Stop the presses!! Is this accurate?

I did it both ways too and it only made a difference of $80!!!  Of course, that will vary on your income, dependents, and how much you actually paid.  I'm sure if I had paid $35k it would have made a MUCH bigger difference.  I didn't come close to paying that much though.  The difference was not worth the chance of being audited in my opinion.

We are switching to an HSA (Health Savings Account) and more importantly my wife is trying to figure out if we can use the HSA overage (Savings) for the surgery in a year or two.

Is a HSA the same as a flex account where you put money in tax free for medical stuff? We were going to do that. My DH and I we're each going to put in the max and then use the money for my plastics. I called the IRS to check first and they told me no. That if my insurance would pay for the surgery then I could use the flex for my co-pay but if the insurance said no then they (the IRS) would consider it cosmetic and you can't use flex for cosmedic. Thank goodness I checked....we would have lost over $10,000!

A Flexible Spending account (FSA) is different than an HSA.  The both use pretax dollars to pay medical expense but with an FSA you have to use or lose the dollars each year.  With an HSA you can accumulate dollars over time much like an IRA but they exist in conjunction with a High Deductiuble Health Plan.  Both the HSA and FSA are governed by IRS 502 on allowable medical expenses and the IRS's answer to you was correct on its surface but was the easy general masses answer that doesn't take into account medical necessity.  It is still a crap shoot at this time in my opinion however it bercome much more urgent if I can pull $10,000 to $15,000 out of my HSA versus saving a couple of hundred dollars on a tax return.  Hope that helps.