A limited-purpose health flexible spending account (referred to as a limited-purpose FSA) is much like a typical, general-purpose health FSA. However, under a limited-purpose FSA, eligible expenses are limited to qualifying dental and vision expenses for you, your spouse, and your eligible dependents.
Here’s how a limited-purpose FSA works. Money is set aside from your paycheck before taxes are taken out. You can then use your pre-tax FSA dollars to pay for eligible vision or dental expenses throughout the plan year. You save money on expenses you’re already paying for, like dental checkups, vision exams, eyeglasses, and much more.
IRS rules do not allow you to contribute to a health savings account (HSA) if you are covered by any non-qualifying health plan, including a general-purpose health FSA. By limiting FSA reimbursements to dental and vision care expenses, you (or your spouse) remain eligible to participate in both a limited-purpose FSA and an HSA. Participating in both plans allows you to maximize your savings and tax benefits.
And depending on how your limited-purpose FSA plan is set up, you may be able to carry over up to $500 of unused funds to the following plan year.
An HSA is a health care account and savings account in one. The main purpose of this account is to offset the cost of a qualifying high deductible health plan (HDHP) and provide savings for your out-of-pocket eligible health care expenses – those you and your tax dependents may have now, in the future, and during your retirement.
HSAs are administered by an HSA custodian, trustee, or its designee, and HSA account holders must agree to the terms of the custodial or trust agreement. This is a “portable” account, which means if you have an HSA, you own it! HSAs may be included in your employee benefits package, but after you set up your account, it’s yours to keep, even if you change jobs or retire.
IRS guidelines govern HSA eligibility, and not everyone can set up an HSA. You must meet all of the following requirements before you can open an HSA and contribute to it each month:
You continue to maintain your HSA eligibility each month that you meet the conditions listed above on the first day of the month. Plus, it’s up to you to decide if you meet these eligibility requirements. This is also important to know when making HSA contributions.
A limited-purpose FSA covers qualified out-of-pocket expenses for dental or vision care provided to you, your spouse, or dependents. Typical eligible expenses include:
Qualified Dental Expenses
Qualified Vision Expenses
These expeneses are defined by IRS rules and your employer's plan. You can learn about your employer's plan by reading the Summary Plan Description (SPD).
Here are some other IRS rules you should know about:
Check out our Eligible Expenses page for more details.
Expenses that are not approved are called “ineligible expenses.” Ineligible limited-purpose FSA expenses include:
These are only a few of the examples of expenses that aren’t covered by a limited-purpose FSA. Find a full list of eligible and ineligible expenses on our Eligible Expenses page.
You may not use funds from both your limited-purpose FSA and your HSA to cover the same eligible expense. Since there’s no double-dipping allowed, you must choose which account will reimburse your expense.
Yes. As a result of the Affordable Care Act, employee contributions have been capped for limited-purpose FSA plans. The annual limit is $2,500, and you cannot contribute more than this amount. However, your plan may have an annual limit that is less. Please review the Summary Plan Description (SPD) to find out the annual limit for your plan.
The statutory $2,500 limit does not apply to certain non-elective employer contributions made to an employee’s limited-purpose FSA. It also does not apply to contributions made to other types of FSAs (such as dependent care FSA), HSAs, or HRAs.
Yes, if your spouse is eligible to make contributions to a limited-purpose FSA. Each spouse may contribute up to the $2,500 maximum limit to their own limited-purpose FSA. This applies even if both spouses participate in the same limited-purpose FSA plan sponsored by the same employer.
Your entire health FSA election is available on the first day of the plan year. If your FSA is active, your available funds decrease as your claims are paid. You can find out your available funds by logging in to your online account.
Your employer chooses the reimbursement schedule. You can find out how often reimbursements are made by reading the Summary Plan Description.
Your FSA information is available any time day or night by logging in to your online account. Log in and find:
Just log in to your online account to find it.
You must save all itemized receipts and other supporting documentation for every FSA expense. Try to keep all of your documentation filed in an envelope or box. Appropriate documentation includes:
In some cases, a Medical Determination Form completed by a vision, or dental provider is required. Credit card receipts, canceled checks, and balance forward statements do not meet the requirements for acceptable documentation.
It depends on the rules for your employer’s FSA plan. Your employer decides the features included in your FSA plan, and the way your health FSA plan is set up determines if you can use funds left in your account after the plan year ends.
Review the Summary Plan Description (SPD) to learn if your plan includes either of these features:
The IRS doesn't allow a limited-purpose FSA plan to have both a carryover feature and a grace period extension. If your limited-purpose FSA had a grace period in the past, it no longer applies to your current plan if the carryover feature is now available.
Even if your plan has a carryover feature or a grace period, it's important to plan carefully when you decide how much to put into your FSA. For example, don’t think of a grace period as an extension of the plan year. It’s more like a cushion in case your expenses fall a little short of what you expected.
Please note: Not all plans have one of the features listed above, and the length of a grace period can vary. So can the maximum amount of a carryover. That’s why it’s important to review your SPD.
It’s a set number of days after the plan year ends that allows you to submit claims for eligible expenses incurred during the plan year. Not all FSA plans include this feature and the time frame of the run-out period may vary by plan. Check your Summary Plan Description (SPD) for details.
Some people get a run-out period confused with a grace period extension, so here’s an example that shows the difference. Let’s say your plan year begins on January 1 and ends on December 31.
The IRS created this rule, which states that all money left in your FSA is forfeited after the plan year ends, or if applicable, after the run-out period. If your limited-purpose FSA has a carryover feature, you may carry over up to $500 of unused funds into the next plan year. The $500 maximum carryover limit was set by the IRS, but your employer may decide to have a lesser amount – check your Summary Plan Description (SPD). After the carryover, you forfeit remaining unused funds that are more than the carryover amount.
The unused portion of your limited-purpose FSA cannot be paid to you in cash or other benefits, and you can’t transfer money between FSAs. To reduce your risk of losing money at the end of the plan year, carefully estimate your expenses when choosing your annual election amount.
Your election can’t be changed during the plan year unless you have a change in status or other qualified event – that’s an event defined by IRS rules – and your employer's plan must allow the change as well. Learn more on our Health FSA Participant Guidelines page.
If you stop working for your employer or you lose your FSA eligibility, your plan participation and your pre-tax contributions will end automatically. Expenses for services you have after your termination date are not eligible for reimbursement.
Please Note: You may be entitled to elect COBRA continuation coverage under the health FSA and receive reimbursement for qualified expenses incurred after your termination, but only if you continue to make the required FSA COBRA premium payment using your money after taxes have been taken out. However, you generally do not have the right to elect COBRA continuation coverage if the cost of COBRA continuation coverage for the remainder of the plan year equals or is more than the amount left in your FSA (excluding your carryover dollars, if applicable). Please see your Summary Plan Description for specific rules that apply to your FSA plan.
The action you need to take depends on if you have a grace period extension or carryover feature included in your general-purpose health FSA.
Please note: If your spouse has a general-purpose health FSA, the details above also apply to that account.
Your HSA custodial agreement and other benefits materials should include details about your rights and responsibilities as an HSA account holder. You’ll also find the eligibility requirements and details about qualifying high deductible health plans, HSA contributions, and distributions.
If you have a CONEXIS HSA, learn more about it on our HSA page. If you have an HSA through another custodian or trustee, contact them for more information.