Flexible spending accounts (FSA)
Is there a cost to participate in a health care or dependent day care FSA?

No, there are no administrative fees for either flexible spending account. The amount of pre-tax money you choose to contribute from your paycheck goes directly into your FSA account.

Why do I have to enroll in the flexible spending accounts each year?

The IRS requires re-enrollment for participation every year. If you don’t re-enroll each fall, you can’t participate the following year.

I elected a Consumer option. What expenses can I pay with my PayFlex debit card?

You can use your PayFlex debit card to pay for all eligible health care costs, including services under your medical plan. Keep in mind you have to use all the money in your HealthFund before you can access your health care FSA to cover medical expenses.

You can also use the PayFlex debit card for prescription drug, dental and vision expenses.

IMPORTANT: We advise you to be cautious when paying for medical provider up-front costs, such as deductibles and/or coinsurance. Ask the medical provider to file the claim with Aetna before you use your debit card to make sure you’re paying the correct out-of-pocket amount and to make sure your claim includes any contract discounts.

Can I use my PayFlex debit card at my doctor’s office?

No. In fact, your PayFlex debit card won't work at your doctor's office. Here’s how doctor office visits should be handled:

  1. Your in-network doctor should file a claim with Aetna. If the doctor doesn’t file a claim, you must file a claim with Aetna. This may happen with an out-of-network provider, for example.
  2. Aetna then pays your doctor the allowable amount.
  3. If you’re responsible for a portion of the charges (for your annual deductible or coinsurance or for amounts above Aetna's out-of-network fee schedule), you can pay that out of your health care FSA.
How are expenses reimbursed?

You must submit a claim form. The claim form provides information about required documentation and claims payment. The rules about when you can receive reimbursement vary by account:

Your health care FSA can reimburse you up to your maximum planned contribution at any time during the year.
Your dependent care FSA can reimburse you up to the amount you’ve contributed to your account at the time your claim is processed. You pay for services up front, and then submit a claim for reimbursement.

Claim forms:

OTC Reimbursement Form
Health Care FSA Claim Form
Dependent Care FSA Reimbursement Form 

If I run low on money in my dependent day care FSA, why can't I use my health care FSA to pay for childcare expenses?

IRS rules don’t allow transfers between flexible spending accounts. The Internal Revenue Code regulations specifically state that any amount set aside on a pre-tax basis to a specific type of flexible spending account can’t be used for any other type of expense.

If I find that my out-of-pocket health care expenses are lower than the amount I chose to contribute to the health care FSA for the year, why can't I just stop making contributions?

The Internal Revenue Code states that, once a participant enrolls for a specific pre-tax contribution amount, the participant can’t change the amount unless he or she has a qualified family status change. More information about family status changes is available here.

What if I don't use all of the money in my flexible spending account?

Unfortunately, you lose any money left in your account. That’s why it’s important to always plan your spending account contributions carefully. You also can’t carry over contributions from one year to the next or transfer contributions from one flexible spending account to another.

What counts as eligible over-the-counter medical supplies and products for reimbursement under the health care FSA?

You can use your account to reimburse expenses for over-the-counter (OTC) medical supplies and products including bandages and wraps, braces and supports, catheters, contact lens solutions and supplies, contraceptives and family planning items, denture adhesives and diabetic supplies. OTC drugs, such as antacids and cold, pain and allergy medications aren’t eligible unless you have a prescription from your doctor. You’re not reimbursed for products that promote general health, such as vitamins, nutritional supplements, toothpaste and moisturizing lotion, even if your doctor suggests them.

How do I submit claims for eligible over-the-counter (OTC) products?

As with all reimbursement requests, you must submit a claim form and any additional required documentation. For OTC items you need to include a cash register receipt showing the date, amount of the purchase and the product description. Only OTC medicines require a doctor's prescription.

If you have an FSA debit card, you can use that for OTC medications at CVS, Walmart, Sam’s Club, Walgreens and drugstore.com.

For any benefits question or concern, including 24/7 Nurse Line access, one call does it all.
Call us at 866-284-AISD (2473)