Medical Expense FSA FAQs
Medical Expense FSA FAQs for Employees/Participants:
How do I know what is covered under my FSA? This (http://hcet.ebia.com/bbi) is a link to a list of all potentially eligible expenses under an FSA. These are arranged alphabetically and include clarification as to whether specific expenses are covered, potentially covered, or not covered at all. Please remember that all services must be provided during the period of time when you were actively participating in the plan. If you join the plan mid-year, any expenses prior to your eligibility date are not considered valid.
Do I have access to my full available election at the beginning of the plan year?Yes, this account is prefunded by your employer, so all of the funds that you will contribute over the course of the plan year are available on day one of the plan.
My doctor did not send me a bill for prior year services until this plan year. Can I use my account to pay for this? No. Unfortunately, the date the services were provided determines eligibility. The services must have been provided within your active dates during the current plan year.
If I don’t use all of my funds, do you send me my balance after the year ends? No, all funds that are unused are returned to your employer for administrative costs.
If I realize I am not going to use all my funds or that I need to have more money in my account, can I change my contributions? The IRS only allows changes to your medical election if you have a qualifying life event. This typically means marriage, divorce, or birth / adoption of a child. The change you make to your account must be consistent with your life event. If you gain a family member, you would be allowed to increase your election, but you would not be allowed to decrease your election. If you lost a family member, you would only be allowed to decrease your election, not increase it.
I used my card at a hospital/doctor’s office/dentist office, which is identified as a medical provider. Why are you requesting documentation? The IRS only allows certain claims to be approved without substantiation. These items are typically medical plan co-pays and prescriptions purchased at a store that only allows eligible items to be purchased with the card. We will always request an itemized bill for dental procedures.
My card is inactive. How can I be reimbursed for expenses I incurred while my card has been disabled? You may fill out a claim form and submit that form with substantiation and you will be reimbursed directly. All claim substantiation must include the provider’s name (stamped or pre-printed), the patient’s name, a date of service, a description of services provided, and your total financial responsibility. You can access the claim form here (http://mybenefitspeople.com/wp-content/uploads/2012/10/FLEXIBLE-SPENDING-ACCOUNT-CLAIM-FORM.pdf)
I have incurred an ineligible expense. This is my money. Why do I have to pay the plan back? The IRS only allows you to pay for certain expenses with pre-tax dollars. If something has been deemed ineligible, it is because the IRS states that your expense is not allowable under the plan. Therefore, you must reimburse your account so that you are following plan guidelines and not misusing your funds.
My spouse called and you would not speak with him/her. Why not? We are only allowed to speak with the cardholder unless you give us written permission to speak to someone else. Speaking with anyone other than the account holder without written permission is a violation of HIPAA. You can get a HIPAA form by logging into your FSA account here (https://www.wealthcareadmin.com/default.aspx)
Can I get a card for my spouse or my dependent child who is away at college? Yes. Please fill out the additional card request form found when you log in to your FSA account here (https://www.wealthcareadmin.com/default.aspx)
How do I submit claims? You can fax (877) 239-6635, email (firstname.lastname@example.org), or mail (PO Box 681569 Franklin, TN 37068) your claims to our office. You may also submit claims online in our online claims entry module.
How do I know which drug stores will accept my card? There is a list of merchants here (http://apps.sig-is.org/SIGISPublicRpts/IIASMerchantList.aspx). This list identifies those locations where you can use your card without submitting a receipt for verification. There is a list here (http://apps.sig-is.org/SIGISPublicRpts/NtyMerchantList.aspx) that identifies where you can use your card, but a receipt may be required for verification.
When should I keep receipts? We recommend keeping all receipts for your own records, but a good policy to follow is to keep your documentation for at least 30 days before disposing of it.