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Accounts

How am I reimbursed for immunizations?

April 24-30 is World Immunization Week. Do you know how you can get reimbursed for immunizations with your Flex Spending Account?

This is an annual effort by the World Health Organization (WHO) to promote the worldwide use of vaccines and protect millions of people from all walks of life from disease. While this event has worldwide focus that targets at-risk populations, the advocacy week is also designed to remind everyday Americans like us about the importance of staying up-to-date on regular vaccinations.

If you're enrolled in a flexible spending account (FSA), health savings account (HSA) or a health reimbursement arrangement (HRA), your benefits will cover the reimbursement of immunization expenses for you and your dependents, whether it's a seasonal flu shot or important vaccinations for hepatitis, measles/mumps and more.

Don't know where to start? Here's how to submit a claim when you or a loved one receives immunizations.

Complete a claim form

The vast majority of benefits administrators will require account holders to submit a claim form to begin the reimbursement process. This form must be completed in full and submitted during your current plan year for full reimbursement of vaccination expenses. Ask your HR department (if you don't know the benefits administrator) or your employee benefits administrator for more details.

Itemized Documentation

When submitting a claim, it's vital to hold onto any purchase receipts, bills, itemized statements or Explanation of Benefits (EOB). However, these receipts must have some description of the product/service being reimbursed, for instance, if you submit a credit card receipt, this would not be sufficient as it does not sufficiently outline the service being offered. Ensure that any receipts include the vendor/doctor's name, contact information for the individual/company who provides the service, the purchase date, a description of the product/service provided and the total amount of the expense.

Incurred vs. date of payment

Last but not least, when submitting claims for FSA/HSA/HRA eligible expenses like immunizations, it's important to note that IRS regulations stipulate that there is a difference between when an expense is paid versus when an expense is "incurred." In the vast majority of cases, expenses reimbursed through your account are based on the date the expense was incurred, not the date the product/service was paid for. Therefore, in the case of immunizations, the date the expense was incurred is the actual date you or a loved one received the vaccination, not when it was charged.

This spring, make sure your family is caught up on their vaccinations and support their continued wellness by shopping at FSAstore.com! We have the web's largest selection of FSA eligible products to help you maximize the potential of your healthcare benefits!

Accounts

The FSA Rx Question

Many people are often confused by health care reform involving how you get reimbursed for OTC medications with an FSA. Learn about the Rx requirement here!

"Can I still buy Rx products with my FSA? What are the new rules for flexible spending accounts? I'm so confused about the prescription requirement."

If you're finding yourself nodding alone with these questions and statements, you're among others who find it a confusing change. A Flexible Spending Account (FSA)offers a great way to save on over-the-counter expenses, and also onmedications. But, many people are often confused by health care reforminvolving how you getreimbursed for OTC medications. Resulting from that reform, products includingAdvil, Tylenolor even Zyrtec require a prescription, if you want to get reimbursed byyour FSA.

Available products

Thousands of products arecovered byan FSA without needing a prescription, though. However, if you do need to submit a prescription, you can submitaprescription to FSA Store, and we can help you process your FSA claim quickly. If you have questions about which FSA eligible products qualify, it’s best to ask yourFSA administratorto get details about your FSA account.

If you do submit your prescription to us, you shouldn’t need to also submit it to your FSA administrator. However, it's not a bad idea tohold on to receipts and any documentation for purchases or uses you made of your FSA, in the rare event that it is requested by your FSA administrator.

FSA Store can help you process your Rx in easy ways:

All we need from you is:

  • Your Physician’s contact information (name, address, phone number) and we’llreach out to the physician directly.
  • You could also mail your prescription (not a copy, but the original Rx) or have your doctor fax it.

Have any questions related to your Flexible Spending Account? Read more about these accounts in our Learning Center or check out our Eligibility List!

Accounts

How FSAstore.com helps eliminate the hassle of OTC regulations

flexible spending account prescriptionsThe Patient Protection and Affordable Care Act (PPACA) undoubtedly changed the landscape of the American health insurance system. To date, the law has helped more than 9 million Americans receive health insurance with many more expected to enroll in the coming years. While there has been an unprecedented expansion in coverage nationwide, other seemingly subtle changes have made a huge impact in the world of consumer spending accounts.

Employees with Flexible Spending Accounts (FSAs) saw various changes to their benefits, including yearly allocation limits and the OTC medication prescription requirement.

FSA Prescription Requirement

  • The over-the-counter (OTC) medication requirement for FSAs brings the most confusion. In the past, FSA account holders were able to use their tax-free funds to purchase OTC medications, but the new law changed their classification as medical expenses. Under the new regulations:

“…a distribution from an FSA, HRA, HSA or an Archer MSA for a medicine or drug is a tax-free qualified medical expense only if: the medicine or drug requires a prescription, is an over-the-counter medicine or drug and the individual obtains a prescription, or is insulin.” Insulin is the clear exception to the Rx requirement.

How FSA Store Helps

  • As a result, FSA account holders who had no obstacles in the past when purchasing OTC medications now have to consult their doctor for prescriptions. This means they need a prescription before purchasing pain relief medications, digestive aids and other items that are usually found on most pharmacy and grocery store shelves.

Thankfully, if your family relies on an FSA to cover healthcare expenses like OTC medications, navigating the OTC provision is easier than ever at FSAstore.com. With an extensive selection of FSA eligible products and a Prescription Process, you can be quickly reimbursed for everything your family will need to stay happy and healthy all year long!

How has the requirement been received?

  • The OTC medication prescription requirement was envisioned to prevent stockpiling of FSA eligible products as well as the general misuse of funds. After three years of being on the books, the OTC requirement now appears to be a major headache for FSA account holders. A recent study conducted by the Consumer Healthcare Products Association (CHPA) of 2,130 random people found that 75 percent of Americans want the law changed to allow the inclusion of OTC medicines (through FSAs) without prescription requirements.

“45 million Americans have FSA and health-savings accounts,” Scott Melville, president and CEO of the CHPA told USA Today. “The ACA was supposed to make healthcare more affordable, not more expensive.”

What’s the future for the OTC requirement?

  • While healthcare reform has been a major success in terms of reducing the uninsured rate throughout the U.S., the law is still a work in progress. Ultimately, it will come down to pressure from the consumer and business spheres to convince Congress to make changes to the law, but it appears that it could be a fact of life for consumer spending account holders for the foreseeable future. Of course, if anything does change, FSAstore.com will be sure to let you know.