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Basics

Flex-Ed: What happens if your FSA claim is denied?

It's embarrassing when your credit card is declined because it feels like everyone—the people in line and the cashier—is looking at you. The good news is that you typically know how to handle it: call the bank, try a different card, or check your balance.

But what happens if your FSA claim is declined? It often feels similar, but the next steps can be confusing. Here's everything you need to know if your FSA card is denied.

Don't panic

Regardless of why your card was denied, there's no need to be embarrassed. It doesn't mean you've done anything wrong and there's a good chance it's not even your fault. There are a lot of reasons your FSA claim might be denied and most have an easy fix. The first step is to figure out whether or not your card has been activated.

Forgetting to activate your card is a common oversite with a simple solution: call your card administrator or explore your company's benefits website to learn how to activate your card.

Double check your funds

Let's be honest: sometimes it's hard to keep track of everything and that includes your FSA card balance. If your FSA claim is denied, it might be because you had insufficient funds in your account or that the price of the item you tried to purchase is higher than your balance. Be sure to check your balance before you use your card again.

Make sure you're using an approved merchant

FSA cards come with a lot of specific rules and one of the primary rules is that you can only use your account to buy FSA-eligible items. Various restrictions are put on the card to ensure that you use the funds correctly, including limitations based on merchant type, limitations based on merchant systems and limitations based on merchant inventory, to name a few.

For the most part, your FSA card should work where it makes sense; at locations such as local pharmacies and drugstores, vision centers, doctor and dental offices, etc. But if you try to use your card at an ice cream parlor or an auto parts store, even if that ice cream parlor happens to sell FSA-eligible band-aids, chances are your card won't work.

If you have questions about whether or not a specific merchant will allow your FSA card, you can contact your FSA administrator to find out.

The easiest way to ensure that your items are eligible is by shopping at a store that exclusively sells FSA-eligible items. It takes the guesswork out of shopping and decreases the chances that your FSA card will be declined.

Confirm with your employer that the item is eligible

Here's the deal: the IRS determines which items are FSA-eligible. However, employers can set their own eligibility rules as long as they are adhering to the IRS guidelines. In other words, it's important to check in with your FSA administrator and confirm that the item you tried to buy is FSA-eligible.

If your FSA card was declined but you decided to buy the item with a different card, then it's still a good idea to try and get reimbursed through your FSA. If you bought the item through FSAStore.com and the item was allowed under your plan guidelines, we guarantee that the item is FSA-eligible, so be sure to save your receipt and submit for reimbursement.

But remember: items with a red checkmark are always FSA-eligible, while products marked with a BLUE "Rx" require a prescription from your doctor in order to be eligible.

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New to FSAs? Need a refresher course in all things flex spending? Our weekly Flex-Ed column gives you a weekly dose of FSA Living 101, offering tips for making the most of your tax-free funds. Look for it every Thursday, exclusively on the FSAstore.com Learning Center.

Accounts

Am I able to use my FSA card to purchase items at Walgreens, CVS or any other type of drugstores?

As long as you're using the card to purchase eligible items then most likely. However not every pharmacy is able to process FSA card transactions, so in some cases you won't be able to find out until you try to make a purchase or unless you check in advance with your FSA administrator. At FSAstore.com, we accept all FSA cards and all major credit/debit cards, so you can rest assured that your purchase of an FSA eligible product will be automatically approved.

Accounts

September FSA Mailbag! Recapping your best Learning Center questions

Each month, we receive hundreds of great questions from our customers about everything relating to FSAs in ourFSA Learning Center. This past August, we received a bunch of fantastic questions relating to FSA product eligibility, deadlines and more, that could help you see your flexible healthcare account in a new way.

If you have a question of your own, feel free to drop by and ask a question and we'll respond ASAP!

"Who is considered a dependent on my FSA?"

An FSA dependent can include the account holder's spouse, a dependent who you claim on your tax return or your adult children up to the age of 26.

"Can I use my FSA card for someone else?"

FSA funds can only be used by the account holder, his/her spouse and qualified dependents that are named on the account. To determine if someone is a qualified dependent, contact your FSA Third Party Administrator, whose information can typically be found on the back of an FSA debit-card or by contacting your HR department.

"Can I use my FSA card to rent mobility equipment, like a scooter?"

Even in the case of equipment rentals as opposed to a full purchase, a scooter rental is a qualified expense. However, this is only the case if your mobility is impaired because of an illness, injury, or other physical condition.

"I would like to order contacts - I have money in my FSA - do I have to pay out of pocket first or can it come out immediately from my account?"

If you visit our Optical Store, you can make a purchase directly with your FSA card. You can also pay with a credit/debit card if you so choose at our store or others, but then you will have to submit a claim for reimbursement with your benefits administrator.

"Does my FSA plan have a "carry over" option?"

Plans can allow one or neither of two options that can provide relief for FSA users. The first is a $500 rollover which allows FSA users to move up to $500 of their current plan year balance into next year's plan year account, sometimes called a "carry over." The other option is a 2.5 month grace period to give account holders more time to spend down their remaining FSA funds. To find out if either of these regulations are in place with your account, contact your benefits administrator whose information can be found on the back of your FSA card.

"Can I use my FSA to pay for exercise programs?"

FSAs can only be used to cover weight loss expenses if the weight gain is tied to a specific medical condition or if weight loss is medically required for a specified condition. Gym memberships, exercise equipment and other products/services that aid in weight loss require a Letter of Medical Necessity (LMN) from a physician that outlines how the product/service will be used to alleviate the condition.

To maximize the potential of your FSA funds with more than 4,000 FSA-eligible products, shop at FSAstore.com! Support your family's wellness year-round and get the most out of your flex dollars!

Basics

What you should know about HR 1270

If you've ever purchased over-the-counter (OTC) medicines with an FSA, you know that in order to buy these items with an FSA card or be reimbursed for a claim, you will need a prescription from a physician for these products. After the Patient Protection and Affordable Care Act (PPACA) (also commonly referred to as Obamacare) went into effect January 1, 2011, new restrictions were put into place regarding the purchase of over-the-counter (OTC) medicines with consumer-directed health accounts like FSAs and HSAs. This OTC Rx provision is a totally new restriction on account holders which requires them to submit a prescription from a physician to purchase OTC medicines with a consumer-directed healthcare account.

But while the provision may have had honorable intent in reducing drug "stockpiling", it has instead passed a heavy burden onto FSA/HSA account holders. As such, Congress has introduced The Restoring Access to Medication Act of 2015, also known as HR 1270, to restore the ability of plan participants to use the funds in their HSA, FSA, HRA or Archer MSA to purchase over-the-counter medications.

Does HR 1270 have a chance of passing?

As a result of the OTC provision, doctors are now saddled with the task of writing otherwise unnecessary prescriptions for medications to fight the common cold, flu or allergies. This has lead to inevitable increased wait times in doctor's offices, greater costs in time money for consumers and strained physician-patient relationships. Patients are forced to reach out to physicians to purchase EVERY over-the-counter product with a medicated ingredient, such as pain relievers, allergy medicines and more.

HR 1270 passed in the House of Representatives on July 6, 2016 and goes to the Senate next. The bill would remove the most difficult restrictions involving the purchase of OTC medications, but it only has a chance of passing with consistent public pressure.

As of January 10, 2017, HR 1270 has been re-introduced to the 115th Congress as HR 394, a nearly identical version of the bill that has bipartisan support and a real chance of passing in the coming year. Be sure to check back at FSAstore.com and on our social media channels for continued updates around the bill's progress and hopefully the future repeal of the OTC Rx provision.