Open Enrollment Tip: GLP-1 and FSA/HSA Contribution

August 25, 2024

GLP-1 medications have shown impressive results, and one in eight Americans has already tried them. However, the cost can be steep, reaching hundreds of dollars per month. If you plan to use a GLP-1 medication in 2025, consider increasing your FSA or HSA contributions. By using pre-tax dollars, you can effectively get the same medication at around a 40% discount, based on the median U.S. tax bracket.

GLP-1 medications have shown impressive results, and one in eight Americans has already tried them. However, the cost can be steep, reaching hundreds of dollars per month. If you plan to use a GLP-1 medication in 2025, consider increasing your FSA or HSA contributions. By using pre-tax dollars, you can effectively get the same medication at around a 40% discount, based on the median U.S. tax bracket.

How Many Americans Use GLP-1 Medications?

As of May 2024, approximately one in eight U.S. adults has tried a GLP-1 medication such as Ozempic or Mounjaro, with about half of these individuals—roughly 6% of adults, or over 15 million people—currently using a prescription.

Will It Be Covered Under My Insurance Plan?

It's always advisable to check directly with your healthcare insurance provider. However, statistics show that GLP-1 medications used for weight loss are rarely covered. According to KFF, which specializes in health-related research, only about 1% of marketplace plans cover GLP-1 drugs solely for weight loss treatment.

How Much Will It Cost Me?

The cost can vary significantly based on your insurance coverage, ranging from $25 a month to as much as $1,000 if your insurance does not cover it. Due to expected supply shortages, some predict that costs may increase over the next 12 months.

Why Should I Consider Using FSA or HSA Contributions for GLP-1?

By planning ahead and increasing your contributions to FSA or HSA programs, you can cover GLP-1 expenses with pre-tax dollars. If you're in a 40% tax bracket (including federal income tax, state income tax, Medicare, and Social Security taxes), this effectively gives you a 40% discount on your 2025 healthcare expenses by including these costs in your FSA or HSA contributions.

What’s the Maximum I Can Contribute to My FSA or HSA Programs?

For 2025, the maximum contributions are:

  • FSA: $3,200 for self-only (each employed family member can contribute this amount)
  • HSA: $4,300 for self-only and $8,550 for a family

So How Much Should I contribute to My FSA?

There is no easy way to just come up with the perfect number to everyone since there are multiple subjective questions that should be answered first:

  • What’s your maximum contribution?
    • The answer is based on the plan you are in and your age. See section above
  • What are the companies policies for grace-period and roll-over
    • Does the company allow rolling over $640 to next year?
  • What’s your expected out-of-pocket expenses
    • This is probably the most subjective answer and it's recommended to use an estimator to calculate your annual expenses

How can Silver Help?

One of the most time consuming tasks of owning an FSA is filling out claim forms. Silver automates this step for our users. Simply forward all receipts to receipts@withsilver.app and Silver will scan that receipts and start the automated claim process on your behalf.

To summarize, many healthcare expenses are eligible for FSA and HSA contributions. By planning ahead, you can save thousands of tax dollars.

Oded Shekel
Co-Founder and CEO of Silver

Contents

Open Enrollment Tip: GLP-1 and FSA/HSA Contribution

August 25, 2024

GLP-1 medications have shown impressive results, and one in eight Americans has already tried them. However, the cost can be steep, reaching hundreds of dollars per month. If you plan to use a GLP-1 medication in 2025, consider increasing your FSA or HSA contributions. By using pre-tax dollars, you can effectively get the same medication at around a 40% discount, based on the median U.S. tax bracket.

GLP-1 medications have shown impressive results, and one in eight Americans has already tried them. However, the cost can be steep, reaching hundreds of dollars per month. If you plan to use a GLP-1 medication in 2025, consider increasing your FSA or HSA contributions. By using pre-tax dollars, you can effectively get the same medication at around a 40% discount, based on the median U.S. tax bracket.

How Many Americans Use GLP-1 Medications?

As of May 2024, approximately one in eight U.S. adults has tried a GLP-1 medication such as Ozempic or Mounjaro, with about half of these individuals—roughly 6% of adults, or over 15 million people—currently using a prescription.

Will It Be Covered Under My Insurance Plan?

It's always advisable to check directly with your healthcare insurance provider. However, statistics show that GLP-1 medications used for weight loss are rarely covered. According to KFF, which specializes in health-related research, only about 1% of marketplace plans cover GLP-1 drugs solely for weight loss treatment.

How Much Will It Cost Me?

The cost can vary significantly based on your insurance coverage, ranging from $25 a month to as much as $1,000 if your insurance does not cover it. Due to expected supply shortages, some predict that costs may increase over the next 12 months.

Why Should I Consider Using FSA or HSA Contributions for GLP-1?

By planning ahead and increasing your contributions to FSA or HSA programs, you can cover GLP-1 expenses with pre-tax dollars. If you're in a 40% tax bracket (including federal income tax, state income tax, Medicare, and Social Security taxes), this effectively gives you a 40% discount on your 2025 healthcare expenses by including these costs in your FSA or HSA contributions.

What’s the Maximum I Can Contribute to My FSA or HSA Programs?

For 2025, the maximum contributions are:

  • FSA: $3,200 for self-only (each employed family member can contribute this amount)
  • HSA: $4,300 for self-only and $8,550 for a family

So How Much Should I contribute to My FSA?

There is no easy way to just come up with the perfect number to everyone since there are multiple subjective questions that should be answered first:

  • What’s your maximum contribution?
    • The answer is based on the plan you are in and your age. See section above
  • What are the companies policies for grace-period and roll-over
    • Does the company allow rolling over $640 to next year?
  • What’s your expected out-of-pocket expenses
    • This is probably the most subjective answer and it's recommended to use an estimator to calculate your annual expenses

How can Silver Help?

One of the most time consuming tasks of owning an FSA is filling out claim forms. Silver automates this step for our users. Simply forward all receipts to receipts@withsilver.app and Silver will scan that receipts and start the automated claim process on your behalf.

To summarize, many healthcare expenses are eligible for FSA and HSA contributions. By planning ahead, you can save thousands of tax dollars.

Oded Shekel
Co-Founder and CEO of Silver

Contents