Flexible spending accounts (FSA)
Is there a cost to participate in a health care or dependent day care FSA?

No, there are no administrative fees for either flexible spending account. The amount of pre-tax money you choose to contribute from your paycheck goes directly into your FSA account.

Why do I have to enroll in the flexible spending accounts each year?

The IRS requires re-enrollment for participation every year. If you don’t re-enroll each fall, you can’t participate the following year.

How are expenses reimbursed?

You must submit a claim form. The claim form provides information about required documentation and claims payment. Claim forms are available here. The rules about when you can receive reimbursement vary by account.

  • Your health care FSA can reimburse you up to your maximum planned contribution at any time during the year.
  • Your dependent day care FSA can reimburse you up to the amount you’ve contributed to your account at the time your claim is processed. You pay for services up front, and then submit a claim for reimbursement.
If I run low on money in my dependent day care FSA, why can't I use my health care FSA to pay for childcare expenses?

IRS rules don’t allow transfers between flexible spending accounts. The Internal Revenue Code regulations specifically state that any amount set aside on a pre-tax basis to a specific type of flexible spending account can’t be used for any other type of expense.

If I find that my out-of-pocket health care expenses are lower than the amount I chose to contribute to the health care FSA for the year, why can't I just stop making contributions?

The Internal Revenue Code states that, once a participant enrolls for a specific pre-tax contribution amount, the participant can’t change the amount unless he or she has a qualified family status change. More information about family status changes is available here.

What if I don't use all of the money in my flexible spending account?

Unfortunately, you lose any money left in your account. That’s why it’s important to always plan your spending account contributions carefully. You also can’t carry over contributions from one year to the next or transfer contributions from one flexible spending account to another.

What counts as eligible over-the-counter medical supplies and products for reimbursement under the health care FSA?

You can use your account to reimburse expenses for over-the-counter (OTC) medical supplies and products including bandages and wraps, braces and supports, catheters, contact lens solutions and supplies, contraceptives and family planning items, denture adhesives and diabetic supplies. OTC drugs, such as antacids and cold, pain and allergy medications aren’t eligible unless you have a prescription from your doctor. You’re not reimbursed for products that promote general health, such as vitamins, nutritional supplements, toothpaste and moisturizing lotion, even if your doctor suggests them.

How do I submit claims for eligible over-the-counter (OTC) products?

As with all reimbursement requests, you must submit a claim form and any additional required documentation. For OTC items you need to include a cash register receipt showing the date, amount of the purchase and the product description. Only OTC medicines require a doctor's prescription.

If you have an FSA debit card, you can use that for OTC medications at CVS, Walmart, Sam’s Club, Walgreens and drugstore.com.

I have a HealthFund. What expenses can I pay with my FSA debit card?

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.

You can also use the FSA debit card for prescription drug, dental and vision expenses.

We advise you to be cautious when paying for medical provider up-front costs, such as deductibles and/or coinsurance. Ask the medical provider to file the claim with PayFlex before you use your debit card to make sure you’re paying the correct out-of-pocket amount and to make sure your claim includes any contract discounts.

Can I use my FSA debit card at my doctor’s office?

Yes. However, because your doctor’s office may charge more than is allowed under PayFlex’s agreement, the charges you pay at your doctor’s office with an FSA debit card may be incorrect. Here’s how doctor office visits should be handled:

  1. Your in-network doctor should file a claim with PayFlex. If the doctor doesn’t file a claim, you must file a claim with PayFlex. This may happen with an out-of-network provider, for example.
  2. PayFlex then pays your doctor the allowable amount.
  3. If you’re responsible for a portion of the charges (for your annual deductible or coinsurance or for amounts above PayFlex’s out-of-network fee schedule), you can pay that out of your health care FSA after you have used all of your HealthFund funds. Note: Effective January 1, 2017, HISD no longer contributes to your HealthFund, but 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. 

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

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