A Limited Purpose Flexible Spending Account (LPFSA) is a tax-advantaged account you can use to pay for eligible dental and vision expenses. It also makes a great companion to a Health Savings Account (HSA). Because your HSA stays with you forever, it's nice if you can avoid spending your HSA dollars. That’s where an LPFSA offers incredible flexibility. Use your LPFSA to pay for routine vision and dental expenses, then save your HSA for long-term healthcare expenses.
By setting aside pre-tax money from your pay into the Limited Purpose Flexible Spending Account (LPFSA), you may later repay yourself for eligible expenses incurred in the calendar year that are not covered by insurance. Because your contributions are deducted from your pay before federal income, state income, and Social Security taxes have been withheld, you save on taxes.
Benefits of enrolling in the LPFSA:
- You have access to your annual contribution amount on day one.
- Fast, convenient payments and reimbursements.
- Pay for your spouse and dependents' eligible dental and vision expenses.
- Carryover part of your unspent funds into the next plan year.
- Plan ahead because funds that don’t carry over will expire.
There are thousands of eligible expenses. Here are just a few:
- Eyeglasses/contacts
- Orthodontia
- Eye drops
- Eye exams
- Lasik surgery
- Prescription sunglasses
- Dental and vision operations
You can access a full list of eligible expenses using this link: healthequity.com/lpfsa-qme
How Much Can I Contribute?
The maximum contribution you can make to your Limited Purpose Reimbursement Account for 2026 is $3,300 (subject to IRS regulations). The minimum contribution is $130. Your contributions will be deducted pre-tax from your pay. This $3,300 annual limit is a per person limit. If both you and your spouse are Duke employees, each of you may contribute up to $3,300 to a LPFSA annually. Up to $660 of your unused Limited Purpose Flexible Spending Account can be carried over to the 2027 plan year. You may only select the Limited Purpose Flexible Spending Account if you are enrolled in the Duke Advantage medical plan with the Duke HSA.
Who's Covered?
You can use your LPFSA to pay for dental and vision expenses incurred by the following people (per the IRS rules effective 01/01/05) even if they are not covered by your employer's health plan:
- Yourself
- Your spouse (but not your same-sex partner, according to federal law)
- Your qualifying child* (including children up to age 26, whether married or unmarried)
- Your qualifying relative*
*Special rules allow a dependent to be eligible for this plan even when that dependent does not qualify to be claimed as your tax dependent on your tax return form. For more information, visit the WageWorks website and contact your personal tax advisor.
Qualified Dependents
Any dependent you claim on your federal income tax return - your spouse, your legally married same-sex partner, your unmarried children, and even a dependent parent - is a dependent under the LPFSA. This means you may submit eligible expenses for reimbursement for these individuals.
LPFSA Account Access
There are several options for accessing your account:
- Via your Duke@Work single sign-on link
- Log in at participant.wageworks.com. You will need to register on your first visit.
- From the EZ Receipts mobile app, which can be downloaded from the Google Play Store for Android and the App Store for iOS.
Health Care Card
The Health Care Card, administered through HealthEquity®, pays for many eligible LPFSA care expenses at the point of sale using funds from an employee's LPFSA account. That means less hassle and less paperwork. Please note: You can only use the LPFSA Card in the plan year of the incurred expense.
Can an LPFSA Save Me Money?
If your answer to any of the following questions is “yes,” then you should consider participating in a LPFSA.
- Do you expect to have dental or vision expenses that are not covered by your insurance plans, such as deductibles, co-pays, co-insurance, or amounts in excess of usual and customary (U&C) limits?
- Do you plan to buy new eyeglasses or contacts or expect orthodontia expenses that are not covered by insurance? (If you have questions about reimbursement account orthodontia expense guidelines, please call HealthEquity at (877) 924-3967 or visit the Orthodontia page for more information.)
- Do you plan to maximize your HSA contributions in order to have long-term savings?
Use the worksheet below or the HealthEquity calculator at wageworks.com/myfsa to help you decide how much to contribute up to the annual limit.
| Estimated Expenses for 2026 | |
|---|---|
| Vision and dental care deductibles. | $____ |
| Co-pays or co-insurance amounts for dental and eye doctor visits. | $____ |
| Dental costs in excess of the plan's reimbursement amount/schedule. | $____ |
| Orthodontia costs not reimbursed by a dental plan. | $____ |
| Vision care expenses such as eye exams, eyeglasses, contact lenses and supplies (e.g., lens solution), and laser eye surgery not covered by insurance. | $____ |
| Items not paid or only partially paid by your dental and vision care plans. | $____ |
| Expenses above your vision plan or dental plan limits (vision care and dental expenses above usual, customary, and reasonable - UCR - limits). | $____ |
| Other vision and dental care costs allowed by the IRS that aren't reimbursed by your dental, or vision plans. | $____ |
| Total Estimated Expenses for January 1 - December 31, 2026. Note: You can carry over up to $660 of unused funds into the next plan year for the LPFSA. | $____ |
Please note: Insurance premiums are not eligible expenses under a reimbursement account plan.
Please remember:
Estimate your expenses carefully when deciding how much you want to contribute for the plan year (Jan 1 - Dec. 31). You may submit your eligible claims for services received during the plan year (Jan. 1-Dec. 31) until April 15 of the following year. Any remaining balance over $660 left in your account from the 2026 plan year after December 31 will be forfeited according to federal tax law unless you submit claims by April 15. You can carry over up to $660 of an unused balance into the next plan year. You must be an Active employee in a benefits-eligible work status on December 31 in order to be eligible for the carryover provision.
Since January 2011, a new category of “adult child” has been added as an eligible individual under the LPFSA. Eligible expenses incurred for your adult child up to their 26th birthday will be reimbursable under your LPFSA. The adult child does not have to live with you and may be married or unmarried.
Please see Making Changes During the Year for information on mid-year status changes and how they may affect your eligibility to participate in the plans and receive reimbursement for expenses.
You can enroll in the LPFSA during Annual Open Enrollment if you enroll in the new Duke Advantage medical plan with the Duke HSA. The Open Enrollment period for 2026 benefits will run for three weeks, giving employees additional time to review plan options — from Oct. 6 to Oct. 24. Details are available on the Open Enrollment 2026 website. The initial start date for the LPFSA will be January 1, 2026.