSAs.

In summary, LSAs can cover fertility counseling, but eligibility hinges on your employer's specific plan design. Always verify with your HR team or benefits administrator.

Benefits of using an LSA for fertility counseling

Financial support

Fertility treatments and related expenses can add up quickly, with a single IVF cycle costing $15,000 to $30,000 on average. LSAs can help offset these costs by reimbursing you for fertility counseling sessions, which are often recommended alongside medical treatments.

Many employers offer generous LSA contributions for family-forming expenses, with some providing up to $35,000 per year. This financial support can make a significant difference in your ability to access the care and resources you need during your fertility journey.

Emotional well-being

Struggling with infertility can be an emotionally challenging and isolating experience. Fertility counseling provides a safe space to process your feelings, develop coping strategies, and navigate the complex decisions involved in building your family.

LSAs that cover mental health services like therapy and counseling recognize the importance of emotional well-being during the fertility process. By using your LSA funds for fertility counseling, you can prioritize your mental health and access the support you need to manage stress, anxiety, and other emotional challenges.

Inclusive benefits

Offering fertility counseling as an eligible LSA expense is a powerful way for employers to demonstrate their commitment to diversity, equity, and inclusion. It acknowledges that there are many paths to parenthood, including assisted reproductive technologies, adoption, and surrogacy.

By covering fertility counseling in an LSA, your employer is sending a clear message that they support your family-building goals and value the well-being of all employees, regardless of their reproductive journey. This inclusive approach to benefits can foster a more supportive and understanding workplace culture.

How do Lifestyle Spending Accounts work?

When your employer offers a Lifestyle Spending Account (LSA), they will define the program parameters, including what expenses are eligible for reimbursement, how much money is available in your account, and the process for submitting claims.

Typically, you'll have a set amount of funds allocated to your LSA each year, which you can spend on approved wellness and lifestyle expenses. The specific categories and items covered will depend on your employer's plan design, but fertility counseling is increasingly included as an eligible expense.

To use your LSA for fertility counseling, you'll need to pay for the services upfront and then submit a claim for reimbursement. This usually involves providing documentation, such as a receipt or invoice from your fertility counselor, along with any additional forms or information required by your employer.

It's important to note that reimbursements from LSAs are considered taxable income, meaning you'll need to pay taxes on the money you receive back from your account. This is different from tax-advantaged accounts like Health Savings Accounts (HSAs) or Flexible Spending Accounts (FSAs), which allow you to use pre-tax dollars for eligible medical expenses.

Your employer may also have specific requirements around the type of documentation needed for fertility counseling claims, such as a letter from a licensed counselor or proof of medical necessity. It's always a good idea to check with your HR team or benefits administrator to understand the details of your company's LSA program and how to properly submit claims for reimbursement.

One of the key advantages of LSAs is their flexibility – you have the freedom to choose the fertility counseling provider and services that best meet your needs, without being limited to a narrow network or facing restrictions on the type of care you can receive. This allows you to prioritize your emotional well-being and access the support you need during your fertility journey.

As more employers recognize the importance of comprehensive fertility benefits, LSAs are becoming an increasingly popular way to provide financial and emotional support for employees navigating the path to parenthood. By offering fertility counseling as an eligible expense, companies can demonstrate their commitment to inclusive, family-friendly benefits that truly make a difference in their employees' lives.

What types of fertility counseling are typically covered by LSAs?

Lifestyle Spending Accounts (LSAs) that include fertility counseling as an eligible expense typically cover a range of services designed to support your emotional well-being during the family-building process. While the specific types of counseling covered may vary depending on your employer's plan, here are some common categories:

Implications counseling

Implications counseling helps you understand the medical, emotional, and social implications of infertility and treatment options. This type of counseling is particularly valuable when you're first exploring your family-building choices or considering a significant decision, such as pursuing IVF, using donor gametes, or considering surrogacy.

During implications counseling sessions, a licensed fertility counselor will discuss the potential risks, benefits, and outcomes of various treatment paths, helping you make informed decisions that align with your values, goals, and circumstances. They can also help you navigate the complex emotions that often arise during this process, such as grief, uncertainty, and hope.

Crisis intervention

Infertility can be an emotional rollercoaster, with many ups and downs along the way. Crisis intervention counseling provides support during particularly distressing times, such as a failed IVF cycle, pregnancy loss, or unexpected medical diagnosis.

In these moments of acute stress and grief, having access to immediate counseling services can be incredibly valuable. A fertility counselor can offer coping strategies, validation, and a safe space to process your emotions, helping you navigate the challenges of infertility with greater resilience and self-compassion.

Therapeutic counseling

Therapeutic counseling involves ongoing therapy sessions to help you cope with the chronic stress, anxiety, and relationship strain that often accompany infertility. This type of counseling recognizes that the emotional impact of infertility can be long-lasting and far-reaching, affecting many aspects of your life and well-being.

Through regular therapy sessions, you can work with a fertility counselor to develop healthy coping mechanisms, communicate effectively with your partner and loved ones, and build a strong support network. Therapeutic counseling can also help you process any trauma or unresolved grief related to your fertility journey, promoting healing and emotional resilience.

Many LSAs cover both individual and couples counseling, acknowledging that infertility can take a toll on even the strongest relationships. By investing in your emotional well-being and your partnership, you'll be better equipped to navigate the challenges of infertility together and emerge stronger on the other side.

When exploring fertility counseling options through your LSA, be sure to check your employer's specific plan details and requirements. Some LSAs may have a pre-approved list of providers or require documentation from a licensed mental health professional specializing in fertility counseling.

You can also ask your fertility clinic or medical provider for recommendations on counselors who have experience working with individuals and couples navigating infertility. Many reproductive endocrinologists and fertility specialists recognize the importance of emotional support during treatment and can connect you with qualified professionals in your area.

By taking advantage of the fertility counseling benefits offered through your LSA, you can prioritize your mental health and well-being during a challenging time. Whether you need one-time implications counseling, ongoing therapeutic support, or crisis intervention during a particularly difficult moment, having access to professional counseling services can make a world of difference in your ability to cope with and navigate the complex journey of infertility.

How to use an LSA for fertility counseling

Review your employer's LSA guidelines

The first step in using your LSA for fertility counseling is to carefully review your employer's plan documents and guidelines. Look for specific mentions of fertility counseling as an eligible expense, or related categories like mental health services or family planning support.

Keep in mind that every employer designs their LSA program differently, so what's covered can vary widely from one company to another. If you're unsure whether fertility counseling is included in your plan, don't hesitate to reach out to your HR team or benefits administrator for clarification.

Submit a pre-approval request

If the eligibility of fertility counseling expenses is unclear based on your employer's LSA guidelines, it's always a good idea to submit a pre-approval request before incurring any costs. This simple step can save you a lot of headache and uncertainty down the line.

To request pre-approval, reach out to your HR department or LSA plan administrator and provide a brief explanation of the fertility counseling services you're considering. They should be able to give you a clear answer on whether those expenses will be reimbursable under your account.

Provide documentation

Once you've confirmed that fertility counseling is an eligible expense under your LSA, make sure to keep detailed records of your sessions and payments. When submitting a claim for reimbursement, you'll typically need to provide documentation such as receipts, invoices, or letters from your licensed fertility counselor.

The exact documentation requirements may vary depending on your employer's plan, so be sure to follow their specific guidelines and instructions. It's also a good idea to keep copies of all your records and correspondence related to your LSA claims, just in case there are any questions or issues that arise.

Stay within your LSA limit

Finally, when using your LSA for fertility counseling and other wellness expenses, it's important to stay within your annual contribution limit. Your employer will set a specific dollar amount that you can use each year, and you'll be responsible for tracking your spending to ensure you don't exceed that limit.

If you're planning to use your LSA for multiple types of expenses, such as fertility counseling, gym memberships, and stress management programs, make sure to budget accordingly. You may need to prioritize certain expenses over others based on your individual needs and goals.

It's also worth noting that LSA funds typically don't roll over from one year to the next, so it's important to use your full contribution within the designated plan year. However, some employers may offer a grace period or allow you to carry over a portion of unused funds, so be sure to check your specific plan details.

By following these steps and maximizing your LSA benefits, you can access valuable support and resources to help you navigate the emotional challenges of infertility. Remember, your employer offers this benefit because they recognize the importance of supporting your overall well-being – so don't hesitate to take advantage of the opportunity to prioritize your mental health and family-building goals.

If you have questions about your LSA coverage or need help navigating the claims process, reach out to your HR team or benefits administrator for guidance and support. They can provide personalized assistance and ensure you're making the most of this valuable benefit.

Is fertility counseling worth the investment?

Navigating the complex world of infertility can be an emotionally taxing experience, one that takes a toll on your mental health, relationships, and overall well-being. The stress, grief, and uncertainty that often accompany fertility challenges can leave you feeling isolated and overwhelmed, wondering where to turn for support.

This is where fertility counseling comes in. Working with a licensed therapist who specializes in infertility can provide you with valuable coping strategies, validation, and guidance during one of the most difficult times in your life. Counseling creates a safe space to process your emotions, communicate with your partner, and build resilience in the face of adversity.

Many individuals and couples who have invested in fertility counseling report that the emotional benefits far outweigh the financial cost. Having a dedicated support system and a professional to help you navigate the ups and downs of your fertility journey can make a world of difference in your ability to cope and move forward.

If you have access to a Lifestyle Spending Account (LSA) through your employer, using those funds for fertility counseling can be a smart way to prioritize your mental health and well-being. LSAs are designed to support a wide range of wellness expenses, including mental health services like therapy and counseling.

By taking advantage of your LSA benefits for fertility counseling, you can access this important support without the added financial strain. This can be especially valuable if you're already facing significant costs related to fertility treatments or other family-building expenses.

Of course, the decision to invest in fertility counseling is a deeply personal one, and what's right for one person may not be right for another. But if you're struggling to cope with the emotional impact of infertility, know that you don't have to go through it alone. LSAs can be a powerful tool to help you access the support and resources you need to take care of yourself during this challenging time.

Forma makes it easy for you to use your Lifestyle Spending Account (LSA) for fertility counseling by offering flexible, employer-funded benefits that support your well-being. With customizable LSA options, you can access the care you need without financial stress. Schedule a consultation with one of our experts today.