Do I have to enroll in my employer’s medical or dental plan to participate in the health care FSA?
Your plan will determine this. Although your employer can require that you take the medical or dental plan in order to have a health care FSA, not all plans are designed this way. You should check your plan documents to confirm this.
I have a health care FSA. If I’m contributing throughout the year, how much will my FSA cover for a claim in the beginning of the year?
With a health care FSA, your full election amount is available on the first day of the plan year. This means that you can use your entire election on day one of the plan year.
You elect to contribute $1,200 for the plan year. In January, you have contributed $100. ($100 x 12 months = $1,200) In that same month, you receive health care services that cost you $1,000. At this point, you haven’t submitted any other claims. This means, you’ll receive the full amount of the claim from your FSA. You don’t have to wait until you actually contribute this amount to your health care FSA.
What expenses are eligible under a health care FSA?
Generally, expenses that are medically necessary are considered eligible. This means if you need the service or product for your health it may be an eligible expense. This includes co-payments, co-insurance and deductibles. You can view a list of common eligible expenses on this website. You can also find more information at www.irs.gov
. Refer to IRS Publications 969 and 502. You should also check your plan documents for eligible expenses under your plan.
Can I use my FSA to pay for over-the-counter (OTC) items, supplies, drugs and medicines?
Yes. However, there are different rules on how you can use your FSA to pay OTC items, supplies, drugs and medicines. You can use your PayFlex Card® to pay for OTC items and supplies. These include items such as bandages, hot/cold packs, thermometers, first aid kits, home diagnostic tests and diabetic supplies. You can also pay for these items out of pocket and then submit a claim to us.
For OTC drugs and medicines
, you can’t use your PayFlex Card. First, you’ll need a written prescription from your doctor. Then you’ll have to pay for the OTC drug or medicine out of pocket and then submit a claim to us. You’ll need to include your written prescription and the detailed receipt with your claim.
May I submit eligible health care expenses incurred by my spouse and dependents?
Yes. You can be reimbursed for eligible health care expenses that you, your spouse and eligible tax dependents incur during the plan year. This is true even if you don’t cover your spouse and dependents on your health plan.
Why do I have to show that an expense was medically necessary?
There are some products or services that aren’t always used for medical care. Some products may be used for general health reasons. Two examples are massage therapy and weight loss programs. If you use the product or service to treat a medical condition, you’ll need to show that. This is “evidence of medical necessity.” You can submit a prescription or letter from your health care provider. You can also have your health care provider complete and sign a Letter of Medical Necessity form. You can find this form in the Resource Center.
Can I pay my spouse’s health insurance premiums through my health care FSA?
No. Premiums aren’t an eligible expense for the health care FSA. You can view a list of common eligible expenses on this website. For more information, visit www.irs.gov
. There you can view IRS Publications 969 and 502.