Flexible Spending Account (FSA): Uses, Benefits, and Amounts

What Is a Flexible Spending Account (FSA)?

A flexible spending account (FSA) is a type of savings account that provides the account holder with specific tax advantages. An FSA is sometimes called a “flexible spending arrangement” and can be established by an employer for employees. The account allows you to contribute a portion of your regular earnings; employers also can contribute to employees’ accounts. Distributions from the account must be used to reimburse the employee for qualified expenses related to medical and dental services.

Another type of FSA is a dependent-care flexible spending account, which is used to pay for childcare expenses for children age 12 and under and can also be used to pay for the care of qualifying adults, including a spouse, who cannot care for themselves and meet specific Internal Revenue Service (IRS) guidelines. A dependent-care FSA has different maximum contribution rules than a medical-related flexible spending account.

Key Takeaways

  • An FSA is a type of savings account that allows employees to contribute a portion of their regular earnings to pay for health-related costs.
  • Funds contributed to the account are deducted from earnings and are not subject to income and payroll taxes.
  • Funds withdrawn from an FSA to pay qualified medical expenses are not subject to tax.
  • The money in an FSA must be used by the end of the plan year, but employers can offer a grace period of up to two-and-a-half months, through March 15 of the following year.
  • Due to the pandemic, the IRS will allow employers to amend FSA plans for 2021, either to raise the carryover amounts or extend the grace period.

How a Flexible Spending Account (FSA) Works

One of the key benefits of a flexible spending account is that the funds contributed to the account are deducted from your earnings before taxes, lowering your taxable income. As a result, regular contributions to an FSA can reduce your annual tax liability.

The IRS limits how much can be contributed to an FSA account per year. For medical expense FSA accounts, the annual contribution limit per employee is $2,750 for 2021 and $2,850 for 2022.

If you are married, your spouse can also put aside up to the annual contribution limit through their employer. Employers can choose to contribute to an FSA, but they do not have to—if they do, their contribution does not reduce the amount that you are permitted to contribute. You are not taxed on employer contributions.

For 2021, the contribution limit for a dependent-care FSA is $10,500 for joint and individual tax returns and $5,250 for married taxpayers filing separately—an increase given through the American Rescue Plan of 2021. For 2022, the contribution limit returns to $5,000 for joint and individual tax returns and $2,500 for married taxpayers filing separately.

The IRS released new guidance that allows employers more flexibility for benefit plans during the COVID-19 crisis, including special provisions for health Flexible Spending Arrangements (FSAs). If an employer elects to allow this (these provisions are entirely at the discretion of the employer), employees may revoke an existing election, make a new election, or decrease or increase an existing election. In addition, employers can elect to allow employees to apply unused amounts remaining in a health FSA at the end of a grace period or plan year ending in 2020 to pay or reimburse medical care expenses incurred through Dec. 31, 2020. If you're not sure about your options, check with your HR or benefits person.

Advantages and Disadvantages of Flexible Spending Accounts (FSAs)

The funds from an FSA can be used to reimburse payments for medical care, which is defined to include amounts paid for the diagnoses, cure, mitigation, treatment, or prevention of disease or ailments affecting any structure of the body. However, expenses for surgery for cosmetic purposes and for items or services that are just beneficial for general health, such as gym memberships, are not reimbursable. Qualified medical expenses for FSA owners, their spouses, and dependents are covered.

Medical equipment purchases, such as diagnostic devices, bandages, and crutches, are covered by FSAs. Expenditures for prescription medications, including over-the-counter (OTC) drugs for which you had a prescription, as well as insulin can be reimbursed with FSA funds. The Coronavirus Aid, Relief, and Economic Security (CARES) Act enacted in 2020 expanded reimbursable qualified medical expenses for 2020 and later years to include the cost of over-the-counter drugs without a doctor’s prescription. The act also permitted the use of FSA funds to reimburse the costs of menstrual care products. Both of these CARES provisions are permanent.

Funds in an FSA may also be used to reimburse amounts paid in accordance with insurance plan deductibles and co-payments for medical services. Unfortunately, the money may not be used to pay for insurance premiums.

The IRS issued a statement notifying taxpayers that at-home COVID-19 tests and personal protective equipment such as face masks and hand-sanitizer are both considered eligible medical expenses that can be paid or reimbursed under health flexible spending arrangements (FSAs), health savings accounts (HSAs), and health reimbursement arrangements (HRAs).

Special Considerations

The money set aside in an FSA generally must be used by the end of the plan year. However, a plan can offer a grace period of up to two-and-a-half months to finish using that funding.

If that option is not taken, a plan may allow you to roll over up to $550 per year of unused funds from your account. Neither option is required, but only one may be offered by the plan.

When the year ends or the grace period expires, any funds that remain in your FSA are lost. Thus, you should carefully calibrate the amount of money you plan to put into your account and how you intend to spend it over the course of the year.

The Internal Revenue Service has announced that because of the impact of COVID-19, it will permit but not require employers to amend health plans so that employees can change elections that usually are allowed only once a year. Also, the IRS will allow employers discretion to amend FSA plans for 2020 and 2021 either to allow employees to carry over more than the current $550 maximum or to extend the grace period for using unspent FSA funds through Dec. 31 of each year.

A different type of FSA—a "limited purpose flexible spending arrangement" (LPFSA)—refers to a savings plan that can be used with a health savings account (HSA). Unlike a standard FSA, employees may use an LPFSA in conjunction with an HSA. Contributions are made using pre-tax earnings. A limited-purpose FSA is more restrictive because the arrangement is reserved for paying dental and vision expenses and sometimes other costs incurred in a high-deductible health plan (HDHP) after the plan holder meets the deductible.

Flexible Spending Account FAQs

How Much Should I Contribute to My FSA?

No specific amount is correct for everyone, and FSA elections vary depending on the particular situation of an individual. Make your election by carefully examining your expected out-of-pocket healthcare expenses for the upcoming year.

What If My Spouse is Enrolled In a Different Health Insurance Plan?

You can use funds from your healthcare FSA to pay for eligible medical costs for both your spouse and tax dependents, regardless of the medical insurance in which they are enrolled. To use funds for your dependents, they must be claimed on your tax return, and dependents cannot file their own return.

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