FAQs about Health Flexible Spending Accounts (FSA)
Is lasik eye surgery a reimbursable expense under the health spending account?
Yes, lasik procedures are reimbursable.
How often am I reimbursed and how do I receive reimbursement?
Reimbursement schedules are determined by your Employer. Please contact Taxsaver Plan’s office for your reimbursement schedule. Generally, a check or direct deposit is sent directly to your home address, but please ask our Customer Service Associate for the method of reimbursement offered by your Employer’s Plan.
What is a claim form and how can I obtain one?
A claim form is a simple piece of paper that identifies you and your Employer and provides a signature line where you attest that the expenses you are submitting are for eligible dependents and have not been submitted elsewhere. A signed claim form is required for all claim submissions unless you are submitting a debit card receipt. Claim Forms are available on our website.
I am going out on a unpaid leave of absence this year. What will happen to my FSA accounts?
This is a question for your Employer’s Benefits Department. In general, you are not eligible to participate in the Dependent Care FSA while on a leave, whether the leave is a FMLA leave or unpaid leave. If the leave is a paid leave, you may still contribute pre-tax dollars to the Dependent Care FSA, but you will not be able to submit claims incurred while on leave. The dollars contributed while on leave will build up in your account and you may claim those dollars when you return with eligible expenses incurred after the leave period ends or if your expenses incurred prior to the leave period exceeded the dollars contributed to the account, those expenses may be reimbursed from the dollars contributed while on leave. In most Plans, you are still considered eligible for the Health FSA while on FMLA leave or unpaid leave. You will need to ask your Employer how to handle missed contributions while on an unpaid leave.
My Doctor has prescribed a treadmill as a part of my rehabilitation after knee surgery. May I claim this expense under my health spending account?
Possibly. The first step is to have your Doctor write a Medical Determination Letter, not a prescription, stating the medical condition or disease that the treadmill has been prescribed for. If the treadmill is a matter of convenience, the claim for the treadmill would be denied. If the treadmill is medically necessary, (example: the support the track of the treadmill provides is deemed by the Doctor to be necessary to the proper healing process after the surgery) the claim may be reimbursed. If anyone else in the household will be using the treadmill, the entire cost of the treadmill may not be reimbursable.
Are health club dues reimbursable under a health spending account?
No, dues are not reimbursable. But, the fee for a specific class that you participate in may be reimbursable with a letter from your physician stating the medical condition/disease that is being treated.
If I have a status change during the plan year that allows me to make an election change to my health spending account, when is the effective date of the status change?
Once a status change has occurred, you normally have a certain amount of days (please refer to your employer’s Summary Plan Description to verify the number of days that your employer’s plan allows) to notify your employer that you have had a qualifying event/status change. Once the plan has approved your change as an eligible status change, the change will be effective as of the date that you first NOTIFIED your employer. For example, if your baby is born on March 2nd and you notify your employer of the birth on March 25th, the change becomes effective on March 25th. It is not effective retroactively to March 2nd.
Is contact lens solution that I purchase over the counter a reimbursable item?
Yes, over the counter contact lens solutions are reimbursable.
If I buy prescription glasses, may I be reimbursed for the clip-on attachment that turns the prescription glasses into sunglasses?
Non-prescription sunglasses are only reimbursable if you have a specific medical condition that requires you to wear sunglasses. The clip-on lenses would only be reimbursable in a case where you have a specific medical condition or disease that requires you wear tinted shades.
Why does Taxsaver Plan request a letter from my physician for certain expenses, like nutritionists, treadmills, massage therapy, weight loss programs/drugs, etc?
In order for an expense to be reimbursable, the IRS says that the expense must be incurred primarily for the prevention or alleviation of a physical defect or ailment. In contrast, expenditures that are merely beneficial to the general health of an individual are not reimbursable when not incurred primarily for a medical purpose.
Are insurance premiums reimbursable under a Health FSA?
No, insurance premiums are not reimbursable under a Health FSA.
Why must my receipt state the date of service and type of service rendered in order to be reimbursed? Why isn't a copy of my paid receipt enough?
A Section 125 Plan states that services must be incurred during the plan year. Incurred is defined as when the service is rendered, not when it is paid. Taxsaver Plan must verify that the dates of service have occurred during the plan year. The type of service determines the eligibility of the expense.
If I terminate employment, or from the Plan, during the plan year, may I claim expenses that I incur after my termination?
Once you terminate from the plan, (termination from the plan is defined in the Summary Plan Description) expenses incurred after your date of termination are not reimbursable. You may submit expenses incurred prior to termination through the open claims period designated by the employer. If you have not incurred any eligible expenses prior to your termination date, you might want to look into the COBRA election for the Health Spending Account offered by your employer at the time of termination.
Are Explanation Of Benefits provided by my insurance company sufficient forms of receipts?
Yes, Explanation Of Benefits (“EOB’s”) are sufficient under most circumstances. If an “EOB” is returned to you, and the insurance company has not paid any of the cost of services, Taxsaver Plan may request more information than the “EOB” provides, such as a detailed receipt from the provider.
How does one go about getting reimbursed for orthodontia expenses?
Getting reimbursed for orthodontia expenses can be tricky. The first thing to keep in mind is that orthodontia treatment most often extends over several plan years. Therefore, it is impossible to be reimbursed for the entire cost of the orthodontia treatment during the course of one plan year. Should you decide to pay for the orthodontia treatment up front at 100%, please be aware that Taxsaver Plan will need a statement from the Orthodontist attesting to the costs associated with the current plan year. If you are paying on a contract, your monthly coupons are eligible for the plan year that you pay them in (example: the braces are placed in March and your employer has a calendar plan year. Your monthly coupons for March – December of that year are reimbursable). If you have an upfront cost associated with the placement of the braces, a receipt attesting to the date the braces were placed and the amount charged for the initial placement would be a sufficient receipt for reimbursement. The initial cost of placing the braces would be reimbursed out of the plan year in which the placement occurred.
My Doctor has told me to take one aspirin a day for my heart. May I be reimbursed for the aspirin that I purchase at the drug store?
Yes, certain over the counter items are reimbursable. However, over the counter drugs and medicines do require a prescription from a licensed physician as of January 1, 2011. If you have a question about a specific over the counter item, please view Taxsaver Plan’s website for a complete listing of over the counter expenses that may be reimbursed under the FSA Plan, assuming that your Employer allows for over the counter reimbursements under the Plan.
I am seeing a Holistic Healer for my chronic stomach pain. Are my visits reimbursable? Are the vitamins and supplements that I purchase from her reimbursable?
The charge for the office visit would be reimbursable, as you are seeking treatment for a medical condition (stomach pain). Any treatments, supplements, vitamins, etc. that you purchase from her would not be reimbursable. If you purchased vitamins or supplements that she prescribed from a licensed pharmacist, they would be reimbursable.
I am having a baby this year, and my doctor has recommended Blood Cord Storage of the baby's umbilical cord. The cost ranges from $300 - $600. Is this cost reimbursable?
No. The IRS has made official comment that the cost of Blood Cord Storage is not reimbursable.
I am having a baby this year, but a surrogate will be giving birth to our biological child. Are the expenses that I pay towards the care of the surrogate and the cost of the birth reimbursable?
No, the costs that you pay for the care of the surrogate and the cost of the birth and the agency fees are not reimbursable. However, the costs that you pay to prepare your eggs for the transfer would be reimbursable. And, costs that you pay for an egg donor incurred for surgery, hospital fees, lab work and transportation are reimbursable.
I am adopting a child this year and my employer does not offer an adoption assistance plan. Are the expenses that I pay for any of the fees associated with the adoption reimbursable?
No, the costs associated with the adoption are not reimbursable. Any costs that you are required to pay for the care of the baby once the baby is born would be reimbursable, even if the adoption is not considered to be final when the baby is born.
My child was recently diagnosed with ADD and part of the course of treatment is to send him to a school that has a course of study that is geared towards teaching children with ADD. Will the tuition that I pay be reimbursable?
No, the tuition costs are not reimbursable. Costs that you pay for therapy to treat the ADD are reimbursable.
I planned to have Lasik Eye Surgery this year and intended to use my Health FSA dollars to pay for this procedure. My doctor now tells me that I am not eligible for the procedure. Is this a qualified event that would allow me to change my election mid-year?
No, this is not a qualified event, per IRS regulations. Please refer to our Eligible Expense tab on our home page for reimbursable expenses under the plan.
How does the 'rollover' option work?
After the Claims Run-Out Period ends, any dollar amount remaining in the prior plan year, not to exceed $500.00, will automatically be rolled into the Health FSA in the current year and your Annual Election will increase by the ‘rollover’ amount. (Note: the rollover feature is optional and not all plans will offer it)
Are medical expenses/prescriptions purchased in a foreign country eligible?
If a participant is in a foreign country and requires FSA approved medical services, they can submit for reimbursement. Prescribed drugs brought in or ordered and shipped from another country are not considered legal. The position of the IRS and FDA is that it is generally illegal for individuals to import prescription drugs/OTC from Canada or any other foreign country.(Exception: If a participant is in a foreign country and is prescribed medication that is legal and considered an eligible expense in the U.S., the drug must be obtained and consumed in the foreign country. The documentation for reimbursement submitted should include a completed claim form, receipt for the drug, a brief description of the reason the drug was purchased, and the equivalent U.S. drug name.) Note: All submissions must be completely translated and converted to U.S. dollars.
What is the annual election limit for Flexible Spending Accounts?
This amount is determined by your Employer’s Plan, but the IRS has the maximum limit set at $2,750 for 2020.
Are expenses for genetic testing and counseling eligible under my FSA?
Genetic testing and counseling are eligible if the testing is done to diagnose a medical condition or to determine possible defects. Certain testing and counseling required to be covered under health care reform’s preventive services mandate, such as the BRCA test for the breast cancer susceptibility gene, would qualify. However, testing done solely to determine ancestry or the sex of a fetus would not qualify.
Are in vitro fertilization (IVF) expenses reimbursable for person(s) not related to the participant?
Medical care expenses, including the costs for identification, retention, compensation, or expense reimbursement for in vitro fertilization (IVF) involving an egg donor and a gestational surrogate who are not related to a participant are ineligible due to the fact that the costs are not medical care expenses as defined under Code § 213(d) because they were not incurred for the medical care of the taxpayer, spouse, or a dependent.
Is medical marijuana eligible under my FSA plan?
No. Although it is approved for medical use in some states, marijuana is still listed as a Schedule 1 drug under federal law, therefore making it illegal and not eligible for reimbursement. Similarly, cannabidiol (CBD) oil products are not eligible.
Is sunscreen eligible under an FSA plan?
Yes, sunscreen that is SPF 15 or higher and protects against UV-A and UV-B radiation is FSA eligible.
Is bug spray FSA eligible?
Currently, insect repellent is only eligible if combined with a sunscreen of SPF 15+.