Many people in the US have healthcare savings accounts (HSA) or flexible spending accounts (FSA). These are special, pre-tax savings accounts with funds that are dedicated toward specific healthcare needs.
HSA and FSA can be funded in a couple of ways:
- The client pays a certain portion of money into the account every pay period.
- The employer pays a certain amount into the account every pay period.
- At the start of the year (defined by the employer), a deposit is made to the account.
- Combination of these.
Getting paid with FSA or HSA money can be as simple as accepting credit cards. Many of these funds issue a credit card to the employee to use as needed. You would then simply provide a receipt for the money and specify that it was for doula services. Occasionally some employers may want a letter of medical necessity from the provider.
Considerations as a Doula
If clients want to use this funding to pay for your services, you will need to be able to accept credit cards. Something like PayPal invoicing works well and others like Stripe. You will pay a credit card service fee for using any credit card service.
If your client has the money going in every month in a certain amount from their paycheck, you might set up a recurring payment from the HSA/FSA card to make automatic payments a few days after that date until the agreed-upon amount. Let’s say your client agrees to pay $1000 and every month $200 is deposited in the account on the first, you would set up your payment plan to bill $200 every month on the fourth for five months.
You may also have your client pay you, then request a receipt where they are reimbursed by the company. It can take as much as a month. This can vary widely from plan to plan. Be sure they check with their plan provider. This does avoid the payment of credit card processing fees.
The big difference between an FSA and HSA is when the funds must be used. At the end of the year, most FSA monies need to be spent. Some organizations may offer a grace period or a carryover period. But if you have a client or potential client due in the next year, they may wish to use the remaining funds on paying ahead. HSA monies typically do not need to be spent at the end of the year.