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FAQ: Can I have an FSA and HSA at the same time?

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Can I have an FSA and HSA at the same time?

For Health Savings Account (HSA) owners, a common question is, “Can I have an FSA and HSA at the same time?”

Generally speaking, you cannot have a health Flexible Spending Account (FSA) and HSA at the same time. However, there are a couple of exceptions: limited purpose FSAs and dependent care FSAs.

How you can have an FSA and HSA at the same time:

Limited Purpose FSA

The first exception is with a limited purpose FSA (LPFSA). An LPFSA covers only eligible expenses related to dental and vision, and is only available to people who are enrolled in an HSA. Sometimes this type of FSA is referred to as an “HSA Compatible FSA.”

Like a health FSA, the maximum annual contribution amount is the same for an LPFSA (learn more about 2018 FSA contribution limits). LPFSAs also have use-it-or-lose it or the $500 maximum rollover, depending on the employer’s plan.

LPFSA Eligible Expenses

Dental:

  • Dental plan deductibles, co-pays, and co-insurance
  • Cleanings
  • Exams and diagnostic services
  • Bridges, crowns, dentures, and fillings
  • Orthodontia
  • Reconstructions and implants
  • Root canals
  • X-rays

Vision:

  • Vision plan deductibles and co-insurance
  • Eye exams and diagnostic services
  • Eye surgery, including LASIK and laser eye surgery
  • Contact lenses and solution
  • Eyeglasses (prescription and over-the-counter)
  • Eyeglass repair kits
  • Orthokeratology
  • Sunglasses (prescription only)
  • Service animals (e.g., guide dogs), including purchase, training, and maintenance

Contact your benefits administrator or consult IRS publication 502 for a full list of eligible medical and dental expenses.

Filing a claim

If you have an HSA and LPFSA, you cannot make a claim through both accounts for the same expense (also known as double-dipping). If you receive reimbursement from your HSA, you cannot file a claim for reimbursement through your LPFSA (and vice versa).

Dependent Care FSA

The other exception is a dependent care FSA, also known as a DCAP. A DCAP can be used for pay for the cost of care for dependents under age 13 and for those who cannot care for themselves during the day while you’re working or attending school (such as an elderly parent or child with disabilities).

Any eligible employee can have a DCAP account, regardless of whether they have an HSA or healthcare FSA, as long as their employer sponsors the account. The maximum annual contribution limit for a DCAP is $5,000.

Dependent Care FSA Eligible Expenses

  • Daycare, preschool, and pre-kindergarten (including deposits for daycare)
  • Before and after school care
  • Day camps (overnight camps do not qualify)
  • Adult care
  • Elderly care
  • Sick child care

Consult with your benefits administrator for a full list of DCAP eligible expenses.

Filing a claim

Talk to your claim administrator about claims filing and reimbursement. Some TPAs offer a recurring expense form for daycare and other recurring expenses.

Can you have an FSA and HSA at the same time? The answer is yes, with certain exceptions.

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