How much to put in a healthcare FSA account?

[egoldber]

We usually don't put any money into this, but since we are expecting next year, we will incur whatever 10% of delivery costs are. For Sarah, I hazily recollect the hospital bill being in the $10K range. Thats not including the anesthesiologist, OB bill, ped bills, etc. DH asked how much to put in, and I said $1000 on the low side and $2000 on the high side.

What do other folks budget for this?

[Puddy73]

I just found out that you can use your FSA account for OTC medications, band-aids, etc. You might want to add a little extra for that. I always put in a little more than I think that we will need. If we have some left in December, I fill a few prescriptions in advance or order contact lenses for DH.


Jennifer
Mommy to Annabelle Mae 9/8/03

"Life is not measured by the number of breaths we take, but by the moments that take our breath away."

[Jen841]

fyi you can do this with most plans, but not all. Check with your plan before you think this is the route to take.

Some plans even allow for parking for Dr visits.

Look at what you expect to spend, then add some. Dr's co-pays, shots,... are all valid expenses. I know we had an annual max for well child care we did not know about. If we had known we would have socked away more than we did.

Remember, when the baby comes, that is a valid life event so you can increase or decease within the window.

[Twin Mom]

I'm assuming your DH's medical plan has some kind of managed care component so when you say $10K for the delivery, are you stating the amount before or after discounts? Discounts would probably apply to the other charges as well. Discounts can be substantial so I wouldn't just go with a straight 10% unless there is no discount on his plan (which would be very unusual these days).

The OTC thing really depends on your DH's employer. Although it is allowed under the law, his employer has to change their plan to allow OTC drugs to be reimbursed since the law recently changed. Some plans limit some of the OTC meds to a certain number per month and others require a doctor's note to get the OTC drugs reimbursed. You should be able to find out from your DH's benefits department what expenses are allowed under the FSA.

I'm the opposite of the PP in that I generally always put a bit less in just in case. It's better to miss out on a bit of tax savings than to lose your money. Seems like the last few years I've been scrambling to find enough expenses to get my money back although if I needed to, I could always buy new glasses or contacts to use it up. I'm actually trying to do the numbers for my 2004 account now so I can figure out if I need to go buy some glasses!

I work part-time in the employee benefits field so I deal with this stuff on my work days and unfortunately sometimes on my off days too :-)

HTH.

[Marisa6826]

Beth-

We calculated $3000. I did a little spreadsheet calculating the anticipated medications, co pays, lab bills, optical needs and family deductible. That's based on four of us, BTW.

If you want to see it, I can email it to you. It's an excel spreadsheet.

-m

[jubilee]

The hard part is: if you put too much in, you lose it. So, I always underestimate a little. My plan "supposedly" allows for OTC medical supplies- but when they refused to pay for vitamins until I submitted the empty bottle (!) I decided it wasn't worth it. I budgeted $250 for the delivery (that is my co-pay), six office visit co-pays for Logan, six office visit co-pays total for the rest of us, $100 for my IUD, $500 for vision expenses, $60 for dental expenses (I knew my DH needed a filling), and $100 for medications- which was $1190, so I had $100/month taken out of the paycheck for the FSA. Hope that helps!

[Momof3Labs]

I'm just looking into the OTC stuff, and vitamins are specifically not allowed. For other things, they are technically allowed but our plan makes it sound like a PITA so I'm trying to use up our money in other ways!

[Momof3Labs]

I'd probably split the difference, depending on your deductibles and co-pays, and go around $1500. You'll have many well baby visits, plus all your OB visits, and probably a few baby cold type visits. Of course, it depends on whether you can use up the money with dental work or eyeglasses/contacts if you have anything left over at the end of the year.

[egoldber]

Hmm. I had forgotten about the "preferred provider discount", so rather than 10K, the cost to the insurance company was probably something like 5K. The way my insurance works, the OB gets paid in one lump sum at the end, that includes delivery and office visits. I don't pay a co-pay at each visit. Just 10% of whatever that final fee ends up being (minus the preferred provider discount, LOL!).

Does anyone know if a doula or an LC's fees can be reimbursed by the account?

But I didn't realize that things like glasses and contacts counted. Hmm.

And I'm just not up for keeping the receipts for OTC meds.

[C99]

This year, we put in about $300, mostly to pay for new glasses, which invariably run over & above what is allowed under our vision plan.

For next year, we budgeted $1500, which assuming that I don't have another premie, should cover the $500 hospital co-pay for me and the $500 hospital co-pay for the baby. It will also cover new glasses, prescriptions (I usually run $30/month in prescripts and the co-pays are going up next year), misc. co-pays, ER visits, etc. So far, I haven't had trouble getting everything out of it because I am a heavy healthcare user (asthma, glasses, dental care + a toddler and newborn).

[mharling]

We decided on about $700 for next year. We won't need to pay any portion of delivery fees, so we are extremely lucky there.

We came up with our number based on the # of well baby visits we will have for 2 kids, a conservative guess of # of sick visits for all us, a conservative guess of # of Rx copays for all of us, an eye exam for me and contacts for me.

Be sure to see how much your copays are. Ours went up for both office visits and prescriptions, so if we had used last year's copay amounts to do our calculations, we would have been way too low.

Like others, I would rather err on the side of being able to use all the money without submitting every possible expense. I remember being at Target one year on December 31 buying loads and loads of contact solution!

Mary
Lane - April 2003
Little sister on the way!!! March 2!

[KrisM]

>Remember, when the baby comes, that is a valid life event so
>you can increase or decease within the window.

I just went through our FSA stuff too. While you can change the amount withheld, if you increase it, the increase only applies to charges incurred after the increase. I was asking specifically if I get pregnant and have a baby next year, could I increase the amount after the baby was born and cover the prenatal visits and delivery. The answer is no. The increase would only cover things that happened after the baby is born...well child visits, etc. I was bummed.

[C99]

Check with your plan administrator. Depending on whether it's an FSA or an HSA, it can depend either on IRS regulations OR what your employer determines is OK or not.

[Marisa6826]

My doula wasn't covered, but I think the LC possibly may be if the Ped writes a script.

Sometimes the catch is that you have to use your insurance company's choice though.

A lot of pharmacies will give you monthly printouts of all your Rx purchases if you reguarly take stuff.

I think that BCPs (as well as alternatives) are covered under the FSA.

-m

[tippy]

Yech...it's that time of the year again. I hate doing my benefit adjustments. This year we actually maxed out on our FSA by October. We are increasing our contribution to 2000.00 this year. DH has terrible eyes and usually has to order new contacts every year for 400.00 a pop. He will also need his prescription on his glasses renewed and is going in for hernia surgery at some point. He uses boat loads of contact solutions and wetting drops for his eyes. I took ds to the dr way more than I expected I ever would and the cost for non preferred medication with our drug plan is steep. You can submit expenses for birth control, any over the counter pain, cough and cold, allergy, or antacid medication. I am attaching a link that has a pretty good listing of what typically is and isn't covered under an FSA. Some of the items I wouldn't have thought of in a million years. The one thing that pisses me off is that you can submit bills for therapy but just not marriage counseling/family therapy... um...why the F#)# not!?!? What rocket scientist in the IRS decided that all therapy but family therapy is worthy of reimbursement? Woops, sorry, I guess that belongs in the bitching post. HTH.

http://www.ceridian.com/myceridian/article/1,2481,11066-53002,00.html

http://www.kent.k12.wa.us/KSD/HR/FlexibleSpendingAccount.pdf

Teva
Mom to AJ born 1-8-03

[macassi]

You may want to check with your company to see how reimbursement works for prescription meds. For my husband's comapany, since the medical insurance and the reimbursement accounts were done through the same firm, the firm automatically paid us back for co-pays for office visits and prescriptions without our having to submit expenses. It made it really nice!

[wagner36]

We put in $2000 for 2004, since we knew that Charlie was having surgery and DH needed a root canal. Of course, then DH needed emergency knee surgery, and my prescriptions fo this damn autoimmune thing I've been diagnosed with are running about $250 a month (not to mention the gzillions of co-pays for appointments) and I need new glasses, etc., so I think I should have put in about $4000. For 2003 we also underestimated. I think it is best to err on the side of caution, so I would do between $1500 and $1750. But, if you and your DH have perfect vision and teeth, you could always go a bit lower. I find that we NEVER have enough left in the FSA for dental or vision care, since the medical takes up everything.

[bnme]

Not sure what you are paying the 10% on (everything or just the maternity fee) but this is how my major costs stacked up. The first # is what the fee was, the second is what the insurance company allowed ("reasonable & customary").

The hospital bill

2,600 - 1,100 baby's hospital stay
2,500 - 300 assist on C/S
1,500 - 700 anesthisia
11,000 - 5,000 my hospital stay (2 DAYS)
6,100 - 2,500 C-section surgery charge
850 - 200 baby's Ped visits in hospital


Also, I think the OB charges 2,500 lump to insurance for maternity care, plus tests and extras. I still can't beleive the difference between what they charge and what the insurance company allows! Thank god for that!! Luckily we only have to pay a hospital copay plus 10% of doctors fees for in-hospital stuff. I think in the end we spent about $600.