Health Care Flexible Spending Account Program


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Frequently Asked Questions


What is HCFSA? View the Answer

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The Health Care Flexible Spending Account (HCFSA) Program is a way to pay for eligible medical expenses (not covered by insurance) or dental, vision and hearing expenses (not covered by your Welfare Fund/Union) with before-tax dollars.

What is the definition of medical care under the HCFSA Program?View the Answer

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Medical care means expenses to diagnose, cure, mitigate, treat or prevent disease, or to affect any structure or function of the body.

When can I enroll? View the Answer

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Generally, employees can enroll during the annual Open Enrollment Period from the end of September through the end of October prior to the Plan Year. Employees can also enroll mid-year only if a Qualifying Event occurs.

How much can I put aside in my HCFSA account?View the Answer

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Per Year

Minimum: $260

Maximum: $2,650

Who can be covered under HCFSA?View the Answer

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Coverage is extended to yourself, your spouse, and your eligible dependents.

What types of health care expenses are covered? View the Answer

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This program pays for deductibles, co-insurance, and eligible out-of-pocket expenses. It covers medical, dental, vision and hearing expenses. You can thus be reimbursed for expenses such as (but not limited to):

 

  • Braces
  • Over-the-counter drugs prescribed by your doctor 
  • Physicals
  • Prescription drugs
  • Prescription frames/contact lenses
  • Psychologist's fees

What kind of over-the-counter (OTC) drugs are eligible under HCFSA?View the Answer

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You may submit claims for any drugs that diagnose, cure, treat, prevent, or mitigate ailments. However, you must obtain a prescription from your doctor for these OTC drugs (other than insulin). Sundries, toiletries, and cosmetic items are not eligible. For example, aspirin and cold medicine with a prescription are eligible, but toothpaste and shampoo are not eligible, even with a prescription. Vitamins/supplements are not eligible, even if recommended by a physician. However, certain vitamins/supplements are eligible if prescribed by a physician.

How do I submit claims for OTC drugs prescribed by a doctor?View the Answer

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You must submit a claims form, along with a copy of the prescription, and an itemized receipt. The itemized receipt must include the name of the drug, the date the drug was purchased, and the amount paid for the drug. If you do not have an itemized receipt, you must submit a copy of the product box.

How can I benefit by joining this program?View the Answer

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By contributing to HCFSA, you not only plan for anticipated expenses but also reduce your gross income for federal and Social Security tax purposes. The end result is that your health care expenses are lower and you save on your taxes.

How does this program work?View the Answer

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First, you estimate your pre-tax contribution to your account for the Plan Year. Second, you fund your account through automatic payroll deductions. Finally, you submit a claim for your eligible expenses and a reimbursement check is sent to your home address from your HCFSA account or the reimbursement is automatically deposited into a bank account you have chosen.

Will I receive a statement of my account?View the Answer

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Each participant will receive a personal account statement every quarter.

What is the deadline for submitting claims?View the Answer

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The last day to submit claims is December 31st. However, for HCFSA only, there is a Grace Period offered following the end of a Plan Year. During the Grace Period, you may submit claims for eligible health care expenses incurred from January 1st through March 15th following the end of the Plan Year using the remaining balance in your previous Plan Year account, if any. In the event that you are unable to submit HCFSA claims by the end of the Plan Year or accompanying Grace Period, a Claims Run-Out Period is provided following the close of the Grace Period, during which you may submit claims for services performed during the previous Plan Year or accompanying Grace Period. The Claims Run-Out Period ends on May 31st following the end of the Plan Year.

What happens if I do not submit claims for the amount I contribute?View the Answer

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According to IRS rules, amounts not used by the end of the Plan Year or Grace Period will be forfeited.

How can I get further information on this program?View the Answer

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Contact the FSA Administrative Office at (212) 306-7760.