News
How to Tell if Your Heart Is Healthy With Help From Your HSA/FSA
Follow your heart for a happier, healthier you.
February 14, 2024
Sam O'Keefe
Co-founder & CEO of Flex
Overview
Overview
Overview
Overview
Follow your heart for a happier, healthier you
The heart is a tireless organ.
It beats about 100,000 times a day, propelling blood and oxygen throughout our bodies which enables us to breathe, walk, talk, and perform all of our essential functions.
However, even this powerful ticker isn't immune to wear and tear. Heart disease — a silent and dangerous but preventable foe — remains a leading cause of death globally. So how can you tell if your heart is healthy and what can you do to reduce the risk of heart-related diseases?
At Flex, we believe in preventative medicine; staying vigilant with heart screenings and being proactive about your health will help you to never skip a beat.
What We’ll Cover About Maintaining and Testing for a Healthy Heart
What is Heart Disease?
What Are the Health Benefits of a Healthy Heart?
How to Improve Heart Health: Lifestyle Strategies for Reducing Heart Disease
What Is a Heart Screening and Why Should You Get One?
What Are the Different Types of Heart Screenings?
How to Tell if Your Heart Is Healthy Using Your HSA/FSA
How Flex Can Help You to Be Proactive About Your Heart Health
What is Heart Disease?
Heart disease encompasses a range of conditions affecting the heart or blood vessels.
Common afflictions include coronary artery disease (narrowing or blockage of the blood vessels that supply the heart muscles), arrhythmias (irregular heartbeats), valvular heart diseases, and even heart failure.
Early detection and management of risk factors can also play a crucial role in preventing or managing heart disease. Talk with your doctor about personal and family medical history, past heart-related symptoms you may have had, and if need be, undertake laboratory testing for further evaluation. It’s important to note that high blood pressure is often called a “silent killer” because it usually has no symptoms, which is why it’s important to be proactive.
We’ll go over common heart screening options in the rest of this article, but first we want to discuss your best defense: Preventative measures.
What Are the Health Benefits of a Healthy Heart?
A healthy heart is the cornerstone of a vibrant life, and it comes with a range of benefits too:
Improved blood circulation and lower blood pressure: A well-functioning heart pumps blood efficiently, which means that oxygen and essential nutrients can reach all parts of the body and support organ function. Coupling that with regular exercise, a balanced diet, and a healthy lifestyle can reduce the risk of hypertension, and its associated complications.
Weight management and better quality of life: A healthy heart is often associated with a healthy weight. Maintaining an appropriate weight through a balanced diet and regular exercise can not only help prevent obesity-related cardiovascular risk factors, but it can also support an active lifestyle — i.e., being able to participate in activities and hobbies you enjoy without being limited by cardiovascular issues.
Live longer: Preventing or managing cardiovascular diseases contributes to increased life expectancy.
How to Improve Heart Health: Lifestyle Strategies for Reducing Heart Disease
A healthy heart first and foremost starts at home. Here are some preventative strategies you can use to maintain a heart-healthy lifestyle.
What diet, exercise, and medication protocols should I follow for heart health?
Maintaining heart health involves a multifaceted approach. This includes a healthy diet, regular exercise, and adherence to prescribed medications if necessary.
Heart-healthy foods play a crucial role in maintaining cardiovascular health. A balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats, combined with regular physical activity and medication adherence as directed by healthcare professionals, makes for a fantastic strategy for cardiovascular well-being.
Include foods rich in omega-3 fatty acids (found in fatty fish), fiber (from fruits, vegetables, and whole grains), antioxidants (found in berries, nuts, and leafy greens), and lean proteins (such as poultry, beans, and legumes). Limiting saturated and trans fats, sodium, and added sugars is also recommended.
What are the 5 best exercises to strengthen your heart?
Pretty much all forms of exercise do the heart good. However, some stand out above the rest. Here are our top 5 picks:
Walking: Is walking good for the heart? Absolutely! Walking is a low-impact aerobic exercise that is excellent for heart health. It improves circulation, helps maintain a healthy weight, and supports overall cardiovascular fitness. Aim for at least 150 minutes of moderate-intensity walking per week to reap the full benefits for your heart.
Interval training: Apart from being more fun than steady-state cardio, alternating between short bursts of intense activity and periods of rest enhances heart strength and endurance.
Strength training: Is lifting weights good for the heart? Yes! Guess what? The heart is a muscle, too! Lifting weights, or strength training, is beneficial for heart health because it improves muscle mass, metabolism, and overall cardiovascular fitness. Engaging in regular strength training exercises contributes to a well-rounded approach to heart health. It’s not all about the cardio.
Yoga: It’s not just for achieving inner peace. Combining physical postures, breathing exercises, and meditation supports overall cardiovascular health and can reduce cortisol levels which can impact hypertension.
Circuit training: Blending the best of both worlds (strength training and cardio), rotating through various exercises in quick succession boosts heart rate and builds endurance.
What are the best supplements for heart health?
While getting essential nutrients from a balanced diet is ideal, certain supplements can complement heart health. Omega-3 fatty acid supplements, coenzyme Q10 (CoQ10), magnesium, and plant sterols/stanols are among the supplements that may benefit cardiovascular health.
You should consult with a healthcare professional before adding any supplements to your routine, especially if you have dietary issues.
Maintaining a healthy heart is vital to overall well-being, but regular screenings are key to staying ahead of potential complications.
What is a Heart Screening and Why Should You Get One?
A heart screening is a comprehensive examination designed to assess your cardiovascular health. There are a variety of ways to do this, ranging from medical imaging using X-ray machines to more invasive techniques such as using dyes to visualize blood flow.
Why bother with one? Simply put, it's about taking cardiac precautions before symptoms emerge. Identifying potential issues early can save lives and prevent irreversible damage.
How do you know if your heart is healthy and what risk factors should you be screening for?
About half of all Americans have at least 1 of 3 key risk factors for heart disease: High blood pressure, high cholesterol, and smoking.
When screening for heart health, start there. But there are other lifestyle factors to consider too, such as diet and exercise, monitoring weight and BMI, checking blood pressure regularly, and assessing cholesterol levels.
Normal, healthy risk factor numbers to strive towards, according to the Mayo Clinic, are as follows:
Blood Pressure: Ideally, below 120/80 mm Hg.
Cholesterol: Total cholesterol below 200 mg/dL, LDL ("bad" cholesterol) below 100 mg/dL, HDL ("good" cholesterol) above 40 mg/dL for men and 50 mg/dL for women.
BMI: Between 18.5 and 24.9.
Cardiac risk calculators are also an effective tool for gauging the likelihood of developing heart disease.
Preventive measures for heart disease include adopting a healthy lifestyle, which includes a balanced diet, regular physical activity, maintaining a healthy weight, avoiding tobacco, limiting alcohol intake, and managing stress.
How often should you screen for these?
Frequency varies based on individual risk factors, but a general guideline for adults is at least once every five years. If you belong to a high-risk factor group (i.e., there is a family history of heart disease, you have high low-density lipoprotein (LDL) cholesterol or diabetes, etc.), you may require more frequent screenings.
What Are the Different Types of Heart Screenings?
CT scans
A cardiac CT (computed tomography) scan combines multiple X-ray images to create a detailed, cross-sectional, and three-dimensional image of your heart. From these, your doctor can evaluate your coronary arteries (looking for calcium or plaque buildup), heart chambers, muscle and valves, pulmonary veins, and thoracic aorta, among other important surrounding structures. They can help evaluate the cause of chest pain and shortness of breath, among many other things.
Electrocardiogram (EKG)
An electrocardiogram (ECG or EKG) is a diagnostic test that records the electrical activity of the heart over a specific period. Your doctor will place electrodes on the skin to detect and measure the electrical impulses generated by the heart as it contracts and relaxes. EKGs provide valuable insights into the heart's rhythm, rate, and overall electrical function. The test can identify abnormal patterns in the heart's electrical activity which may indicate a lack of blood flow to certain areas of the heart muscle.
Echocardiogram
An echocardiogram is a non-invasive imaging test that uses ultrasound technology to create detailed images of the heart's structure and function. It provides valuable information about the heart's chambers, valves, and blood flow, helping your doctor assess cardiac health and identify any abnormalities.
Cardiac stress test
A cardiac stress test is a diagnostic examination that evaluates how well the heart performs under stress or increased workload. It typically involves exercising on a treadmill or stationary bike while the heart's activity is monitored. Stress tests help detect abnormalities in blood flow to the heart and assess overall cardiovascular fitness.
Coronary angiogram
A coronary angiogram is an invasive procedure that involves injecting contrast dye into the coronary arteries to visualize blood flow and identify blockages or narrowed areas. It’s commonly used to diagnose coronary artery disease and guide interventions such as angioplasty or stent placement. It is typically performed after non-invasive tests indicate significant issues.
Cardiac enzyme test
A cardiac enzyme test, also known as cardiac biomarker testing, is a blood test that measures the levels of specific enzymes and proteins released into the bloodstream during heart muscle damage. Heart enzymes, such as creatine kinase (CK), troponin, and lactate dehydrogenase (LDH), are proteins found in heart muscle cells. When heart cells are damaged or die, these enzymes are released into the bloodstream. Monitoring their levels through a cardiac enzyme test provides valuable information about the extent of heart muscle damage.
How to Tell if Your Heart Is Healthy Using Your HSA/FSA
Your Health Savings Account (HSA) or Flexible Spending Account (FSA) can be a secret weapon in the pursuit of heart health. Learn how to use these accounts to ensure your cardiovascular screenings don't leave a dent in your wallet.
How does HSA reimbursement work in regard to heart screening?
HSAs can be used to cover eligible medical expenses, including heart screenings. Most likely, this will be covered by your insurance. However, should it not be, you can use your HSA or FSA funds to pay for the test or to reimburse yourself for the out-of-pocket costs associated with the screening. Make sure to keep records and receipts for these expenses to facilitate the reimbursement process.
What are some heart health-associated FSA/HSA eligible expenses?
Several heart health-related expenses may be eligible for reimbursement through FSAs or HSAs. These include, but are not limited to, expenses related to doctor visits, diagnostic tests, prescription medications, and medical equipment prescribed by a healthcare professional.
Are heart rate monitors HSA eligible?
Heart rate monitors are among many health-related items you can use your HSA/FSA for if they are prescribed by a healthcare professional to treat or alleviate a medical condition.
Just know that it's essential to obtain a prescription or documentation from a healthcare provider specifying the medical necessity of the heart rate monitor for it to be considered a qualified medical expense.
Are blood pressure monitors HSA eligible?
Blood pressure monitors are generally considered eligible for reimbursement through an HSA.
As with other medical expenses, it's advisable to keep documentation of the purchase and, if possible, get a prescription or Letter of Medical Necessity from a healthcare provider.
How Flex Can Help You to Be Proactive About Your Heart Health
The heart screenings we mentioned in this article will either be covered by your insurance or can be paid for with your HSA/FSA directly at your healthcare provider.
However, there are a variety of heart health-related gadgets and lifestyle medical expenses that you can use your HSA or FSA for — a process that we make much simpler and smoother. Proactive devices like heart rate and blood pressure monitors or fitness trackers and biomarker and metabolic testing (to see what diseases you might be predisposed to) are potentially reimbursable, while nutrition counseling and weight-loss programs prescribed by your doctor, and even transport to the hospital can also be paid for with your HSA or FSA.
Here’s how we do it:
For pre-approved medical expenses: Flex makes purchasing eligible items easier. If a company has partnered with Flex, you'll see a "checkout with Flex" option on the payment page. Pay for the product or service with your HSA or FSA card and checkout as usual. Flex will substantiate the purchase automatically. This means you don't need to submit for reimbursement.*
The item or expense falls outside of standard IRS guidelines: If a company has partnered with Flex to issue a Letter of Medical Necessity, you'll see a "checkout with Flex" option on the payment page. Complete the following steps to pay with your HSA or FSA debit card:
Fill out a short eligibility form, sharing relevant information with Flex’s medical team.
If you qualify, Flex sends the LOMN to you via email.
Then, simply enter your HSA or FSA card details and complete the purchase.
(*Note that in some cases, your FSA may ask for further details, like a receipt.)
How to Tell if Your Heart Is Healthy? Heart Screenings — Don’t Skip Yours!
More than half of all cardiovascular disease, the world’s leading cause of death, is avoidable. Fortunately, routine screenings can help with early detection and preventative tools have never been more available.
A single doctor's appointment could prevent life-threatening issues down the road. So pick up the phone, schedule that check-up, and treat your heart the way it deserves.
Follow your heart for a happier, healthier you
The heart is a tireless organ.
It beats about 100,000 times a day, propelling blood and oxygen throughout our bodies which enables us to breathe, walk, talk, and perform all of our essential functions.
However, even this powerful ticker isn't immune to wear and tear. Heart disease — a silent and dangerous but preventable foe — remains a leading cause of death globally. So how can you tell if your heart is healthy and what can you do to reduce the risk of heart-related diseases?
At Flex, we believe in preventative medicine; staying vigilant with heart screenings and being proactive about your health will help you to never skip a beat.
What We’ll Cover About Maintaining and Testing for a Healthy Heart
What is Heart Disease?
What Are the Health Benefits of a Healthy Heart?
How to Improve Heart Health: Lifestyle Strategies for Reducing Heart Disease
What Is a Heart Screening and Why Should You Get One?
What Are the Different Types of Heart Screenings?
How to Tell if Your Heart Is Healthy Using Your HSA/FSA
How Flex Can Help You to Be Proactive About Your Heart Health
What is Heart Disease?
Heart disease encompasses a range of conditions affecting the heart or blood vessels.
Common afflictions include coronary artery disease (narrowing or blockage of the blood vessels that supply the heart muscles), arrhythmias (irregular heartbeats), valvular heart diseases, and even heart failure.
Early detection and management of risk factors can also play a crucial role in preventing or managing heart disease. Talk with your doctor about personal and family medical history, past heart-related symptoms you may have had, and if need be, undertake laboratory testing for further evaluation. It’s important to note that high blood pressure is often called a “silent killer” because it usually has no symptoms, which is why it’s important to be proactive.
We’ll go over common heart screening options in the rest of this article, but first we want to discuss your best defense: Preventative measures.
What Are the Health Benefits of a Healthy Heart?
A healthy heart is the cornerstone of a vibrant life, and it comes with a range of benefits too:
Improved blood circulation and lower blood pressure: A well-functioning heart pumps blood efficiently, which means that oxygen and essential nutrients can reach all parts of the body and support organ function. Coupling that with regular exercise, a balanced diet, and a healthy lifestyle can reduce the risk of hypertension, and its associated complications.
Weight management and better quality of life: A healthy heart is often associated with a healthy weight. Maintaining an appropriate weight through a balanced diet and regular exercise can not only help prevent obesity-related cardiovascular risk factors, but it can also support an active lifestyle — i.e., being able to participate in activities and hobbies you enjoy without being limited by cardiovascular issues.
Live longer: Preventing or managing cardiovascular diseases contributes to increased life expectancy.
How to Improve Heart Health: Lifestyle Strategies for Reducing Heart Disease
A healthy heart first and foremost starts at home. Here are some preventative strategies you can use to maintain a heart-healthy lifestyle.
What diet, exercise, and medication protocols should I follow for heart health?
Maintaining heart health involves a multifaceted approach. This includes a healthy diet, regular exercise, and adherence to prescribed medications if necessary.
Heart-healthy foods play a crucial role in maintaining cardiovascular health. A balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats, combined with regular physical activity and medication adherence as directed by healthcare professionals, makes for a fantastic strategy for cardiovascular well-being.
Include foods rich in omega-3 fatty acids (found in fatty fish), fiber (from fruits, vegetables, and whole grains), antioxidants (found in berries, nuts, and leafy greens), and lean proteins (such as poultry, beans, and legumes). Limiting saturated and trans fats, sodium, and added sugars is also recommended.
What are the 5 best exercises to strengthen your heart?
Pretty much all forms of exercise do the heart good. However, some stand out above the rest. Here are our top 5 picks:
Walking: Is walking good for the heart? Absolutely! Walking is a low-impact aerobic exercise that is excellent for heart health. It improves circulation, helps maintain a healthy weight, and supports overall cardiovascular fitness. Aim for at least 150 minutes of moderate-intensity walking per week to reap the full benefits for your heart.
Interval training: Apart from being more fun than steady-state cardio, alternating between short bursts of intense activity and periods of rest enhances heart strength and endurance.
Strength training: Is lifting weights good for the heart? Yes! Guess what? The heart is a muscle, too! Lifting weights, or strength training, is beneficial for heart health because it improves muscle mass, metabolism, and overall cardiovascular fitness. Engaging in regular strength training exercises contributes to a well-rounded approach to heart health. It’s not all about the cardio.
Yoga: It’s not just for achieving inner peace. Combining physical postures, breathing exercises, and meditation supports overall cardiovascular health and can reduce cortisol levels which can impact hypertension.
Circuit training: Blending the best of both worlds (strength training and cardio), rotating through various exercises in quick succession boosts heart rate and builds endurance.
What are the best supplements for heart health?
While getting essential nutrients from a balanced diet is ideal, certain supplements can complement heart health. Omega-3 fatty acid supplements, coenzyme Q10 (CoQ10), magnesium, and plant sterols/stanols are among the supplements that may benefit cardiovascular health.
You should consult with a healthcare professional before adding any supplements to your routine, especially if you have dietary issues.
Maintaining a healthy heart is vital to overall well-being, but regular screenings are key to staying ahead of potential complications.
What is a Heart Screening and Why Should You Get One?
A heart screening is a comprehensive examination designed to assess your cardiovascular health. There are a variety of ways to do this, ranging from medical imaging using X-ray machines to more invasive techniques such as using dyes to visualize blood flow.
Why bother with one? Simply put, it's about taking cardiac precautions before symptoms emerge. Identifying potential issues early can save lives and prevent irreversible damage.
How do you know if your heart is healthy and what risk factors should you be screening for?
About half of all Americans have at least 1 of 3 key risk factors for heart disease: High blood pressure, high cholesterol, and smoking.
When screening for heart health, start there. But there are other lifestyle factors to consider too, such as diet and exercise, monitoring weight and BMI, checking blood pressure regularly, and assessing cholesterol levels.
Normal, healthy risk factor numbers to strive towards, according to the Mayo Clinic, are as follows:
Blood Pressure: Ideally, below 120/80 mm Hg.
Cholesterol: Total cholesterol below 200 mg/dL, LDL ("bad" cholesterol) below 100 mg/dL, HDL ("good" cholesterol) above 40 mg/dL for men and 50 mg/dL for women.
BMI: Between 18.5 and 24.9.
Cardiac risk calculators are also an effective tool for gauging the likelihood of developing heart disease.
Preventive measures for heart disease include adopting a healthy lifestyle, which includes a balanced diet, regular physical activity, maintaining a healthy weight, avoiding tobacco, limiting alcohol intake, and managing stress.
How often should you screen for these?
Frequency varies based on individual risk factors, but a general guideline for adults is at least once every five years. If you belong to a high-risk factor group (i.e., there is a family history of heart disease, you have high low-density lipoprotein (LDL) cholesterol or diabetes, etc.), you may require more frequent screenings.
What Are the Different Types of Heart Screenings?
CT scans
A cardiac CT (computed tomography) scan combines multiple X-ray images to create a detailed, cross-sectional, and three-dimensional image of your heart. From these, your doctor can evaluate your coronary arteries (looking for calcium or plaque buildup), heart chambers, muscle and valves, pulmonary veins, and thoracic aorta, among other important surrounding structures. They can help evaluate the cause of chest pain and shortness of breath, among many other things.
Electrocardiogram (EKG)
An electrocardiogram (ECG or EKG) is a diagnostic test that records the electrical activity of the heart over a specific period. Your doctor will place electrodes on the skin to detect and measure the electrical impulses generated by the heart as it contracts and relaxes. EKGs provide valuable insights into the heart's rhythm, rate, and overall electrical function. The test can identify abnormal patterns in the heart's electrical activity which may indicate a lack of blood flow to certain areas of the heart muscle.
Echocardiogram
An echocardiogram is a non-invasive imaging test that uses ultrasound technology to create detailed images of the heart's structure and function. It provides valuable information about the heart's chambers, valves, and blood flow, helping your doctor assess cardiac health and identify any abnormalities.
Cardiac stress test
A cardiac stress test is a diagnostic examination that evaluates how well the heart performs under stress or increased workload. It typically involves exercising on a treadmill or stationary bike while the heart's activity is monitored. Stress tests help detect abnormalities in blood flow to the heart and assess overall cardiovascular fitness.
Coronary angiogram
A coronary angiogram is an invasive procedure that involves injecting contrast dye into the coronary arteries to visualize blood flow and identify blockages or narrowed areas. It’s commonly used to diagnose coronary artery disease and guide interventions such as angioplasty or stent placement. It is typically performed after non-invasive tests indicate significant issues.
Cardiac enzyme test
A cardiac enzyme test, also known as cardiac biomarker testing, is a blood test that measures the levels of specific enzymes and proteins released into the bloodstream during heart muscle damage. Heart enzymes, such as creatine kinase (CK), troponin, and lactate dehydrogenase (LDH), are proteins found in heart muscle cells. When heart cells are damaged or die, these enzymes are released into the bloodstream. Monitoring their levels through a cardiac enzyme test provides valuable information about the extent of heart muscle damage.
How to Tell if Your Heart Is Healthy Using Your HSA/FSA
Your Health Savings Account (HSA) or Flexible Spending Account (FSA) can be a secret weapon in the pursuit of heart health. Learn how to use these accounts to ensure your cardiovascular screenings don't leave a dent in your wallet.
How does HSA reimbursement work in regard to heart screening?
HSAs can be used to cover eligible medical expenses, including heart screenings. Most likely, this will be covered by your insurance. However, should it not be, you can use your HSA or FSA funds to pay for the test or to reimburse yourself for the out-of-pocket costs associated with the screening. Make sure to keep records and receipts for these expenses to facilitate the reimbursement process.
What are some heart health-associated FSA/HSA eligible expenses?
Several heart health-related expenses may be eligible for reimbursement through FSAs or HSAs. These include, but are not limited to, expenses related to doctor visits, diagnostic tests, prescription medications, and medical equipment prescribed by a healthcare professional.
Are heart rate monitors HSA eligible?
Heart rate monitors are among many health-related items you can use your HSA/FSA for if they are prescribed by a healthcare professional to treat or alleviate a medical condition.
Just know that it's essential to obtain a prescription or documentation from a healthcare provider specifying the medical necessity of the heart rate monitor for it to be considered a qualified medical expense.
Are blood pressure monitors HSA eligible?
Blood pressure monitors are generally considered eligible for reimbursement through an HSA.
As with other medical expenses, it's advisable to keep documentation of the purchase and, if possible, get a prescription or Letter of Medical Necessity from a healthcare provider.
How Flex Can Help You to Be Proactive About Your Heart Health
The heart screenings we mentioned in this article will either be covered by your insurance or can be paid for with your HSA/FSA directly at your healthcare provider.
However, there are a variety of heart health-related gadgets and lifestyle medical expenses that you can use your HSA or FSA for — a process that we make much simpler and smoother. Proactive devices like heart rate and blood pressure monitors or fitness trackers and biomarker and metabolic testing (to see what diseases you might be predisposed to) are potentially reimbursable, while nutrition counseling and weight-loss programs prescribed by your doctor, and even transport to the hospital can also be paid for with your HSA or FSA.
Here’s how we do it:
For pre-approved medical expenses: Flex makes purchasing eligible items easier. If a company has partnered with Flex, you'll see a "checkout with Flex" option on the payment page. Pay for the product or service with your HSA or FSA card and checkout as usual. Flex will substantiate the purchase automatically. This means you don't need to submit for reimbursement.*
The item or expense falls outside of standard IRS guidelines: If a company has partnered with Flex to issue a Letter of Medical Necessity, you'll see a "checkout with Flex" option on the payment page. Complete the following steps to pay with your HSA or FSA debit card:
Fill out a short eligibility form, sharing relevant information with Flex’s medical team.
If you qualify, Flex sends the LOMN to you via email.
Then, simply enter your HSA or FSA card details and complete the purchase.
(*Note that in some cases, your FSA may ask for further details, like a receipt.)
How to Tell if Your Heart Is Healthy? Heart Screenings — Don’t Skip Yours!
More than half of all cardiovascular disease, the world’s leading cause of death, is avoidable. Fortunately, routine screenings can help with early detection and preventative tools have never been more available.
A single doctor's appointment could prevent life-threatening issues down the road. So pick up the phone, schedule that check-up, and treat your heart the way it deserves.
Flex is a modern marketplace for consumers to discover and purchase HSA/FSA eligible products. From fitness and nutrition, to sleep and mental health, Flex takes a holistic view of healthcare and enables consumers to use their pre-tax money to do the same.