1. Recently I heard over-the-counter medicines are now reimbursable under a health FSA, is
this true?
On September 3, 2003 the IRS announced it would allow reimbursement under a health FSA for
over-the-counter medicines. To find out if your company has agreed to reimburse for OTC medicines,
please refer to your companies plan document.
2. Is my claim eligible for reimbursement?
Please refer to your Summary Plan Document for specific regulations. The link below will take
you to a list of
FSA Eligible and Ineligible
Expenses
3. How do I complete the claim forms for my Flexible Spending Account?
-
OTC claims should use the Health Care Claim Form.
-
Include a copy of third party documentation containing 1) date of
service, 2) specific item name, 3) charge amount, and 4) provider name for each claim. If the
receipt does not include the name of the drug, additional third party substantiation will be
required (e.g., a box top that includes the name and price tag matching the price on the
receipt).
-
To allow for proper reimbursement, you must include the total
reimbursement amount being requested on the claim form.
-
The claim form needs to be signed and dated. Fiserv Health cannot
process your request without a signature.
-
Make a copy of your documents for your records before submitting them
to the Flex Spending Department.
4. What information should I include when I fax an FSA claim to Fiserv Health?
Include a cover sheet with the employer name, employee name, daytime phone number
and number of pages being sent.
The toll-free fax number to submit your claims is 877-390-4782.
5. Eye drops/solutions (Visine) are listed as covered. Does this category also include
saline solution for contact lenses?
Yes. Contact solution was covered as an eligible expense even before the IRS
ruling.
6. What kind of documentation is needed for the dual-purpose (vitamins, supplements)
over-the-counter items?
Dual-purpose expenses need to be submitted with a medical practitioner’s note
(letter of medical necessity) explaining the diagnosis and treatment being prescribed for that
specific medical condition.
7. Can the member submit a copy of the medical practitioner’s recommendation with each
claim or are they required to get an original note with each claim submission?
The medical practitioner’s recommendation is valid for one calendar year, unless a
lesser length of time is specified in the letter. Fiserv Health keeps a copy of these letters on
file.
8. Who needs to write the letter of medical necessity?
The letter of medical necessity needs to come from a medical practitioner who has
the "professional competence" to diagnose and treat the illness.
9. Are Dietary Supplements a reimbursable expense?
Dietary supplements can be reimbursable if they treat a specific medical condition. However,
because they also fall into the “dual-purpose” category they would need a letter of medical
necessity as stated above.
10. Are Shipping and Sales tax costs included?
Yes. Shipping costs and sales tax are a part of the expense to obtain the item,and
therefore are reimbursable.
11. Can I be reimbursed for an electronic toothbrush prescribed by my dentist?
No, because everyone uses a toothbrush to maintain general health.
|
