How To Get Reimbursed From Your FSA

Quick answer

• Understand your FSA’s eligible expenses and deadlines.
• Keep all receipts and detailed Explanation of Benefits (EOBs).
• Submit claims promptly through your FSA administrator’s portal, app, or mail.
• Know your FSA’s reimbursement method (direct deposit, check, or debit card).
• If using an FSA debit card, save receipts for potential verification.
• Contact your FSA administrator for any claim denials or questions.

Who this is for

• Individuals with a Flexible Spending Account (FSA) for healthcare or dependent care expenses.
• People who have incurred eligible expenses and need to submit a claim for reimbursement.
• Those who are new to using an FSA or need a refresher on the reimbursement process.

What to check first (before you act)

Your FSA’s eligible expenses and deadlines

Before you even think about submitting a claim, it’s crucial to know what your FSA covers and when you need to use your funds. Most FSAs have lists of eligible expenses, which typically include medical co-pays, prescription drugs, dental care, vision care, and sometimes even over-the-counter medications. There are also specific deadlines for incurring expenses and submitting claims. Some plans have a “use-it-or-lose-it” policy, while others may offer a grace period or limited carryover.

Your current cash flow

Understanding your personal finances is key to managing your FSA effectively. While an FSA helps you save money on taxes, it’s important to ensure you have the cash on hand to pay for eligible expenses upfront before you get reimbursed. This means knowing your monthly income, expenses, and available funds to cover these costs without causing financial strain.

Emergency fund or safety buffer

An emergency fund is your financial safety net. Before relying heavily on FSA reimbursements, ensure you have a solid emergency fund in place. This fund should cover unexpected expenses like job loss, medical emergencies, or major home repairs. This way, you won’t be forced to dip into funds needed for everyday eligible FSA expenses if an emergency arises.

Debt and interest rates

If you have high-interest debt, such as credit card balances, it might be more financially prudent to prioritize paying that down before maximizing your FSA contributions, depending on your individual circumstances. While FSAs offer tax savings, the interest paid on high-interest debt can negate those savings quickly. Evaluate your debt load and interest rates to make an informed decision about your financial priorities.

Credit impact

While not directly related to the FSA reimbursement process itself, maintaining good credit is always important. Ensure you are paying your bills on time, including any medical bills that your FSA might cover. Late payments or defaults can negatively impact your credit score, which can affect your ability to borrow money in the future or get favorable interest rates.

Step-by-step: How to get reimbursed from your FSA

1. Confirm Expense Eligibility:

• What to do: Review your FSA plan’s list of eligible expenses. Many administrators provide this on their website or in your plan documents.
• What “good” looks like: You have a clear understanding of what types of medical, dental, vision, or dependent care services and items your FSA will cover.
• Common mistake: Assuming an expense is eligible without checking.
• How to avoid: Always refer to your administrator’s official list of eligible expenses.

2. Gather Necessary Documentation:

• What to do: Collect all receipts for your eligible expenses. For medical expenses, also obtain Explanation of Benefits (EOBs) from your insurance provider.
• What “good” looks like: You have detailed receipts showing the provider name, date of service, patient name, and the amount paid. EOBs clearly outline what insurance covered and what your responsibility is.
• Common mistake: Losing receipts or not getting EOBs.
• How to avoid: Create a system for organizing receipts (e.g., a dedicated folder, a digital scanner app) and request EOBs for every insurance-processed claim.

3. Determine Your Reimbursement Method:

• What to do: Understand how your FSA administrator reimburses participants. Common methods include direct deposit, check, or a dedicated FSA debit card.
• What “good” looks like: You know whether funds will be sent directly to your bank account, mailed to your address, or if you can use a card for direct payment.
• Common mistake: Not knowing how you’ll receive funds, leading to delays.
• How to avoid: Check your administrator’s website or contact them to confirm your preferred reimbursement method.

4. Access the Claim Submission Portal:

• What to do: Log in to your FSA administrator’s online portal or mobile app.
• What “good” looks like: You can easily navigate to the claims section and begin the submission process.
• Common mistake: Not knowing where to find the online portal or app.
• How to avoid: Bookmark your administrator’s login page or download their official app.

5. Complete the Claim Form:

• What to do: Fill out the online claim form accurately, providing all requested information, such as your name, employee ID, date of service, provider name, and the amount of the claim.
• What “good” looks like: All fields are completed accurately and match your documentation.
• Common mistake: Typos or incomplete information.
• How to avoid: Double-check all entries against your receipts and EOBs before submitting.

6. Upload Supporting Documents:

• What to do: Upload clear, legible copies of your receipts and EOBs to the claim submission portal.
• What “good” looks like: The uploaded documents are easy to read and contain all necessary details.
• Common mistake: Uploading blurry or incomplete documents.
• How to avoid: Ensure your scanner or phone camera produces clear images. Crop them if necessary to focus on the relevant details.

7. Submit Your Claim:

• What to do: Review all information one last time and click the submit button.
• What “good” looks like: You receive a confirmation message or email that your claim has been successfully submitted.
• Common mistake: Submitting without a final review.
• How to avoid: Take a moment to ensure everything is correct before hitting submit.

8. Track Your Claim Status:

• What to do: Monitor your claim status through the online portal or by checking your email for updates from your administrator.
• What “good” looks like: You can see your claim progressing through the system (e.g., “Submitted,” “Under Review,” “Approved,” “Paid”).
• Common mistake: Forgetting about the claim after submission.
• How to avoid: Set a reminder to check the status a few days after submission if you haven’t heard back.

9. Receive Reimbursement:

• What to do: Await the reimbursement via your chosen method (direct deposit, check, or debit card transaction).
• What “good” looks like: You receive the correct reimbursement amount in your bank account or via mail, or the debit card transaction is processed.
• Common mistake: Not receiving reimbursement or receiving an incorrect amount.
• How to avoid: If delays or discrepancies occur, contact your FSA administrator promptly.

10. Respond to Inquiries or Denials:

• What to do: If your administrator requests more information or denies your claim, review their explanation and provide any missing documentation.
• What “good” looks like: You understand the reason for the inquiry or denial and can provide the necessary information to resolve it.
• Common mistake: Ignoring requests for information, leading to claim denial.
• How to avoid: Respond promptly to all communications from your FSA administrator.

Common mistakes (and what happens if you ignore them)

Mistake	What it causes	Fix
Not checking eligible expenses	Submitting claims for non-covered items, leading to denial and loss of funds.	Always consult your FSA administrator’s list of eligible expenses before incurring costs.
Losing or not keeping receipts	Inability to prove the expense, resulting in claim denial.	Maintain a meticulous system for organizing and storing all receipts and EOBs.
Missing claim submission deadlines	Forfeiting funds that are not reimbursed by the deadline (use-it-or-lose-it).	Be aware of your plan’s specific claim filing deadlines and submit well in advance.
Incorrectly filling out claim forms	Delays in processing, requests for more information, or outright claim denial.	Double-check all personal information, dates, provider details, and amounts against your documentation before submitting.
Uploading unclear or incomplete documents	Administrator cannot verify the expense, leading to denial.	Ensure all scanned or photographed documents are clear, legible, and include all required details.
Not understanding the FSA debit card usage	Using the card for non-eligible items or not keeping receipts for verification.	Only use the FSA debit card for known eligible expenses and always save receipts for any transaction.
Not tracking claim status	Unaware of claim denials or delays, potentially missing opportunities to fix them.	Regularly check the status of your submitted claims through your administrator’s portal or app.
Not responding to administrator inquiries	Claim being automatically denied due to lack of required information.	Promptly address any requests for additional information or clarification from your FSA administrator.
Assuming insurance covers everything	Incurring out-of-pocket costs that are not fully covered by insurance and FSA.	Understand your health insurance benefits first, then verify if the remaining out-of-pocket costs are eligible for FSA reimbursement.
Not understanding the “use-it-or-lose-it” rule	Losing remaining funds at the end of the plan year without making a claim.	Plan your expenses throughout the year and make a conscious effort to use your FSA funds before the deadline.

Decision rules (simple if/then)

• If you have an eligible medical expense, then submit a claim because your FSA is designed to cover these costs and save you money.
• If you received an EOB from your insurance provider, then attach it to your FSA claim because it details your responsibility after insurance has paid.
• If your FSA administrator offers a debit card, then use it for eligible expenses to simplify the process, because it reduces the need for out-of-pocket payments and subsequent reimbursement.
• If you are unsure if an expense is eligible, then check your FSA administrator’s list of covered items before purchasing because submitting ineligible items will result in denial.
• If you are close to your plan year end and have remaining funds, then look for eligible over-the-counter medications or other approved items to purchase because you risk losing the money if you don’t use it.
• If your claim is denied, then review the denial reason and provide any requested documentation because many denials can be resolved with additional information.
• If you have a dependent care FSA, then ensure the provider is qualified and obtain necessary tax identification numbers because these are specific requirements for dependent care claims.
• If you are submitting a claim for a recurring service (like therapy), then understand your administrator’s policy on recurring claims to avoid submission issues.
• If you have a high-deductible health plan (HDHP) with a Health Savings Account (HSA), then be aware that HSAs and FSAs have different rules; you generally cannot contribute to an HSA and have a general-purpose FSA simultaneously.
• If you are using the FSA debit card and receive a request for receipt verification, then promptly provide the requested documentation because failure to do so can lead to the amount being debited from your paycheck.
• If you have a large medical bill, then verify the amount with your insurance company and the provider before submitting to your FSA to ensure accuracy.
• If you are nearing the end of your plan year and have a significant balance, then consider scheduling future eligible appointments or purchasing necessary supplies to maximize your FSA benefit.

FAQ

Q1: How long does it typically take to get reimbursed from my FSA?

Reimbursement times can vary by administrator. Generally, you can expect to receive funds within 5-10 business days after your claim is approved, but check with your specific provider for their typical processing times.

Q2: What if I don’t have an FSA debit card?

If you don’t have a debit card, you’ll typically pay for eligible expenses out-of-pocket and then submit a claim form with your receipts and EOBs to your FSA administrator for reimbursement.

Q3: Can I get reimbursed for expenses incurred before my FSA plan year started?

No, you can only be reimbursed for eligible expenses incurred during your current FSA plan year. Check your plan documents for the exact start and end dates of your plan year.

Q4: What is an Explanation of Benefits (EOB)?

An EOB is a document from your health insurance company that explains what medical treatments and/or services the insurance company paid for on your behalf. It details what you owe the provider.

Q5: Can I submit claims for my spouse or dependents?

Yes, if your FSA covers eligible expenses for your spouse and dependents, you can submit claims for their qualified medical, dental, vision, or dependent care costs. Ensure you have the necessary documentation for each individual.

Q6: What happens if I forget to submit a claim before the deadline?

Most FSAs have a “use-it-or-lose-it” policy. If you don’t submit claims for eligible expenses incurred within the plan year by the specified deadline, you will forfeit the remaining funds.

Q7: Can I use my FSA for over-the-counter (OTC) medications?

Many FSAs now allow reimbursement for OTC medications, but it’s essential to check your specific plan’s guidelines. Some plans may require a Letter of Medical Necessity from your doctor for certain OTC items.

What this page does NOT cover (and where to go next)

• Specific tax implications of FSA contributions: Consult with a tax professional for personalized advice on how your FSA impacts your tax return.
• Detailed rules for Health Savings Accounts (HSAs) or Health Reimbursement Arrangements (HRAs): These are different types of accounts with their own distinct regulations. Research HSA or HRA specific resources if you have one of these.
• Employer-specific FSA plan variations: While general rules apply, your employer’s plan might have unique features. Refer to your employer’s benefits handbook or HR department for details.
• Appealing denied claims beyond the administrator’s process: If you exhaust the administrator’s appeal process, you may need to explore other avenues, but this is typically a last resort.