Get a receipt to submit with your FSA/HSA claim.

A 2019 ruling by the Internal Revenue Service* means that you should be able to use funds set aside in either a Flexible Spending Account (FSA) or Health Savings Account (HSA) to cover all or a portion of the medical care costs of the 23andMe services listed below.

Check with your FSA/HSA benefits coordinator or your tax professional for confirmation on the specific requirements for individual eligibility and reimbursement, including usage, procedures and qualifications.

• 23andMe+ Total Health^TM Bundle**
• 23andMe+ Total Health Membership**
• 23andMe+ Premium^TM Bundle***
• 23andMe+ Premium Membership**
• Health + Ancestry Service***
• Health Service**
• Upgrade to 23andMe+ Total Health (for customers who originally purchased the 23andMe+ Premium Bundle, Health + Ancestry Service, or Ancestry Service)**
• Upgrade to 23andMe+ Premium (for customers who originally purchased the Health + Ancestry Service or Ancestry Service)**
• Upgrade to Health + Ancestry Service (for customers who originally purchased the 23andMe Ancestry Service)**
• Health + Ancestry Service lab fee (for customers who purchased their saliva collection kit from an authorized retailer, such as CVS, Walgreens, or Walmart, but who purchased the Health + Ancestry Service from 23andMe)***
• Health + Ancestry Service chip upgrade (for customers who purchased a new kit to be genotyped on the latest platform)***

Additionally, clinical laboratory testing fees and telehealth/telemedicine clinical consultation fees should be eligible for reimbursement with a flexible spending account (FSA) or health savings account (HSA).

To determine the amount of your 23andMe purchase that may be eligible medical care, and to obtain a receipt to submit with your original purchase receipt for your FSA/HSA claim, complete this form for each item that you purchased. If you purchased more than one item that may be FSA/HSA-eligible, submit information for each item into this form one at a time.