Duke faculty and staff can protect up to $2,650 of their salary from taxes by signing up for a Health Care Reimbursement Account during open enrollment. This account allows you to set aside money to pay for eligible health expenses such as co-pays, deductibles, and medical supplies. You will be provided with a WageWorks health care card you can use to draw money from the account at the point of sale.
Money set aside in a Health Care Reimbursement Account is not subject to federal or state taxes. That means a reimbursement account may save you an average of $30 on every $100 you spend on eligible expenses. The maximum allowable contribution for a Health Care Reimbursement Account is $2,650 (subject to IRS regulations).
Up to $500 of your unused Health Care Reimbursement Account balance can be carried over to the next plan year. Any amount above $500 remaining in your account after December 31, 2019 will be forfeited unless Pay Me Back claims are submitted by April 15, 2020 for eligible expenses incurred January 1–December 31, 2019. The health care card cannot be used in 2019 for 2018 expenses. The carryover only applies to the Health Care Reimbursement Account.
Can a Health Care Reimbursement Account Save Me Money?
If your answer to any of the following questions is “yes,” then you should consider participating in a Health Care Reimbursement Account.
- Do you expect to have medical, 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 expect to have prescription drug expenses not covered by insurance, such as deductibles or co-pays?
- Do you plan to buy new eyeglasses or contacts, have your hearing tested, or expect orthodontia expenses that are not covered by insurance? (If you have questions about reimbursement account orthodontia expense guidelines, please call WageWorks at (877) 924-3967 or visit the Orthodontia page for more information.)
Use the worksheet below or the WageWorks calculator at wageworks.com/myfsa to help you decide how much to contribute up to the $2,650 annual limit.
|Estimated Expenses for 2019|
|Health and dental care deductibles||$|
|Co-pays or co-insurance amounts for doctor visits||$|
|Prescription drug co-pays and deductibles (OTC medications are not eligible for reimbursement unless prescribed by a physician.)||$|
|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||$|
|Items not paid or only partially paid by your health, dental, and vision care plans:||$|
|• Hearing exams, hearing aids||$|
|• Expenses above your health care plan or dental plan limits (health care and dental expenses above usual, customary, and reasonable -UCR- limits)||$|
|• Other health care costs allowed by the IRS that aren't reimbursed by your health care, dental, or vision plans||$|
|Total Estimated Expenses for January 1 - December 31, 2019. Note: You can carry over up to $500 of unused funds into the next plan year for the Health Care Reimbursement Account only.
Please note: Insurance premiums are not eligible expenses under a reimbursement account plan.
How Much Can I Contribute?
The maximum contribution you can make to your Health Care Reimbursement Account in 2019 is $2,650 (subject to IRS regulations). The minimum contribution is $130. Your contributions will be deducted pre-tax from your pay. However, if you enroll in the Duke Basic medical plan, the contribution made by Duke, which is described on page 6, is not included in this limit.
Up to $500 of your unused Health Care Reimbursement Account balance can be carried over to the next plan year. Any amount above $500 remaining in your account after December 31, 2019 will be forfeited unless claims are submitted by April 15, 2020 for eligible expenses incurred January 1–December 31, 2019. The carryover only applies to the Health Care Reimbursement Account.
Whose Health Care Expenses Can I Pay For?
Any dependent you claim on your federal income tax return is a dependent under the Health Care Reimbursement Account. Expenses for unmarried partners are not eligible for reimbursement, according to federal tax law unless he/she meets federal dependent eligibility criteria.
What Can I Pay for With a Health Care Reimbursement Account?
In the box below are some examples of out-of-pocket expenses eligible or not eligible for reimbursement from the Health Care Reimbursement Account. To review a full list, contact WageWorks at (877) 924-3967, or visit wageworks.com, or refer to Internal Revenue Service (IRS) Publication 502, available by calling (800) TAX-FORM or by accessing the IRS website at irs.gov.
Expenses Eligible for Reimbursement
- Alcoholism treatment
- Ambulance fees
- Car controls for the disabled
- Chiropractor fees
- Contact lenses and cleaning solutions
- Co-pays, deductibles, and co-insurance not covered by insurance
- Guide dogs
- Hearing aids
- Lab fees
- Lamaze classes for expectant mothers
- Orthodontia expenses
- Prescription medications
- Smoking cessation program fees and prescription drugs
- Varicose vein treatment
Expenses NOT Eligible for Reimbursement (per IRS)
- Babysitting & child care
- Calcium supplements
- Cancelled appointment fees
- COBRA premiums
- Cosmetic surgery procedures
- Exercise equipment (unless physician certified as part of treatment program)
- Fitness programs
- Hair transplant
- Herbs & herbal medicines
- Insurance premiums
- Over the counter medications* (unless prescribed by physician)
- Personal trainer
- Student health premiums
- Tattoo removal
- Teeth whitening/bleaching
- Vitamins (unless prescribed by physician)
- Weight loss programs and/or drugs (unless prescribed by physician)
*Reimbursement for over-the-counter medications is not allowed unless the medications are prescribed by a physician. Reimbursement requests for prescribed over-the-counter medications must be processed using a paper or online claim form, accompanied by the physician prescription and a copy of the receipt.
When calling WageWorks, you will be prompted to provide the last four digits of your social security number or employee ID. You must provide the last four digits of your Duke Unique ID number instead. Your Duke Unique ID is located on the back of your ID badge.