Health Care Flexible Spending Accounts

Key Takeaway

A health flexible spending account allows employees to pay for expenses necessary to treat or alleviate a physical or mental condition or illness with pre-tax dollars. Pre-tax means before state, federal, Social Security, and Medicare taxes are applied.

How It Works

Prior to each plan year, employees elect how much they would like to have taken out of their paycheck on a pre-tax basis. Contributions are deducted from each payroll. The amount contributed should be carefully considered, as unused amounts are generally forfeited at the end of the plan year. Health FSAs may include an optional carryover provision. See your employer for details specific to your plan.

As eligible expenses are incurred, employees submit claims to Alerus for reimbursement. Alerus is required to substantiate each claim by reviewing receipts, explanation of benefits, and/or claim forms to ensure expenses meet applicable regulations. Alerus reimburses employees by check or direct deposit. Your plan may also include a debit card for making purchases directly.

Important Facts

  • New elections are required each plan year.
  • Elections are irrevocable during the plan year unless there is a qualified change in status.
  • IRS Publication 502 (available at explains health care expenses.
  • For current limits, please check the Plan Design Checklist. Log in to your plan online and click on Tools & Support.

Eligible Expenses

A listing of eligible expenses can be viewed here.

Supporting Documentation

Supporting documentation is required with all claims. Documentation should be itemized to show:

  • Date of service
  • Service being claimed
  • The amount you are responsible for paying

If the expense was covered by insurance the Explanation of Benefits from your insurance carrier must be included with your claim.

Dual Purpose Expenses

Some expenses may be considered cosmetic or general use, but they also serve a medical purpose. If a doctor recommends a service/item that would not typically be considered “medically necessary” to treat or alleviate a specific, diagnosable medical condition, it is considered a dual-purpose expense. A written statement from the physician must accompany these expenses. This statement must explain what the medical condition is, what service/item is recommended, and how it will alleviate this condition. A listing of eligible expenses can be viewed here.

Expenses Ordered, Paid For, and/or Picked Up In Different Years

Occasionally an expense may be ordered and/or paid for before it is obtained, such as with eyeglasses. The service date listed on the itemized provider bill will determine which plan year the expense is applicable.

Submitting Claims

You can submit claims online, through the Alerus Benefits mobile app, or by completing a Reimbursement Request Form. Always include documentation to support the expenses you are claiming. Claims cannot be paid until itemized documentation is submitted to and approved by Alerus.