Health care FSA

Money you set aside for health care expenses

  • ​A health care FSA lets you set aside pre-tax dollars to pay for eligible health care expenses, even for dependents not covered under your HISD medical plan.
  • It’s available to participants in all plans.
  • You can contribute up to $2,600 per year through automatic payroll deductions over 24 pay periods.
  • The full amount you set aside is available to you from the day your coverage begins. Since your contribution is pre-tax, it takes less out of your paycheck. 
  • PayFlex administers the plan.
What your health care FSA covers
  • Deductibles, coinsurance and copays under your medical, dental and vision plans
  • Other eligible health costs that are not covered by your health care plan (for example, dental costs not covered by your dental plan)
  • Prescription drugs
Acupuncture Special medical equipment
Hearing aids Special education devices
Individual psychiatric and psychological counseling Smoking-cessation programs or related prescription drugs
Lasik or other
vision correction surgery
Weight-loss programs for individuals diagnosed as obese

 

Over-the-counter medical supplies and products, such as:

Bandages and wraps Contraceptives and family planning items
Braces and supports Denture adhesives
Catheters Insulin and diabetic supplies
Contact lens solutions
and supplies
 
What's not covered
  • Cosmetic surgery
  • Health plan premiums
  • Vitamins
  • Weight reduction programs (unless prescribed by a physician for obesity)
  • Over-the-counter smoking cessation medications, such as nicotine gum and patches

 

Over-the-counter medicines without a doctor’s prescription, such as:

Acid controllers Digestive aids
Allergy & sinus Feminine antifungal/anti-itch
Antibiotic products Hemorrhoidal preparations
Antidiarrheals Laxatives
Anti-gas Motion sickness
Anti-itch & insect bite Pain relief
Antiparasitic treatments Respiratory treatments
Baby rash ointments/creams Sleep aids and sedatives
Cold sore remedies Stomach remedies
Cough, cold & flu  
Rules and restrictions

In return for the favorable tax advantages, the IRS has strict rules on these accounts.

  • You can’t change the amount you contribute until the next plan year, unless you have a qualified life event
  • You can’t transfer money from this account to another FSA account
  • To be reimbursed, you must be enrolled in the FSA when you incur expenses
  • You need to keep all of your records to substantiate all claims
  • You may use your FSA funds for expenses incurred through March 15 of the following year, and you have until May 15 of that year to submit documentation for those expenses
  • You lose any funds that you don’t spend by March 15 of the following year
Determining your contribution

Only list expenses that are not paid through your medical, dental, vision, cancer and specified diseases, hospital indemnity, other district health care coverage selections or any other health plan. Using last year’s expenses can help. You can also use the Health Care Flexible Spending Account Worksheet. Estimate from the date your coverage begins if you’re hired or if you become eligible for benefits during the year.

Consumer and Select plan members, please note: Effective January 1, 2017, HISD no longer offers the HealthFund. You may continue to use any funds you have left over from previous years to pay for eligible expenses as long as you are enrolled in an HISD Consumer or Select medical plan. You use your HealthFund first to pay for all eligible health care costs, including services under your medical plan. After you have used all the money in your HealthFund, you may use your FSA debit card to cover medical expenses. 

How it works

After you enroll, you receive a PayFlex Visa debit card that you can use to pay for prescriptions and over-the-counter items. If you don’t use your FSA PayFlex debit card, you must submit a claim form and any additional required documentation to Aetna to be reimbursed. You can file claims online through PayFlex’s secure website or by fax at 888-238-3539. You can also check your health care FSA balance at the Payflex website.

You can use your debit card to pay up-front costs for a doctor or dentist, but filing a claim gives you a better chance of paying the correct out-of-pocket amount.

The IRS limits the use of FSA debit cards. Retail locations that contain pharmacies and also sell non-pharmacy items must use the Inventory Information Approval System (IIAS) to automatically substantiate pharmacy purchases and allow you to use your FSA debit card. Visit Aetna’s FSA website to find out which non-traditional pharmacy providers use IIAS. You may still use your FSA debit card at traditional pharmacies and with the Express Scripts mail service program.

2017 health care FSA account calendar

January 1, 2017 – March 15, 2018
Eligible health care FSA expenses are covered

 

May 15, 2018
Deadline to submit documentation for 2017 health care FSA expenses

 

If you get close to the March 15 date and have money in your health care FSA that you don’t know what to do with, use the money to stock up on covered OTC products listed above.

Helpful resources

For more information call PayFlex at 888-678-8242 or Aetna FSA customer service at 888-238-6226. Both are available between 7 a.m. and 5 p.m. weekdays, excluding holidays. Also, review the flexible spending account FAQs.

Your cost

Maximum amount $2,600

Based on 24 pay periods $0.00

For any benefits question or concern, one call does it all.
Call us at 877-780-HISD (4473)

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