Question 1

Is Dexcom Stelo definitely FSA and HSA eligible?

Accepted Answer

Dexcom states the Stelo glucose biosensor is a qualified medical expense for FSA/HSA purchase. However, eligibility is a provider claim. Your specific employer's FSA plan administrator has the final say on what qualifies. Some administrators may require additional documentation, like a receipt showing the item description, even for over-the-counter items. Always check with your plan before assuming reimbursement.

Question 2

What do I need for FSA/HSA reimbursement for Stelo?

Accepted Answer

You typically need a detailed receipt showing the date of purchase, merchant name (e.g., Dexcom), a clear item description (e.g., 'Stelo Glucose Sensor 2-pack'), and the amount paid. Since Stelo is over-the-counter, a prescription is not required, but some conservative plan administrators might ask for a Letter of Medical Necessity from a doctor. Using a dedicated FSA/HSA debit card at checkout is the simplest method, if your provider offers one for the merchant.

Question 3

Can I use my FSA for the Stelo monthly subscription?

Accepted Answer

This depends entirely on your FSA plan administrator. Some allow recurring subscription payments for eligible items, while others only reimburse one-time purchases. The subscription price is $89 per month for a 2-sensor pack. To be safe, pay for the subscription with a personal card and then submit the monthly receipt for reimbursement. This also helps if your plan has a 'pay and claim' process instead of a debit card.

Question 4

How does Stelo's cost fit within 2026 FSA contribution limits?

Accepted Answer

The 2026 health FSA contribution limit is $3,400 per employee. A year of Stelo at the $89 monthly subscription costs $1,068, using about 31% of your annual limit. This is a significant but viable use of funds, especially for those with prediabetes or type 2 diabetes not using insulin who want to monitor glucose trends. Remember, you can only use the current plan year's funds, plus any carryover from the previous year, which for 2026 is up to $680.

Question 5

What's the difference between using an FSA vs. an HSA for Stelo?

Accepted Answer

An FSA is 'use-it-or-lose-it' within the plan year (with a limited carryover), while HSA funds roll over indefinitely and are yours to keep. If you have a High Deductible Health Plan (HDHP), an HSA is often the better long-term tool. The tax treatment is similar: both use pre-tax dollars. However, HSAs offer the added benefit of investment growth for future healthcare costs, making them superior for funding ongoing expenses like a CGM if you are eligible to contribute to one.

Question 6

Who is Stelo actually designed for, according to experts?

Accepted Answer

The Association of Diabetes Care & Education Specialists states Stelo is appropriate for adults 18 and over who are not using insulin and do not experience hypoglycemia. This includes individuals with prediabetes, those with type 2 diabetes who don't meet prescription CGM criteria, and even people without diabetes who want to track glucose responses to diet and exercise. It is not intended for insulin users or those who need alerts for low blood sugar.

Question 7

Are there other OTC CGMs that are FSA eligible?

Accepted Answer

Yes, as of late 2024, Abbott Lingo is another FDA-cleared over-the-counter glucose sensor marketed in the U.S. Like Stelo, it is described as FSA-eligible. This gives consumers a choice. When comparing, look at sensor wear time, app features, and cost per month. Both represent a new category of health tech that can be purchased with tax-advantaged funds without a prescription, expanding access.

Question 8

What happens if my FSA claim for Stelo gets denied?

Accepted Answer

First, request a specific reason from your plan administrator. Common denials include missing item details on the receipt or the administrator not recognizing the product. You can appeal by providing Dexcom's official marketing material stating it is a qualified medical expense and citing IRS Publication 502, which includes diagnostic devices. If you purchased it for managing a diagnosed condition like prediabetes, a supporting note from your doctor can strengthen your appeal.

Feature	Using a Flexible Spending Account (FSA)	Using a Health Savings Account (HSA)
Account Ownership & Portability	Employer-owned, often forfeited if you leave job	Individually owned, fully portableWinner
Fund Rollover Year-to-Year	Limited carryover ($680 for 2026) or grace period	Unlimited rollover, funds never expireWinner
Investment Potential	Generally no investment option	Funds can be invested in stocks/funds once balance thresholds are metWinner
Eligibility for Reimbursement Decision	Employer's third-party administrator (TPA) has final say	Account holder decides, subject to IRS rules and auditWinner
Contribution Limits (2026)	$3,400 (Health FSA & LPFSA)	$4,300 (self-only HDHP) / $7,750 (family HDHP) plus $1,000 catch-up if 55+Winner
Ease of Use for OTC Purchase	Can be complex; depends on TPA rules and receipt submission	Straightforward; pay with any method, keep receipt, reimburse yourselfWinner
Tax Benefit for Self-Employed	Not available to self-employed individuals	Contributions are an above-the-line deduction on Form 1040Winner
Impact on HDHP 'Sticker Shock'	No direct link; FSA is separate from insurance deductible	Funds directly pay the HDHP deductible, easing cash flow fearWinner
Best for Funding a Recurring Subscription	Risky due to annual forfeiture rules; must predict annual need	Ideal; funds are always available, subscription cost is predictableWinner

Using a Flexible Spending Account (FSA) vs Using a Health Savings Account (HSA)