Health Care Reimbursement Account
This account lets you set aside money from your paycheck on a pre-tax basis to use for eligible out-of-pocket health care expenses including medical, dental, vision, hearing and prescription drug expenses. You can also use the account funds to pay for copayments, deductibles, coinsurance, certain over-the-counter items, and more.
You may reimburse yourself or an eligible dependent (i.e., your spouse and, in general, a dependent you can claim as an exemption on your tax return) with before-tax dollars for certain out-of-pocket expenses. By paying for expenses on a before-tax basis, you reduce your income for the purpose of state, federal and Social Security taxes.
How it Works
You estimate how much you expect to spend on unreimbursed health care expenses for the calendar year and have that amount withheld pre-tax from your paychecks throughout the year in equal weekly or monthly amounts. You may either pay for your qualified expenses using the HealthHub / PayFlex Card at the point of service or you can file a claim (online, by paper, or by fax). Claims are processed daily. You have until March 31 of the following calendar year to submit claims for expenses incurred. The Account has a use-it-or-lose-it rule. You forfeit any unused funds at the end of the plan year.
How to Enroll
New employees sign up for coverage by completing an enrollment form within 30 days from your first day of employment. All other eligible employees may sign up for coverage during the Open Enrollment period. You may also be eligible to sign up for coverage if you have a Qualifying Event. You may contribute from a minimum of $300 to a maximum of $3,050 each calendar year (subject to change each year). You may only change your contribution during the Open Enrollment period or if you experience a Qualifying Event. To continue your coverage, you must re-enroll during each Open Enrollment period.
You can be reimbursed for many expenses incurred by you or your eligible dependents that the IRS allows as income tax deductions, but not all items that qualify as a tax deduction also qualify for the reimbursement account. Premiums paid for health care coverage cannot be reimbursed. Eligible expenses include but are not limited to:
- Deductibles, coinsurance, and copayments not covered by your medical or dental programs
- Out-of-pocket medical or dental expenses and charges above reasonable and customary levels
- Hearing and vision care expenses such as eye exams, eyeglasses and contact lenses
- Annual physical examinations
- Approved weight-loss and stop-smoking programs, if prescribed by a physician to treat a specific condition
- Over-the-counter medications used to alleviate or treat personal illness or injuries if they are deemed as medically necessary and for which the participant has received a prescription for these expenses. Dietary supplements to maintain one's health (such as vitamins) do not qualify for reimbursement.
Use IRS Publication 502 (PDF) as a guide, but not all items that qualify for a tax deduction also qualify for the reimbursement account. For additional information, see PayFlex's list of eligible and non-eligible expenses or contact PayFlex customer service at the number shown at the top of this page.