Health Care Flexible Spending Account (HCFSA)
Eligible Expenses
Eligible expenses are defined by the IRS and typically cover most treatments or services used in preventing an illness or improving a medical condition. For example, most health care expenses not covered or not paid in full by a health care plan, including deductibles, coinsurance, or out-of-pocket expenses for prescription drugs and out-of-network services, are eligible expenses. To be eligible for reimbursement, the service must be received during the period in which you have contributed to an HCFSA (except for the last $500 remaining in your HCFSA each year, which can be rolled over and used for eligible expenses in the following plan year). If you begin contributing mid-year, for example, after certain eligible change-in-status events, expenses incurred before you began contributing are not eligible for reimbursement. Likewise, if you do not continue contributing during an unpaid leave of absence, expenses for health care services received during the leave are not eligible for reimbursement.
Eligible health care expenses are subject to rules set by the IRS (see IRS Section 213d). Refer to the IRS Publication 502, Medical and Dental Expenses, available from your local IRS office (or the IRS website at www.irs.gov) for more details on eligible health care expenses. Use IRS Publication 502 with caution, as it is meant only to help taxpayers determine what medical expenses can be deducted on their personal income tax returns and not what is reimbursable under a health care FSA. Contact your Claims Administrator if you need further information about which expenses are reimbursable.
For KPIC Members Only
Your eligible dependents are individuals who qualify as dependents under Internal Revenue Code Section 152, as modified by Code Section 105.
If you have an enrolled domestic partner under HAP who does not qualify as a dependent under Internal Revenue Code Section 152, you must turn off the automatic reimbursement process under the Health Care FSA in order to comply with IRS regulations concerning reimbursement for non-eligible dependents. Please call Kaiser Health Payment Services at 877-750-3399 to turn off the automatic reimbursement option.