Healthcare FAQs

  1. What is an "eligible expense" under the health care FSA?
  2. May I use my FSA health care account to cover my children even though they are not covered under my medical plan?
  3. My spouse has a Health Savings Account (HSA). Am I eligible to enroll in a health care FSA plan?
  4. Are domestic partners eligible?
  5. Is mileage in conjunction with a medical visit or appointment a covered FSA expense?
  6. I had an FSA account with my prior employer and I noticed that your list of covered expenses doesn’t include (X item). Why is that?

1. What is an "eligible expense" under the health care FSA?
Eligible expenses for a health care FSA are defined in section 213(d) of the IRS code. Examples of common out-of-pocket expenses covered by a health care FSA include: out of pocket costs for eye exams, LASIK surgery, eyeglasses, contact lenses, saline solution, chiropractic treatment, orthodontia and dental work. Premiums are not considered eligible medical expenses.

You are encouraged to consult a tax advisor or IRS Publication 502 "Medical and Dental Expenses" for further guidance as to what is or is not an eligible expense. To access Publication 502, visit the IRS website at www.irs.gov/formspubs/index.html.

2. May I use my FSA health care account to cover my children even though they are not covered under my medical plan?
Yes. Your children or other dependents do not have to be covered under your medical plan to be covered under your FSA plan.


3. My spouse has a Health Savings Account (HSA). Am I eligible to enroll in a health care FSA plan?
No. You are not eligible to participate in an FSA program if your spouse has an HSA.*
* Aetna does offer a limited scope FSA plan that pays for only vision and dental expenses. Check with your employer to find out if a limited scope plan is available.


4. Are domestic partners eligible?
Usually, a domestic partner is not eligible to be covered under your health care FSA. However, if you claim your domestic partner as a qualifying dependent for federal income tax purposes and the conditions described below apply, then your domestic partner may be eligible. Your domestic partner must:

  1. Be a citizen, national or resident of the U.S.
  2. Have your household as his or her principal place of residence for your entire tax year.
  3. Live in a relationship with you that does not violate local laws.
  4. Receive over half of their support from you during your tax year.
  5. Meet the Gross Income Test ($3,200 or less for 2005).


5. Is mileage in conjunction with a medical visit or appointment a covered FSA expense?
Yes. Mileage incurred for medical treatments or trips to the pharmacy is a covered FSA expense. For 2005, the rate is 15 cents per mile. Claim filing must be manual, entering the total mileage charge (traveled round trip x .15) as a separate expense on the claim form. The dates of travel must match the corresponding dates of service.


6. I had an FSA account with my prior employer and I noticed that your list of covered expenses doesn’t include (X item). Why is that?
The IRS only provides general guidance with regard to what expenses are covered. It is the responsibility of each employer (plan sponsor) to determine, through review of the IRS guidance, what expenses it deems to be within guidance and, therefore, to be covered under the FSA plan.