How Does It Work?
During your employer’s open enrollment period, you’ll estimate your out-of-pocket expenses for the upcoming plan year. The amount you elect will be deducted out of each pay check on a pre-tax basis and put into your Limited Health Care FSA. Since the FSA is pre-funded, you will have access to your full election amount and can use those pre-tax dollars in your FSA to pay for your eligible out-of-pocket expenses.
Example: During open enrollment, you choose to set aside $1,200 for the year. If you’re paid once per month you will have $100 deducted from each paycheck to apply towards your Limited Health Care FSA.
You have an expensive medical procedure in the first month of your plan year. At this point, you’ve only contributed $100 from your paycheck towards the FSA but you can still use your full $1,200 right away! Your entire election amount is available to use in advance of any paycheck contributions and your remaining paycheck contributions will pay back the plan.
Limited FSAs are restricted to reimbursing dental, vision and orthodontia expenses. Some plans allow for medical expenses to be reimbursed after the High Deductible Health Plan deductible has been satisfied. See your Plan Documents for more information.
What Does It Cover?
The Limited Health Care FSA covers most dental, vision, and preventive expenses including, but not limited to:
- Lasik Eye Surgery
- Orthodontia Payments
- Tobacco Cessation Programs
For a more extensive list of eligible items, check out our Eligible Expense List
Whose Expenses are Eligilble?
The Limited Health Care FSA covers you, your spouse, and any tax dependents even if they aren’t covered on your employer’s medical insurance. As the employee, you don’t even have to be covered on your group medical insurance to participate in the FSA, you just need to be eligible for benefits through your employer.
How much should I elect?
If you need help estimating your out-of-pocket expenses, check out our eligible expense list to help estimate your out-of-pocket expenses. A good rule is to set aside funds for your predictable eligible expenses so you can be sure to use your entire election amount within the plan year. If you do not use your entire election amount, the remaining funds are subject to the “Use-it or Lose-it” rule.
Use-it or Lose-It
The Limited Health Care FSA is subject to the “Use-It or Lose-It” rule. This means that if you do not use your all of your annual election within the plan year, the remaining funds are returned to your employer and are not refundable to you.
Check your employer’s plan design to see if the Grace Period or Carryover feature has been put in place to help reduce your risk of loss.
The Carryover feature allows participants to roll over up to $550 from one plan year to the next. Any funds above the $550 threshold would be forfeited to your employer. This is an optional feature so check your employer’s plan design to see if the Carryover is included.
The Grace Period gives you an extra 2.5 months at the end of the plan year to incur expenses against your FSA balance. This is an optional feature so check your employer’s plan design to see if the Grace Period is included.
How do I access my Limited Health Care FSA?
There are four ways you can access your FSA:
1.The Navia Benefits Debit MasterCard
The Navia Benefits Card is loaded with your full election amount and can be used to pay for eligible expenses. When the card is used, funds will be pulled directly from your Limited Health Care FSA and are paid to the provider. For more information on the debit card, click here.
2. The Online Claim Submission tool
If you’ve paid out-of-pocket for eligible services and are requesting reimbursement, you can use the Online Claim Submission tool. You just need to fill out your claim information, upload documentation from your computer, and click submit! Login above to gain access to the online claim submission tool.
3. The MyNavia App
You can use the MyNavia App to submit claims right through your phone! Just enter your claim information and upload a photo of your documentation right from your phone’s camera. Learn more about the app!
You must be registered on our website to use the App, click the register button at the top of the page to start the registration process.
4. Email or Mail
What type of documentation do I need to submit?
It is important to send proper documentation to substantiate the claim. The IRS requires that the documentation shows the:
- Date of service (Must fall within the plan year)
- Type of service or item
- Cost or your patient responsibility of the service or item
Itemized bills from providers and Explanation of Benefits (EOB’s) from insurance carriers are perfect forms of documentation. You do not need to show proof of payment unless you are submitting an orthodontia claim. Do not submit copies of cancelled checks, credit or debit card receipts.