Health Care FSA

The Health Care Flexible Spending Account

The Health Care FSA reimburses you for certain eligible expenses that aren’t paid in full or covered under your medical, dental and/or vision care programs.

  • You can claim expenses for:
  • yourself
  • your spouse
  • your dependent children
  • any other person you can claim as a dependent for federal income tax purposes (without regard to their gross income)

You do not have to cover your dependents under the medical, dental and vision plans to use the Health Care FSA for their eligible expenses. Similarly, you do not have to enroll in health care coverage to use this account. You can contribute from $120 to $2,600 to the Health Care FSA. The full amount you elect for a plan year is available to you on January 1 of that year. In other words, you can be reimbursed for eligible expenses before sufficient funds to pay for them have accumulated in your account.

Considerations for Participation –

  • Will you have any expenses not covered by any health care plan?
  • Do you anticipate any health care expenses higher than the maximum plan benefits?
  • Do you have dependents living with you who are eligible for coverage under the medical, dental, and vision plans but who are considered dependents for tax purposes?

For help estimating how much you should contribute to the Health Care FSA, don’t miss out on the FSA Estimator — part of the online Pearson Health Choice tool!

Some examples of eligible expenses that can be reimbursed are:

  • Medical, dental and vision deductibles
  • Copayments and co-insurance
  • Eyewear expenses not covered under your vision plan
  • Amounts in excess of reasonable and customary limits

Note: Over-the-counter medicines can be reimbursed only if accompanied by a doctor’s prescription.

Some expenses are not eligible for reimbursement through the Health Care FSA. Ineligible expenses include:

  • Premiums for Medicare, COBRA or other insurance plans, fees for health clubs or gyms and cosmetic treatments.
  • Medical or dental expenses that have been reimbursed by any other plan or policy or that you claim as health care deductions on your federal income tax return.

For a comprehensive list of eligible expenses go to: http://hcet.ebia.com/bencon

Getting Reimbursed

You can get reimbursed from your Health Care FSA by using the WageWorks® Visa® Healthcare card, by filing claims online on the WageWorks website (http://www.wageworks.com) or by filing paper claims.

If you enroll in the Health Care FSA, you’ll receive a Visa® card that you can use when you incur eligible services.

Your card can be used at many major providers, hospitals and pharmacies that accept Visa® and works like a bank debit card. You present your card for eligible services and the money is immediately withdrawn from your Health Care FSA. You don’t need to submit a claim form and wait to be reimbursed.

Refer to the Frequently Asked Questions document on the Benefits website for detailed information about getting reimbursed.