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Health Care Flexible Spending Accounts Stretch Your Health Care Dollars

Everybody loves a bargain. Whether it's an end-of-season closeout sale, or a coupon clipped and used, we all appreciate being able to save money on any item we need to buy. And if the bargain in easy to come by, so much the better. That's why health care flexible spending accounts (HCFSAs) are one of the best bargains available to employees.

HCFSAs let you put away dollars throughout the year that you can then use to pay for your out-of-pocket health care expenses on a pre-tax basis. You choose the amount to contribute annually, and that amount is divided by the number of paychecks you receive in a year and deducted from those paychecks accordingly. Then, when you have an out-of-pocket health care expense, you pay it from the HCFSA. The full annual election amount is available to you immediately. For example, if you made a $1,200 annual election but have a $500 expense in February (by which time you would have contributed only two months' worth, or $200, of the annual election amount), the full $500 can be claimed.

What makes HCFSAs such a bargain is that the money you put into them is not subject to federal (and most states') income taxes or social security tax. Nor are these amounts taxed when you take them out to pay for health care expenses. So remember the $500 that was withdrawn in the previous paragraph? Without the HCFSA, you would have had to earn a lot more than $500 to pay for that expense. Though federal and state income tax rates vary, suppose for purposes of this example that your combined tax rate adds up to 30%. Without the HCFSA, you'd have to earn $714 to have $500 remaining after these taxes have been taken out. With the FSA, you only had to earn $500. That's a savings of $214. And all you have to do to get this savings is to sign up for the plan and choose how much to contribute annually. Your employer, or the HCFSA administrator, does the rest.

You can pay for just about any health care expense from an HCFSA-expenses that your health plan doesn't cover (so long as the tax code considers them to be qualified medical expenses), your health plan copayments/deductibles/coinsurance, and dental and vision care expenses. You can also pay for over-the-counter medications, such as pain relievers and cold and allergy remedies, and for items such as contact lens solution and reading glasses. One health-care-related expense you cannot pay from an HCFSA is a health plan premium.

To claim an expense from an HCFSA, it must have been incurred during the 14-1/2 month period beginning with the first day of the HCFSA plan year and running through 2-1/2 months after the end of the plan year. Most employers run their HCFSAs on a calendar year, so for the 2007 HCFSA plan year, your account could be used to pay for expenses incurred from January 1, 2007 through March 15, 2008.

If you don't use all of your HCFSA money during that 14-1/2 month period, you lose it. This is the use-it-or-lose-it rule, established by the Internal Revenue Service and required to apply to all HCFSAs (in other words, it's not your employer's rule). Fear of losing money keeps many employees from signing up for an HCFSA. But, with a little planning, the risk of not spending down your account is easily managed, and losses avoidable.

Here's how-

• Before choosing an election amount, estimate your out-of-pocket health care expenses for the coming year. Think what you expect to pay for annual exams, plus regular dental and vision care. Tack on some extra for the supplies you buy for your family's medicine cabinet (aspirin, bandages, cold/allergy medications, etc.). Tack on some more if you know additional, non-routine health care services are on the horizon, such as any planned surgeries, or orthodontia or other major dental work.

• Keep track during the year of how you are spending down your account. If the end of the year approaches and you don't expect to use up these funds, use what's left in the account for more medicine cabinet items, to buy a spare pair of eyeglasses, or the like.

• Even if you end up with a few dollars in your account, you're still ahead financially. Remember that you've saved significant tax dollars by contributing to an HCFSA. Let's use the $1,200 annual election/30% combined tax rate again...your $1,200 in HCFSA contributions have saved you $360 in taxes. If the amount you don't spend is less than this-and given all that the HCFSA can be used for, it certainly should be-you're still ahead.

HCFSAs are easy to use. After you've had an expense, you file a simple claim form, and attach substantiation of the expense, such as a dentist bill or explanation of benefits from your health insurance carrier. Many HCFSAs now come with a debit card, which you can use to pay for an expense at the time of service, rather than paying out of your pocket and filing a claim for reimbursement.

Virtually everyone has out-of-pocket health care expenses; why not pay for them in the most cost-effective way? Sign up for your employer's HCFSA.

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