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Comment by efsavage | Hacker News Reader

Does this mean that you could be prescribed an Apple Watch if you were at risk of apnea? Or even use an HSA?

I have been really curious to this. In IRS Publication 502, it states: "Medical care expenses must be primarily to alleviate or prevent a physical or mental disability or illness."

You could make the argument that the Apple Watch can be used to manage your sleep apnea condition. On the off chance you get audited by the IRS you might just be better off paying for it with non-HSA funds rather than dealing with that mess.

PSA: HSA expenses are based on the honor system, but obviously don't go to Best Buy and buy a PS5 on a HSA debit card. You are allowed to reimburse yourself for medical purchases. For example, if you have a large ticket medical expense you can use a credit card that provides a perk like air miles and then just transfer the funds from your HSA checking account to your regular checking account. Just remember to keep detailed records/receipts.

No, the watch is not a medical device intended to treat something. Just a general fitness device. Even the built-in EKG doesn't qualify it for HSA, and that is a lot closer to being medical than a notification pop-up saying you might want to ask your doctor to test you for sleep apnea.

I can see it now: it's December and my FSA still has a balance, must be time to buy 12 Apple Watches and sell them on eBay.

Out of curiosity, does your health plan have an HSA? After learning about these I decided that FSAs are a total rip off. Why would my money expire?

If you know you're going to have certain recurring expenses, they can be great. That money's untaxed so you're basically getting a 25% or whatever discount on whatever you buy with FSA money. But yes, the expiration bit is insane. That's how I ended up buying a pair of prescription Ray-Bans in late December several years ago.

> That money's untaxed so you're basically getting a 25% or whatever discount on whatever you buy with FSA money

This is the same with an HSA. The difference is that you can invest funds from an HSA and the growth is tax free.

That's not the difference. The difference is that you have to have an HDHP to use an HSA. My employer pays for me to have a very good low-deductible policy. I did the math and it would almost certainly cost me more out of pocket to have an HDHP than what I have now. If you are young, single, and healthy, the equation may look different. If you're older and have a spouse and kids, it's shockingly easy to hit the deductible and OOP max year after year.

I could imagine a case where I'd start an FSA. An HSA did not work out well for me a few years ago when I tried it, and would be even less likely to be a win for me now.

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