A Health Care FSA can reimburse you for eligible Health Care expenses that are not covered by your health insurance plan. These include deductibles, copays and certain out-of-pocket expenses.
The IRS does not limit contributions to a Health Care FSA, but many employers limit contributions to between $2,500 and $5,000. Your enrollment materials will specify a maximum annual amount you can set aside in your account.
Consider last year's health-related expenses, including medical, dental, vision or pharmacy costs you foresee that might not be covered under your health plan. Also consider any changes in your family status that might have an impact on these expenses.
Your savings will depend on several factors, including your income, tax bracket and yearly health care expenses. For example, assuming an annual income of $40,000, a 15% tax bracket, and estimated health care expenses of $2,000, your tax savings will be approximately $453 annually by using a Health Care FSA.
With FSA
Without FSA
FSA Savings
Annual
Income:
$40,000
$40,000
Estimated
Health Care Pretax Contributions:
$2,000
$0
Taxable Income:
$38,000
$40,000
Estimated
Federal Withholding:
$5,163
$5,463
Estimated
FICA:
$2,907
$3,060
Health
Care Expenses (without FSA):
$0
$2,000
Net Pay:
$29,930
$29,477
$453
Filing Status: Head of Household with one dependent. These projections are only estimates of 2006 tax information and should not be assumed to be tax advice.
Consult a tax advisor to determine the appropriate tax advice for your situation. To see how much YOU can save, check out the FSA Savings Calculator.
Orthodontia is a reimbursable expense through your FSA account. We can reimburse you for eligible orthodontia services incurred during the current enrollment plan year. Initially, you must submit a signed FSA Health Care claim form along with:
the contract from the orthodontist, indicating the initial fee charged
estimated insurance payment
initial start date*
duration of treatment
proof of payment for reimbursement request of any partial or full down payment.
*Future dates of service cannot be submitted.
Orthodontia claims must be manually submitted utilizing an FSA Health Care Claim form available from your employer.
We make reimbursement easy! We offer several automatic reimbursement options so you don't have to complete a paper claim form. Please see your plan administrator to find out which options are available to you.
How Does It Work?
(1 page)