A Health Care Reimbursement Account reimburses you for health care expenses
not covered or only partly covered by your medical and dental plans. In addition
to claiming uninsured expenses for your own medical care, you can claim expenses
for someone the IRS recognized as your eligible dependent, even if that person
is not covered under your medical plan. You may be reimbursed for uninsured
dental expenses, even if you do not carry dental coverage.
The Health Care Reimbursement Account is authorized by the IRS. The account
is designed to help you save taxes on eligible expenses incurred during the
year. The amount you contribute to the account will be deducted from each
paycheck on a pre-tax basis.
This is generally how you use your Health Care Reimbursement
Account:
You have until April to submit claims
for expenses incurred during the prior plan year. Remember that the cost of a
service is incurred when it is received. All expenses are reimbursed based on
the date that the service is received, not based on when you are billed or when
you pay for the service.
Special Rules for Divorced Parents Special rules apply if you and your spouse are
divorced or legally separated, or if you have lived apart at all times during
the last six months of the tax year. Either parent is eligible to be reimbursed
for a child’s health care expenses through the Health Care Reimbursement Account
if the child receives over one-half of his or her support from one or both
parents and is in the custody of one or both parents for more than one-half of
the tax year.
Eligibility To participate in a
Health Care Reimbursement Account, you must:
- be a regular employee and have been employed at least
one year as of January 1 of the current year
- carry at least individual health coverage through Erlanger.
The maximum amount which may be reimbursed in a plan year is $2,002.
Reimbursable Expenses Expenses that
can be reimbursed through a Health Care Reimbursement Account are those expenses
that are not covered by your health insurance plan(s) and are allowed by the IRS
as a tax-deductible medical expense on your Federal income tax return. Such
expenses include:
- Health insurance deductibles and co-pays
- Health care co-insurance cost
- Dental insurance deductibles
- Dental care co-insurance cost
- Routine medical exams
- Physicians’ fees
- Psychologists’ fees
- Prescribed medications
- Eye glasses and contact lenses
- Contact lens solution
- Insulin
- Artificial limbs
- Crutches
- Wheel Chairs
- Special equipment (e.g., telephone equipment for
the deaf)
All expenses listed above must first be filed with your insurance
provider(s), except for vision care. Note: Only
those medical expenses that are specifically allowed by IRC section 213 are
eligible.
Non-reimbursable
Expenses Expenses
not eligible for reimbursement through you Health Care Reimbursement Account
include:
- Programs to stop smoking (no exceptions)
- Weight loss programs (no exceptions)
- Non prescription or over-the-counter drugs, such as
aspirin
- Cosmetic surgery or cosmetic procedures
- Any medical or dental procedure that is not medically
necessary
- Electrolysis
- Health insurance premiums
- Diaper service
- Funeral and burial expenses
- Health club dues
- Household help
- Maternity clothes
- Illegal operations and treatment
- Expenses for trips even if for general health
improvement
- Cost of exercise classes even if recommended by your
doctor
- Toothpaste, cosmetics, or toiletries
Planning for a Reimbursement Account Estimate the amount you will spend on eligible expenses
during the coming year. Then, decide how much to contribute into each account.
Your contributions to the Health Care Reimbursement Accounts are deducted from
your paycheck in equal amounts, divided over 26 pay periods. Money cannot be
transferred from the Health Care Reimbursement Account to the Dependent Care
Reimbursement Account or from the Dependent Care Reimbursement Account to the
Health Care Reimbursement Account. You will want to plan your deposits carefully
and conservatively. If you have money left in the account after you have
submitted all your claims for the year, you will lose the remaining money
according to IRS rules.
Changing Your Election
You may
change your reimbursement account election only if you notify Human Resources
within 30 days of a qualifying change in family status, which includes:
- Marriage
- Divorce
- Birth of child
- Death of dependent
- Change in your employment status
- Beginning or termination of your spouse’s employment, significant changes
in your spouse’s health care plan. (You cannot change your election if you
simply decide you can’t afford the deductions or have an unforeseen
expense.)
Requesting Reimbursement You
may request to be reimbursed only after a service has been rendered. With your
Health Care Reimbursement Account, you may be reimbursed up to the total amount
of your annual contribution – even before that amount has accumulated in your
account. For Health Care Reimbursement Account claims,
you will need to provide copies of explanations of benefits (EOBs) from your
insurance provider(s) to be reimbursed for uninsured medical and dental
expenses. Invoices or receipts are acceptable only for expenses that are clearly
not covered by our medical or dental plan, such as vision care and adult
orthodontia.
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