If your health FSA runs on a calendar year, money you don’t spend by December 31 may be gone. Every year, people forfeit hundreds of dollars they meant to use. If you’ve been putting off hormone testing, a weight loss evaluation, or a lab panel, the end of the year is a practical time to get it done with pre-tax dollars. Here’s what typically qualifies at Defiance Health, what usually doesn’t, and how to avoid the common mistakes.
FSA vs. HSA: which one has a deadline?
They sound alike, but they work very differently at year-end.
- FSA (Flexible Spending Account): “Use it or lose it” is the default. Your employer’s plan can offer either a carryover of up to $680 into 2027 or a grace period (typically to March 15) — never both, and some plans offer neither.
- HSA (Health Savings Account): No year-end deadline. The money is yours and rolls over indefinitely. The 2026 contribution limits are $4,400 for self-only coverage and $8,750 for family coverage.
The urgent one is your FSA. If you don’t know your plan’s rules, log in to your benefits portal or call your plan administrator this week and ask three things: your remaining balance, whether you have a carryover or a grace period, and your claims deadline.
What typically qualifies at Defiance Health
FSA and HSA dollars can generally be used for medical care, lab fees, and prescribed medications. At our clinics, that usually includes:
Hormone therapy
- The comprehensive intake ($495), which includes your in-office lab draw, full lab panel, and a 60–75 minute provider visit
- Follow-up visits and follow-up labs
- Prescribed bioidentical hormone therapy and testosterone replacement therapy
Learn more about hormone therapy for women, testosterone replacement therapy, and menopause care.
Medical weight loss
- Provider visits and lab work for your weight loss evaluation
- Prescribed GLP-1 medications such as semaglutide or tirzepatide
The IRS allows weight loss expenses when they treat a specific disease diagnosed by a physician, such as obesity. Many plan administrators ask for a letter of medical necessity for weight loss medication, so ask your administrator before you submit. See our medical weight loss program.
Lab testing
- Provider-ordered hormone, thyroid, metabolic, and inflammation panels
- Lab panels ordered through our lab testing service, which start at $159
What usually doesn’t qualify
We’d rather tell you upfront than have a claim denied:
- Cosmetic aesthetic treatments. The IRS generally excludes cosmetic procedures, so Botox for wrinkles, fillers, and cosmetic laser treatments typically aren’t eligible.
- Some treatments can qualify with medical necessity. For example, treatment for a diagnosed medical condition, like urinary incontinence, may qualify with documentation. Ask your administrator before you book.
- Supplements and general wellness products usually aren’t eligible without a documented medical need.
Our team can provide itemized receipts and superbills so you have the documentation your administrator asks for.
Five mistakes to avoid
- Waiting until the last week of December. With Thanksgiving and the holidays ahead, schedules fill up fast. Our Centennial clinic is open Wednesday–Friday and Alamosa is open Monday–Wednesday and Friday, so book early.
- Assuming you can prepay. FSAs generally reimburse care you’ve received during the plan year. The service needs to happen by your deadline, not just be paid for.
- Forgetting the claims deadline. Many plans give you a run-out period, often until about March 31, to submit receipts for 2026 care. Missing it can cost you the money even if the visit happened in time.
- Mixing up FSA and HSA. If you only have an HSA, you don’t lose anything at year-end, so there’s no need to rush.
- Skipping documentation for weight loss medications. Get your letter of medical necessity before you need it.
A simple year-end plan
- Check your FSA balance and plan rules this week.
- If you’ve been meaning to check your hormones, thyroid, or metabolic health, book your comprehensive intake while there’s still room on the schedule.
- Ask us for an itemized receipt or superbill at checkout.
- Submit your claim well before your plan’s run-out deadline.
Book in Centennial, Alamosa, or by telehealth
Our Centennial clinic, near the Denver Tech Center, serves the south Denver metro, including Greenwood Village, Lone Tree, Highlands Ranch, Littleton, and Parker. Our Alamosa clinic serves the San Luis Valley. Established patients in Colorado, Arizona, California, and Washington can use telehealth for follow-ups. Pricing is the same at both locations — see our full pricing. For more on eligibility, read Can you use HSA or FSA at Defiance Health?
Frequently asked questions
Do I lose my FSA money on December 31?
Unused health FSA money is forfeited by default. Your plan may offer a carryover of up to $680 into 2027 or a grace period, typically to March 15, but not both. Check your plan’s rules.
Can I use my FSA or HSA for hormone therapy?
Generally, yes. Provider visits, lab work, and prescribed hormone therapy are typically eligible medical expenses. Confirm with your plan administrator.
Can I use FSA or HSA funds for semaglutide or tirzepatide?
Often, yes, when the medication treats a diagnosed condition such as obesity. Many administrators require a letter of medical necessity, so ask before submitting.
Is Botox FSA eligible?
Cosmetic Botox and other cosmetic aesthetic treatments are generally not eligible. Treatments for a diagnosed medical condition may qualify with documentation.
Does my HSA expire at the end of the year?
No. HSA funds roll over year to year and stay with you. The year-end deadline applies to FSAs.
Put your FSA dollars to work
Book a comprehensive intake in Centennial or Alamosa before the year ends. Labs, a full provider visit, and a clear plan — with pre-tax dollars.
Book Your VisitThis article is general information, not tax or legal advice. FSA and HSA rules vary by plan; confirm eligibility with your plan administrator or a tax professional. — Defiance Health