Duke faculty and staff can protect up to $3,300 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 copays, deductibles, and medical supplies. You will be provided with a HealthEquity health care card you can use to draw money from the account at the point of sale. The health care card can only be used for eligible expenses incurred during the current plan year.
Money set aside in a Health Care Reimbursement Account is not subject to federal, state or Social Security 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 $3,300 (subject to IRS regulations).
Up to $660 of your unused 2025 Health Care Reimbursement Account balance can be carried over to the 2026 plan year. Any amount above $660 remaining in your account after December 31, 2025 will be forfeited unless Pay Me Back claims are submitted by April 15, 2026 for eligible expenses incurred January 1 - December 31, 2025. The health care card cannot be used in 2025 for 2024 expenses.
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, copays, coinsurance, 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 copays?
- Did you know Personal Protective Equipment (PPE) and over-the-counter medications are considered eligible health care expenses? For a list of eligible/ineligible expenses, please review Eligible & Ineligible Health Care Reimbursement Account Expenses.
- Do you plan to buy new eyeglasses or contacts, have your hearing tested, or expect orthodontia expenses that exceed what is 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.
How Much Can I Contribute?
The maximum contribution you can make to your Health Care Reimbursement Account in 2025 is $3,300 (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 is not included in this limit. If you or your spouse are enrolled in a Health Savings Account (HSA), you are not eligible to participate in a 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.
Estimate Your Health Care Reimbursement Account Expenses
Use the worksheet below or the HealthEquity calculator to help you decide how much to contribute up to the $3,300 annual limit.
| Estimated Expenses for 2025 | |
|---|---|
| Health and dental care deductibles | $ |
| Co-pays or co-insurance amounts for doctor visits | $ |
| Prescription drug copays and deductibles, over-the-counter drugs and medications | $ |
| Dental costs in excess of the plan’s reimbursement amount/schedule | $ |
| Orthodontia costs not reimbursed by a dental plan | $ |
| Vision care expenses, to include eye exams, eyeglasses, contact lenses/supplies, and laser eye surgery | $ |
| Items not paid or only partially paid by your health, dental, and vision plans: | $ |
| • Hearing exams and hearing aids | $ |
| • Expenses above your health plan or dental plan limits (health 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, dental, or vision plans | $ |
| Total Estimated Expenses for January 1 - December 31, 2025. Up to $640 of your unused 2025 Health Care Reimbursement Account balance can be carried over to the 2026 plan year. | $ |
Please note: Insurance premiums are not eligible expenses under a reimbursement account.