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FAQs
Flexible Spending Accounts > HCFSA


What is HCFSA?
When can I enroll?
How much can I put aside in my spending account?
Who can be covered under HCFSA?
What types of health care expenses are covered?
What kind of over-the-counter drugs are eligible under HCFSA?
How do I submit claims for over-the-counter drugs?
How can I benefit by joining this program?
How does this program work?
Will I receive a statement of my account?
What is the deadline for submitting claims?
What happens if I do not submit claims for the amount I contribute?
How can I get further information about this program?

 

What is HCFSA?
The Health Care Flexible Spending Account (HCFSA) Program is a way to pay for eligible medical expenses (not covered by insurance) or dental, vision and hearing (not covered by the Welfare Fund) with before-tax dollars.

Download FSA Program Forms and Brochures

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What is the definition of medical care under the HCFSA Program?
Medical care means expenses to diagnose, cure, mitigate, treat or prevent disease, or to affect any structure or function of the body.

When can I enroll?
Generally, employees can enroll during the annual Open Enrollment Period from the end of September through the end of November prior to the Plan Year.  The Plan Year runs from January 1st through December 31st.  Employees also can enroll mid-year only if a Qualifying Event occurs.

Learn more about Qualifying Events 

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How much can I put aside in my HCFSA account?
The minimum contribution is $260; the maximum is $2,500.

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Who can be covered under HCFSA?
Coverage is extended to yourself, your spouse, and your eligible dependents.

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What types of health care expenses are covered?
This program pays for deductibles, co-insurance, and eligible out-of-pocket expenses. It covers medical, dental, vision and hearing expenses. You can thus be reimbursed for expenses such as (but not limited to):

  • Braces
  • Over-the-counter drugs prescribed by your doctor 
  • Physicals
  • Prescription drugs
  • Prescription frames/contact lenses
  • Psychologist's fees

Download FSA Program Forms and Brochures

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What kind of over-the-counter (OTC) drugs are eligible under HCFSA?
You may submit claims for any drugs that diagnose, cure, treat, prevent, or mitigate ailments. However, you must obtain a prescription from your doctor for these OTC drugs (other than insulin).  Sundries, toiletries, and cosmetic items are not eligible. For example, aspirin and cold medicine with a prescription are eligible, but toothpaste and shampoo are not eligible, even with a prescription.  Vitamins/supplements are not eligible, even if recommended by a physician.  However, certain vitamins/supplements are eligible if prescribed by a physician.

Download FSA Program Forms and Brochures

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How do I submit claims for OTC drugs prescribed by a doctor?
You must submit a claims form, along with a copy of the prescription, and an itemized receipt.  The itemized receipt must include the name of the drug, the date the drug was purchased, and the amount paid for the drug.  If you do not have an itemized receipt, you must submit a copy of the product box.

Download FSA Program Forms and Brochures

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How can I benefit by joining this program?
By contributing to HCFSA, you not only plan for anticipated expenses but also reduce your gross income for federal and Social Security tax purposes. The end result is that your health care expenses are lower and you save on your taxes.

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How does this program work?
First, you estimate your pre-tax contribution to your account for the Plan Year. Second, you fund your account through automatic payroll deductions. Finally, you submit a claim for your eligible expenses and a reimbursement check is sent to your home address from your HCFSA account or the reimbursement is automatically deposited into a bank account you have chosen.

Download FSA Program Forms and Brochures

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Will I receive a statement of my account?
Each participant will receive a personal account statement every quarter.

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What is the deadline for submitting claims?
The last day to submit claims is December 31st. However, for HCFSA only, there is a Grace Period offered following the end of a Plan Year. During the Grace Period, you may submit claims for eligible health care expenses incurred from January 1st through March 15th following the end of the Plan Year using the remaining balance in your previous Plan Year account, if any.

In the event that you are unable to submit HCFSA claims by the end of the Plan Year or accompanying Grace Period, a Claims Run-Out Period is provided following the close of the Grace Period, during which you may submit claims for services performed during the previous Plan Year or accompanying Grace Period.  The Claims Run-Out period ends on May 31st following the end of the Plan Year.

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What happens if I do not submit claims for the amount I contribute?
According to IRS rules, amounts not used by the end of the Plan Year or Grace Period will be forfeited.

Learn more about the forfeiture rules

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Can I submit any medical claims incurred prior to eligibility to receive City of New York health benefits?

No, if you are not eligible to receive City of New York health benefits as of the date of hire, claims must be submitted for services rendered on or after the effective date of City of New York health benefits.

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How can I get further information about this program?

Contact the FSA Administrative Office at (212) 306-7760.

Download the FSA Program Forms and Brochures 

Learn more about HCFSA

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