Transgender Counseling or Surgery

Transgender counseling or surgery is eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA) or a health reimbursement arrangement (HRA). Transgender counseling or surgery reimbursement is not eligible with a limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA). In certain circumstances a letter of medical necessity (LMN) may be required to show that the expense was for the treatment of gender identity disorder and not an otherwise cosmetic procedure, such as breast augmentation.