By setting aside pre-tax money from your pay into the Health Care Reimbursement Account, you may later repay yourself for eligible expenses incurred in 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.

Please note: Insurance premiums are not eligible expenses under a reimbursement account plan.

Maximum Contribution

The maximum contribution you can make to your Health Care Reimbursement Account annually is $3,200. 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 here, is not included in this limit. This $3,200 annual limit is a per person limit. If both you and your spouse are Duke employees, each of you may contribute up to $3,200 to a health care reimbursement account annually.

Mobile App For Reimbursement Accounts

A mobile app called HealthEquity EZ Receipts is available in the Apple and Google Play app stores. The app allows smartphone users to take pictures of receipts and upload them to assist with verification of purchases or submission of health care and dependent care reimbursement claims.

Health Care Reimbursement Account Form

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Who's Covered?

You can use your Health Care Reimbursement Account to pay for health care 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, go to and contact your personal tax advisor.

Please note: If your spouse is enrolled in a Health Savings Account (HSA), you are not eligible to participate in a Health Care Reimbursement Account.

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 Health Care Reimbursement Account. This means you may submit eligible expenses for reimbursement for these individuals. If your spouse is enrolled in a Health Savings Account (HSA), you are not eligible to participate in a Health Care Reimbursement Account.

Health Care Card

The Health Care Card, administered through HealthEquity®, pays for many eligible health care expenses at the point of sale using funds from an employee's health care reimbursement account. That means less hassle and less paperwork. Please note: You can only use the Health Care Card in the plan year of the incurred expense.

Duke Basic HMO

Duke will make a contribution to Duke Basic plan participants' Health Care Reimbursement Accounts based on the level of coverage selected:

  • $200 for Individual
  • $300 for Employee/Child
  • $400 for Employee/Children
  • $400 for Employee/Spouse or Employee/Same-Sex Partner
  • $500 for Family (includes Spouse)

It can take up to 60 days for the Duke Basic contribution to be posted to your Health Care Reimbursement Account.

Please Note: Additional contributions will not be made if dependents are added during the plan year. Also, if your spouse is enrolled in a Health Savings Account (HSA), please contact the HRIC at (919) 684-5600 before enrolling in Duke Basic.

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 HealthEquity at (877) 924-3967 or visit the Orthodontia page for more information.)

Use the worksheet below or the HealthEquity calculator at to help you decide how much to contribute up to the annual limit.

Estimated Expenses for 2023 
Health and dental care deductibles$
Co-pays or co-insurance amounts for doctor visits$
Prescription drug co-pays and deductibles$
Over-the-counter medications$
Feminine hygiene and menstrual care products$
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, 2023. Note: You can carry over up to $610 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.

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 $610 left in your account from the 2023 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 $610 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 health care reimbursement account. Eligible expenses incurred for your adult child up to their 26th birthday will be reimbursable under your health care reimbursement account. 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.