Flexible Spending Accounts
How do I submit a claim for reimbursement of my expenses?
For your Medical Care FSA, you should submit a detailed receipt or an Insurance Company's Explanation of Benefits (EOB) (where expenses are partially covered by insurance) along with a completed and signed Flexible Spending Account Request for Reimbursement form. The receipt or statement you submit along with your Request for Reimbursement should be from the party that provided the service (the receipt should bear the provider's name), the date the service or services were provided, to whom the services were provided, an explanation of the actual service or services provided, and the amount of the expense associated with those services. You will be reimbursed up to your annual election amount less any previous reimbursements.
In submitting for Dependent Care expenses, the same rules apply. However, the Request for Reimbursement Form can act as a receipt from the provider, when you have the provider sign and date the form. If there is no provider signature, then a detailed receipt or statement should be attached to your request. Unlike, the Medical Care FSA you will be reimbursed only up to what you have thus far contributed to the FSA less any previous reimbursement.
Cancelled checks do not meet the requirement that a receipt or statement come from the party providing the service and are therefore not adequate for reimbursement from either FSA.
Click here for a Flexible Spending Account Request for Reimbursement Form.
In some cases, your employer may provide you with a debit card to pay for unreimbursed FSA expenses. This increases your cash flow as moneys are paid straight from your account. For more detail please click here for Debit Card FAQs.
View additional questions:
- What is a Flexible Spending Account (FSA)?
- How much can I contribute to each account?
- What expenses are reimbursable under each of the plan?
- How do I enroll in a Medical Care or Dependent Care FSA?
- Do I have to participate in my employer's medical insurance plan to enroll in the Medical Care FSA?
- What's better for me, the Dependent Care FSA or the Federal Dependent Care Tax Credit?
- Can I change my Medical Care or Dependent Care election at any time?
- When can I submit a claim for reimbursement?
- How do I submit a claim for reimbursement of my expenses?
- What happens if I terminate employment during the year?
- What happens if my expenses are lower than anticipated?
- Are there any filing requirements at the end of the year when I file for my income taxes?