A lot of concierge doctors like to tell patients and prospective patients that their periodic fees are either tax deductible or payable out of some form of tax-favored plan, like flexible spending accounts (“FSAs”). Some web sites are so bold as to state this as a fact. But this is a major jump in logic and in some situations is just not true.

The first problem is that there are a number of these tax-favored plans (I refer to them as acronym plans). A basic one is an employer’s cafeteria plan, where an employer can help employees pay for certain expenses on a pre-tax basis, for instance health insurance premiums. In addition to FSAs and cafeteria plans there are health reimbursement accounts (“HRAs”) and health savings accounts (“HSAs”). Each of these has characteristics and requirements that differ from the other, and some of these requirements make it unlikely that in all cases periodic concierge fees can be paid out each of these acronym accounts. One dimension of the problem is that in order to qualify under ANY circumstances the fees must be for medical care or services. Fees paid for enhanced access only will not qualify.