Q. What is the advantage of using the Health Care Flexible Spending Account (HCFSA)?
A. You save money — as shown in the Examples of tax savings using the Plan— by using pre-tax dollars for unreimbursed, out-of-pocket medical, dental and vision expenses. You cannot be reimbursed for amounts paid by any insurance provider or health care plan.
You may claim reimbursement of eligible health care expenses for your family members even if they are not covered under ExxonMobil's medical, dental or vision plans. Your dependents for the purposes of the HCFSA include:
- Your spouse.
- Anyone whom you can claim as a dependent for income tax purposes.
- A child who would otherwise qualify but you cannot claim as a dependent for income tax purposes because you do not have custody.
You may elect to contribute up to $2,500 to the HCFSA for the plan year. If you and your spouse both work for ExxonMobil:
- Each of you can enroll in this account up to the $2,500 limit — a total of $5,000 for your family
- You may file claims as an employee or as a dependent of another employee participating in the Plan, but you may not be reimbursed for more than 100% of your out-of-pocket expenses.
You can contribute up to $2,500 a year on a pre-tax basis. You may use your account for out-of-pocket expenses not covered or not fully reimbursed by any health plan.
Availability of funds
Although your election directs funds to this account on a monthly basis, your total projected plan year contributions are available to reimburse you for expenses incurred from the beginning of the plan year. Participants may carryover up to $500 of any remaining unused health care flexible spending account amount to the immediately following Plan year.
Charges spanning more than one plan year
If doctors require payment in advance for services rendered during more than one plan year, ask them to specify the dates services were rendered and the charges for those services. With adequate documentation, you may be reimbursed for expenses incurred for services provided during the plan year. Prescription reimbursement is based on the fill date and not the pick-up date. Orthodontia, however, is treated differently. Reimbursement is based on your treatment plan, not your payment schedule, even if you pay the total cost in advance.
Orthodontia is unlike most other kinds of health care treatment because:
- It usually spans more than one plan year; and
- Frequently the length of treatment is different from the payment schedule.
Initial Banding Fee Reimbursement: Depending upon available FSA funds and amounts paid by the dental plan, if you pay orthodontic charges in full on the date of banding, you will receive up to 25% of the allowed amount as an initial banding fee reimbursement. If you make an initial banding fee payment (down payment), you will be reimbursed up to the total amount paid. If no banding fee is indicated on the claim or you did not make an initial banding fee payment, you will be reimbursed up to 25% of the allowed amount.
Contact Aetna when estimating your annual orthodontia election.
Only qualified medical expenses for services while you are a participant are eligible for reimbursement. These expenses include your deductible, co-payments and other out-of-pocket expenses under your group health plans. The calendar year in which a qualified medical expense may be reimbursed under the HCFSA is determined by when the expense is incurred not when you pay the expense. This is consistent with the ExxonMobil Medical Plan and ExxonMobil Dental Plan.
The following are covered expenses:
Services provided by:
- Advanced clinical practitioners (an advanced practical registered nurse or a nurse practitioner with a master's degree).
- Certified social workers.
- Christian Scientist practitioners.
- Doctors of medicine.
- Guides for a blind person.
- Optometrists or opticians.
- Physical and occupational therapists.
- Speech language therapists.
Medical and dental treatment or services:
- Ambulance services.
- Artificial insemination.
- Artificial limbs.
- Artificial teeth.
- Braille books and magazines.
- Chemical dependency treatment centers.
- Diathermy (electromagnetic heat therapy).
- Drug addiction treatment.
- Fees for special homes for the mentally challenged.
- Fertility enhancement.
- Healing services.
- Medical care in a nursing home. Note: Custodial care is not reimbursable.
- Mental health services.
- Nursing care for medical services only. Note: This excludes the care of a healthy person. It includes medical care for an elderly person unable to move about or a person subject to dizziness or seizures. It also includes board and wages for a nurse, including Social Security taxes you pay on the wages.
- Orthodontic appliances and services (see Availability of funds, Orthodontia).
- Oxygen and oxygen equipment.
- Physical, occupational or speech therapy.
- Radial keratotomy, laser or similar surgery to correct vision.
- Routine eye examinations.
- Temporomandibular joint (TMJ/TMD) disorder.
- Weight loss programs, when accompanied by a physician's statement documenting the medical necessity for the treatment of a specific disease and not for general health.
Equipment and supplies:
- Canes or other walking supports.
- Diabetic supplies including those purchased over the counter.
- Eyeglasses and contact lenses and supplies.
- Hearing aids, hearing aid batteries and equipment for the hearing impaired, such as closed captioned devices and special telephone equipment.
- Medications available by prescription only and prescribed by a physician, including birth control pills and devices, allergy medications, vitamins and mineral supplements if prescribed for a particular medical condition which cannot be available as an over-the-counter medication.
- Prescription orthopedic footwear, including arch supports and inlays.
- Guide dogs.
- Special hand controls and other equipment installed in a car in order for a disabled person to operate a car.
- Special equipment, furniture or fixtures in your home, including installation, primarily to provide medical care for you or an eligible family member living in your home. If the improvement increases the value of your home, only the portion of the cost in excess of the increased value may be reimbursed.
- Wheelchairs, wheelchair lifts and their installation.
- Wigs and false eyelashes when natural hair is lost as the result of a disease.
Special schools and lessons:
- Cardiac rehabilitation classes.
- Charges by special schools to teach Braille to a blind child, signing/lip reading to a deaf or hearing impaired child, remedial language training to correct conditions caused by birth defects, remedial reading for children suffering from dyslexia, and speech therapy.
- Job placement classes for handicapped family members.
- Smoking cessation programs and prescription drugs to alleviate nicotine withdrawal symptoms.
- Tuition and fees for special schools, if recommended by your doctor, for a child with severe learning disabilities.
- Transportation expenses to and from a school recommended by a doctor as a medical treatment.
- Transportation, including air fare, when medically necessary for a spouse to accompany a spouse or one parent to accompany a child requiring surgery or medical treatment.
- Travel expenses incurred en route to medical treatment sites, including transportation (either the actual cost or, if unsubstantiated, up to IRS limits).
- COBRA costs for children under any plan to which ExxonMobil contributes.
- Capital improvements to your home to help the delivery of medical care. If the improvements increase the value of your home, only the portion of cost in excess of the increased value may be reimbursed.
- Charges exceeding annual or lifetime maximums paid by a health care plan.
- Fees paid to health institutes for physician prescribed exercises, rubdowns and similar treatments designed to alleviate a physical or mental defect or illness.
- Halfway house residency.
- Lead based paint removal.
- Legal fees necessary to treat mental illness.
- Meals and lodging provided with medical care at a hospital or similar institution.
- Non-professional administration of patterning exercises.
Medical care items other than over the counter drugs and medications:
- Braces and supports.
- Diabetic supplies and equipment.
- Ear care products.
- Eye care products.
- Eye drops and eye wash products.
- First aid supplies.
- Home diagnostic tests or kits.
- Hot and cold packs.
- Incontinence products.
- Joint-support bandages and hosiery.
- Vaporizers and humidifiers.
- Be sure to budget carefully, up to $500 of carryover is allowed for the Healthcare Flexible Spending Account, however, any other unused amounts must be forfeited.
Expenses not eligible for reimbursement
The following expenses are not eligible for reimbursement under the HCFSA:
- Antiseptic diaper services.
- Baby-sitting fees enabling you to get medical care.
- Cosmetic surgery.
- Custodial care.
- Ear piercing.
- Household help.
Lessons or meetings:
- Childbirth classes.
- Dancing or swimming lessons, even if recommended by a doctor.
- Recreational exercise programs or health club dues.
- Meetings of Alcoholics Anonymous and similar groups.
- Tuition allowing problem children to attend a particular school for a beneficial change of environment.
- Wellness programs for general health or nutrition courses.
- Depreciation of a car as part of transportation expenses.
- Transporting a disabled person to and from work.
- Transporting people to care for a healthy child to enable parents to be with a hospitalized child or a spouse to be with a spouse.
- Trips for a change of environment to boost the morale of an ailing person.
- Trips or vacations taken for a change of environment or general improvement in health, even if advised by a physician.
Equipment and supplies:
- Air conditioners.
- Bottled water.
- Elastic hosiery.
- Electricity or special power sources to operate equipment.
- Exercise equipment, unless prescribed by a physician for a specific medical condition.
- Hot tubs or whirlpool baths.
- Maternity clothes.
- Natural foods such as herbal tinctures and wheat grass, even when prescribed by a naturopath.
- Non-allergic foods for individuals with allergies.
- Occupational therapy supplies.
- Orthopedic pillows.
- Over-the-counter drugs or medications, both oral and topical, whether or not they are prescribed by a physician.
- Toothpaste and other non-prescription hygienic supplies.
- Auto insurance premiums, even if some portion would pay for medical coverage.
- Concierge fees
- Boarding school fees paid for healthy children while a parent is recuperating from an illness.
- Deductions from your pay for short-term disability insurance under state laws.
- Divorce costs, even if recommended by a psychiatrist.
- Marriage or family counseling.
- Medicare Part A premiums.
- Medical expenses for the natural mother of a child you adopt.
- Scientology fees.
- Telephone calls to a doctor, hospital or pharmacy.
- Contributions or premiums to health plans except those listed under Eligible expenses.
- Earnings lost as a result of an automobile accident.
- Expenses and premiums for long-term care.
- Expenses reimbursed by any insurance plan or policy or by any individual, plan or company.
- Illegal operations or drugs.
- Medical bills for a former spouse.
Tax-deductible vs. tax-free
If you itemize on your federal tax return, you have a choice about the tax treatment of your health care expenses:
- If you itemize your deductions the federal government offers a federal income tax deduction for unreimbursed eligible health care expenses that exceed a stated percentage of your adjusted gross income. Tax laws determine what this percentage will be. See the IRS web site for more details (www.irs.gov).
- The HCFSA offers tax-free reimbursement from the first dollar of your eligible expenses (maximum $2,500) even if you don't itemize.
Many people find the HCFSA offers a greater advantage. However, because tax laws are complicated and change from time to time, you should consult your personal tax advisor to find out which approach is best for you. You cannot claim a tax deduction on expenses reimbursed to you from the spending account.