It’s that time of year again! Nope, not the holidays. For millions of Americans, it’s time to find a new health insurance plan or renew an existing one. But thankfully this blog is not about health insurance. This blog is about the Omega-3 Index test and how it is covered by your Health Savings Account (HSA) or Flexible Spending Account (FSA).
The Omega-3 Index is a self-ordered and self-administered test you can do at-home – it does not require an office visit or a doctor’s order. However, in this situation, the cost of the test cannot be reimbursed by third party payers (insurance or Medicare).
When the test IS ordered by a doctor, then it can be reimbursed, with either the physician’s office or the patient him/herself submitting for reimbursement. The good news is that the Omega-3 Index test can, in most settings, be covered by HSA/FSA plans.
First, what are HSA/FSA accounts and how can they help you? If you have a high deductible health insurance plan, an HSA would work in conjunction with it as a tax-free savings account from which you can pull money to pay for expenses not covered by your regular health plan. Healthcare.gov describes a high deductible health plan as one that carries a higher deductible than a traditional insurance plan, and that has a lower monthly premium.
The IRS defines a high deductible health plan as any plan with a deductible of at least $1350 for an individual or $2700 for a family. In terms of how much you can contribute to an HSA, the IRS has set a limit for individual contributions at $3450; the limit for a family is $6900.
So where can you go to set up an HSA? Apparently, it’s as easy as visiting a local bank or talking to your stock broker, insurance company or credit union. TheBalance.com points out that banks, credit unions and insurance companies will only have their own specified plans to offer you. Brokers on the other hand will have several options.
The CollegeInvestor.com, which caters specifically to Millennials, lists Fidelity, Lively, HSA Bank and Optum Bank as some of the leading choices for opening an HSA account. Optum bank is part of Optum, the technology services division for UnitedHealth Group. So if you work for a major employer, chances are this will be your HSA provider. There is also a robust search tool that will compare and contrast HSA providers for you, so you can make a truly informed decision.
According to HealthInsurance.org, an HSA account also functions as an interest-bearing nest egg that grows until you retire, similar to an IRA. In fact, a recent article comparing IRAs and HSAs said people might opt for the latter, especially if funds are limited. “Most people don’t think about an HSA … like a savings account. Instead, they think of it as an account where you set aside money to spend on healthcare items during the current year.
“That view needs to change,” the article said. “An HSA can be a great addition to an IRA or 401(k) plan, and if funds are limited it might be better to contribute to an HSA instead of the IRA.” Why? Because, as the article points out, “an HSA is like an IRA account on steroids.”
The author went on to explain that with a traditional IRA or 401(k), if you are eligible, you get a tax deduction for the amount you contribute to the plan. The money grows tax-deferred, and then you pay taxes when you withdraw it in retirement.
But with an HSA, you get the same tax deduction when you contribute money, but when you use the money in your HSA for medical expenses and qualified health insurance premiums, it comes back out tax-free. “Where else do you get to contribute tax-deductible dollars and withdraw them tax-free? Nowhere else that I know of,” the author said.
The point of an HSA is to give you better control over how you spend that money on medical expenses. Some of the “expenses” covered by an HSA include deductibles, copays, coinsurance, vision and dental care, and yes, nutritional status tests like the Omega-3 Index, which fits under the categories of “laboratory” or “diagnostic” tests.
So what about an FSA? An FSA is also a tax-advantaged account that allows people to pay for qualified medical expenses and works in combination with any health plan. In fact, you don’t even need a health plan to get an FSA. Your FSA is set up by your employer. An HSA by contrast can be set up by you or your employer, but only if you have a high deductible health plan.
Typically the money you put into this account is funded through a payroll deduction. However, employers can also put money toward this account as well. Employees can use the full amount designated for their FSA even if the full amount has not been deposited by the employee/employer.
Like an HSA, the typical covered expenses by an FSA include deductibles, copays and coinsurance, as well as qualified medical expenses not covered by your health plan. And yes, again, the Omega-3 Index test because it is considered a laboratory or diagnostic test.
One of the biggest differences between an HSA and FSA is that the money in an FSA must be used within the year, or by March 15th of the following year. In other words, “use it or lose it”. And you can’t use the money in an FSA for anything but medical expenses.
The Future Looks Bright for Omega-3s and Omega-3 Testing
First proposed for use in medical care about 15 years ago, the Omega-3 Index is still a relatively new test from a medical standpoint. A new blood test usually takes about 30 years to be standardized and finally adopted by the medical community.
With the awareness of omega-3s being nearly universal these days, the increase in research funding and positive results from recent studies will only continue to fuel this very important nutritional category. And the Omega-3 Index will be along for the ride, as future studies make it a standard measure of omega-3 status among subjects and correlate actual blood levels of omega-3s with health outcomes.
In 2018 alone, several high profile studies strengthened the importance of omega-3s and the Omega-3 Index not only in heart health, but also in brain health and pregnancy. The most important takeaway from these studies is that retailers, consumers and health practitioners alike can all recommend omega-3s and the Omega-3 Index with great confidence to their customers, friends, family and patients.
It all started in March with the publication of data from the Framingham Heart Study in the Journal of Clinical Lipidology, where omega-3 blood levels (i.e., Omega-3 Index) were shown to be a better predictor of death than serum cholesterol. Results showed that the risk for death from any cause was reduced by about 33% when comparing participants with the lowest Omega-3 Index to those with the highest Omega-3 Index.
Then in June a study published in Hypertension found a direct link between the Omega-3 Index and blood pressure. The researchers concluded that a higher Omega-3 Index was associated with statistically significant, clinically relevant lower blood pressure levels in healthy, young adults, and that diets rich in omega-3 fatty acids — specifically EPA and DHA — might be a strategy for preventing hypertension.
Finally, November witnessed the publication of three landmark studies on omega-3s — the REDUCE-IT and VITAL trials, as well as an updated Cochrane Review. REDUCE-IT was notable for being the highest dose omega-3 study looking at effects on risk for, in this case, cardiovascular disease, ever performed. VITAL stood out for being the largest and most ethnically diverse study with clinical endpoints. In short, REDUCE-IT found a 25% risk reduction in cardiovascular events, while VITAL found significant reductions in heart attacks (28%) and fatal heart attacks (50%).
The Cochrane Review looked at omega-3s and pregnancy and whether or not they represent an effective strategy for reducing risk for early preterm birth. The 70 randomized controlled trials (RCTs) the researchers analyzed in this updated review involved more than 20,000 women — showing that supplementation with omega-3s reduced the risk of having a baby before 37 weeks by 11% and before 34 weeks by 42%. The researchers went so far as to say that “more studies are not needed … to prove causality in relation to preterm birth.”
As 2019 approaches, it is important to remember that getting your omega-3s from fish or supplements is important — for everyone in your family. But knowing your Omega-3 Index is even more important, so you know that you are taking enough of the right omega-3s — EPA and DHA — to achieve health protective levels.
In the end, it is reassuring to know that a laboratory test like the Omega-3 Index is a covered health expense that is simple, safe and convenient. As always, though, it is best to check with your own health savings plan if you’d like to verify this as a covered expense before purchase.