Health Care Flexible Spending Accounts: Last-Minute FSA Eligible Ideas

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Here’s my annual reminder to get back all the money you put into your Healthcare Flexible Spending Accounts (HC FSA) before the end of the year. The maximum salary deduction limits were $2,650 (2018) and $2,700 (2019).

Quick ideas. If you didn’t exhaust your funds with insurance copays or deductibles, here are eligible items that you can still buy over-the-counter without a prescription. Just order things online and then submit the receipt. Amazon even has a special FSA-eligible page with an “under $25” and “little-known eligible item” section.

Certain over-the-counter (OTC) items such as cough medicines, pain relievers, acid controllers, and diaper rash ointment require a prescription for reimbursement. (No, I don’t understand why sunscreen and contact lens solution don’t require a prescription but cough medicine and ibuprofen does. Why would I buy it if I didn’t need it? Shrug.)

When getting a receipt, make sure it clearly includes the following:

  • Date of service or purchase
  • Name or description of the item
  • Amount of purchase

Deadline extensions. Starting in 2013, employers have had the option of adding one of the following:

  • Some plans allow a grace period until March 15th of the following year as opposed to a December 31st deadline to use your 2017 funds, but it may only apply to claims and not late purchases. Check with your employer.
  • Some plans allow participants to carry over up to $500 in unused FSA funds into next year. Check with your employer.

Big, exhaustive lists.

Finally, only your FSA administrator can provide you with the exact guidelines for reimbursement according to your plan. I learned this the hard way when our FSA administrator switched one year from in-house to Conexis (now since acquired by WageWorks). Wow, Conexis was a pain. I had to submit some claims three times before finally getting approved. If you count the time wasted, I probably lost money by participating in the FSA at all. The other employees in the company must have also complained so much that the very next year, FSA reimbursement was again managed in-house.

If you have an HSA, look for a “limited-purpose FSA” option that is restricted to dental and vision care services. These have the same max annual salary deduction.

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  1. FSAFeds recently switched massages as only being eligible with a doctors note to being eligible without one. This is a pretty major change, do you know if this is true for all FSAs? I tried searching for an explanation but came up with nothing.

  2. Scott Guirlinger says:

    With the rise of HSA’s as the preferred option by employers, I’d be curious to know how many people still participate in healthcare FSA’s. (You aren’t allowed to participate in FSA if you have HSA.)

  3. Joshua Katt says:

    It is a PITA for sure but the tax savings can’t be ignored. Here’s a tip if a bit short at year end, buy contact lens solution and reader glasses at Costco (roughly $20 each per package) and return what you don’t need after photocopying the receipt for the FSA.

  4. As noted by prior comment on rise if HSAs, an additional important caveat is that if your plan allows your FSA balance to carry over into the first several months of the next plan year, this does not apply if you are switching to a plan with an HSA in lieu of an FSA. If you do not empty our your FSA on or before 12/31 then you will be barred from contributing anything to your HSA (and your employer will be barred from making a contribution to the HSA if they do so) until after the last date that the carryover FSA funds could be used (i.e., generally March 15) – I suspect that given the HSA can’t be funded that you would then be able to use the carryover FSA funds during this period, but not certain on this.

  5. This “use it or lose it” philosophy is not as necessary as it was a decade ago. In recent years, my employer allows for $500 of carryover each year. I would expect that many other employers do as well.

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