Use Your FSA or HSA Before Dec 31: Pre-IVF Testing to Do at Home First

If you’re in the US and thinking about IVF in Colombia next year, the last weeks of December are a good time to get your pre-IVF testing done at home. Leftover FSA money may expire, a deductible you’ve already met resets on January 1, and your insurance may cover diagnostic tests even if it excludes IVF itself. The results also make your first consultation with a Colombian clinic more useful.

Why year-end timing matters for IVF patients

Three separate clocks run out on December 31 for many US patients, and pre-IVF testing is a good use of all three.

Your FSA balance

A health flexible spending account is usually funded through payroll deductions, and money you don’t spend by the end of the plan year can be forfeited. Employers may soften that rule in one of two ways, but not both:

• Carryover: for 2026 plan years, up to $680 of unused funds can carry into 2027, if your plan offers it.
• Grace period: some plans give you up to 2.5 extra months after the plan year ends to incur expenses against the old balance.

Some plans offer neither. Your plan documents will say which rule applies, and a non-calendar plan year has a different deadline.

Your HSA balance

Health savings account money is yours, it rolls over every year, and there’s no use-it-or-lose-it deadline. You don’t have to rush to spend an HSA in December. Many people save their HSA for the larger costs that come later, such as the treatment cycle itself. One rule to know: an HSA can generally only reimburse expenses incurred after the account was opened.

Your deductible and out-of-pocket maximum

On a calendar-year health plan, your deductible and out-of-pocket maximum reset on January 1. If you’ve already met some or all of your 2026 deductible, covered testing done before December 31 may cost you much less than the same tests in January. For an FSA, the expense generally counts in the year you receive the care, not the year the bill arrives, so book appointments, not just payments, before the deadline.

Pre-IVF tests you can usually do at home first

Most fertility clinics, in Colombia or elsewhere, want a similar baseline before they design a protocol. Doing these tests at home means your first consult can focus on a plan instead of a list of tests to order. Our guide to fertility testing before an IVF consultation goes into more detail. The table below is a quick reference.

If you’re not sure what a result means, our guides to understanding fertility tests and AMH and ovarian reserve explain the basics. Carrier screening is covered in genetic carrier screening before IVF.

Will insurance cover testing if it excludes IVF?

Often it will. Many US plans exclude IVF but cover testing to diagnose infertility or an underlying condition. A thyroid panel, prolactin level, pelvic ultrasound or semen analysis may be billed as diagnostic care, not fertility treatment. Coverage depends on your plan, your state and how the provider codes the visit, so do two things:

1. Read your plan’s infertility section. Look for the words “diagnosis” and “treatment.” Some plans cover the first and exclude the second.
2. Call before you book. Ask the insurer whether the specific tests are covered and whether you need a referral or prior authorization. Write down the date, the rep’s name and the reference number.
3. Ask the ordering provider how they code. The diagnosis code on the order affects how the claim is processed. A provider can’t code dishonestly, but they can make sure the code accurately reflects why the test is needed.
4. Use FSA or HSA for what’s left. Copays, coinsurance and uncovered tests can usually be paid from these accounts.

For a fuller look at what plans cover, see our guide to IVF insurance coverage. If your employer offers a separate fertility benefit, employer fertility benefits and IVF abroad explains what to ask.

Can you use FSA or HSA money for IVF in Colombia?

Possibly, but confirm before you rely on it. Here’s what IRS guidance says and what it doesn’t.

IRS Publication 502, which defines qualified medical expenses, lists procedures such as in vitro fertilization, including temporary storage of eggs or sperm, as includible when done to overcome an inability to have children. It excludes illegal operations and treatments. It also says you can include a prescription drug you buy and use in another country if the drug is legal in both that country and the US. Pub 502 doesn’t have a dedicated section on medical care abroad. Legal care received abroad is generally treated as eligible, and IVF is legal in Colombia, but your plan administrator applies the rules and may ask for specific paperwork.

• Ask your administrator whether they reimburse care received outside the US, and what documentation they need.
• Ask whether they accept invoices in Spanish or need a translation.
• Ask how they handle charges billed in Colombian pesos, and keep your card or transfer statements showing the US dollar amount.
• Ask about travel. Pub 502 allows transportation primarily for and essential to medical care, and limits lodging to $50 per night per person (2025 edition). Meals aren’t included. Your FSA plan may be narrower than IRS rules.
• Keep itemized receipts for everything. A card statement alone may not be enough.

Read the current edition of IRS Publication 502, and talk to a tax professional if large amounts are involved. For other ways to cover the cycle, see financing IVF treatment. For what the treatment itself costs, see our IVF cost in Colombia guide.

A December action plan

1. Check your balances and deadlines. Find your FSA balance, your plan’s carryover or grace period rule, and how much of your deductible you’ve met.
2. Get orders from a home doctor. Your OB-GYN or primary care doctor can often order the core labs and an ultrasound. A local reproductive endocrinologist can order all of them.
3. Book cycle-dependent tests first. Work out when your next period is due and book day 2–4 labs and the early ultrasound around it.
4. Book your partner’s semen analysis. It’s easy to forget, and it affects the protocol.
5. Request copies of every result. Ask for the full report with reference ranges, plus ultrasound images if available, not just a summary.
6. Send everything to the Colombian clinic before your consult. Our guide to transferring IVF medical records internationally explains how to organize them.

Keep your home doctor involved

A doctor nearby can follow up on abnormal results, such as a high TSH, elevated prolactin or a cavity finding, some of which should be treated before you travel. See coordinating your home doctor and Colombian clinic. A qualified reproductive endocrinologist should interpret your results and make treatment decisions with you.

Frequently asked questions