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Use '12 FSA money now, get ready for '13 changes

Most plans require employees to use themoney in their flexible spending accounts by the end of the year or forfeit it. The program will change slightly next year.

By MSN Money Partner Dec 11, 2012 7:13PM

This post is by Susan Johnston of U.S. News & World Report. medicine expenses © Don Farrall/Photodisc/Getty ImagesAs the year draws to a close, many employees with flexible spending accounts for medical expenses will rush to the doctor or dentist to use up any remaining funds.


For the uninitiated, FSAs allow employees to set aside pretax money to pay for qualified medical expenses, but at the end of the plan year -- or two-and-a-half months into the following year, if the employer offers a grace period for FSAs -- the employee forfeits any money left in the account. However, any money in a health savings account carries over from year to year.


"Typically, what people are going to do is schedule any medical procedures that they can, particularly elective procedures," says Matt Thomas, the president of WorkSmart Systems, a professional employer organization in Indianapolis. "A big one would be things that have to do with vision: if they need to get classes or contacts, or if they're interested in getting a lasik procedure."


Here's a look at ways to use up FSA dollars and how FSAs will change next year:


Using FSA money


Jeremy Miller, the president and founder of, an online shop in New York dedicated to selling FSA-eligible products, says now is a good time to check account balances and pending transactions before creating a strategy for how to spend what's left.

But before you rush out to the drugstore and load up your cart, Tami Simon, managing director of knowledge resources for Buck Consultants, recommends reading your employer's summary plan description so you know what is and isn't eligible for reimbursement. "Eligible expenses are those things that are specifically linked to medical care -- things like a blood pressure monitor, a blood sugar test kit and test strips, a breast pump for lactating mothers," she says. (Lactation supplies became eligible for FSA reimbursement last year.)


Items purchased for preventive care, such as a gym membership or an electric toothbrush, or for cosmetic purposes, including cologne and tooth-whitening strips, are generally not reimbursable. Over-the-counter (OTC) medications previously qualified as FSA-eligible expenses, but as of Jan. 1, 2011, the IRS excluded OTC medications (except for insulin) unless the patient has a prescription from his or her doctor.


A partial list of reimbursable items includes:

  • Acupuncture
  • Inpatient treatment for alcohol addiction and, in some cases, transportation to and from Alcoholics Anonymous meetings
  • Home improvements to accommodate a home to the disabled condition of the employee, a spouse or dependent, such as exit ramps or grab bars
  • Eye exams, eye surgery and items such as contact lenses, contact solution, prescription sunglasses and eyeglasses
  • Fertility treatments, such as in vitro fertilization, temporary storage of eggs or sperm, and vasectomy reversal
  • Prescription medications, including birth control pills

As Simon adds, "(With) any expense that is reimbursed through a health FSA, you should be prepared to prove it and describe why you needed to have that expense."


Changes to FSAs


For 2012, there is no federally mandated limit on FSA funds, although most employers cap FSAs around $2,000 to $5,000. To help fund health care reform, changes to FSAs in 2013 will limit the potential tax savings by placing a $2,500 per-year cap on health care FSAs. (Dependent care FSAs are not subject to this cap, but HSAs have their own caps.)


The limit applies to plan years starting Jan, 1, 2013, so employers with FSAs based on the fiscal year can choose to keep the higher reimbursement limit in effect through the end of the 2012-2013 plan year.


Since the $2,500 cap is per person, couples in which both partners have FSAs through an employer would have $5,000 of pretax money to spend on medical expenses. "The FSA can be used for you, your spouse, dependent kids, grandparents or anyone who is dependent," explains Miller.


According to Miller, the average person puts $1,500 into an FSA, so those people wouldn't be affected by the change, but about 18% of heavy FSA users could feel the pinch next year. Among that group are people who use FSAs in conjunction with a high-deductible health plan.


Beyond FSAs, the IRS allows taxpayers who itemize to deduct medical expenses that exceed 7.5% of their income. "Anything reimbursed by (an FSA) could not also be deducted," explains Thomas. However, if you had enough medical expenses that weren't reimbursed by your FSA, you might be able to deduct those expenses. In 2013, that threshold will rise to 10%.


If you're used to itemizing or maxing out your FSA, these changes could affect how you pay for medical expenses going forward. "Compared to prior years, someone with the same income will need to have more unreimbursed medical expenses to be able to take advantage of the deduction," says Thomas. "In theory, the cap might feed into this for someone who is used to paying $3,500 out of flex and now has to pay that $1,000 on an after tax basis and claim a deduction if available, for example. This only affects those who itemize."


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