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Published: Dec 07, 2022 6 min read
Photo Collage of a hand holding a Flexible Spending Account Debit Card with Pills, money and a bandage in the background
Money; Shutterstock; Getty Images

In case you’ve been ignoring those reminders from your HR department (or worse: you didn't get any reminders at all), you really need to check in on your flexible spending account if you have one.

FSAs, as they’re commonly called, are employer-sponsored accounts that allow you to set aside pre-tax dollars each year — up to $2,850 in 2022 — to use on certain health care expenses. More than 20 million Americans use health care FSAs to offset out-of-pocket medical costs.

A key caveat of these accounts is that they have a use-it-or-lose-it provision. In other words, money you’ve been contributing to your FSA could disappear if you don’t spend it by the annual deadline, which is typically Dec. 31. Employers have the option to let you roll over up to $570 of unused money into next year’s account, but not all companies offer this perk.

This year especially, there could be a particularly large sum sitting in your account due to pandemic-related FSA rule changes.

The third COVID-relief package, which was enacted by former President Donald Trump in 2020, gave employers the option to extend the spending deadline by 12 months or allow their workers to roll over all of their unused FSA dollars into the following year’s account — both in 2020 and 2021.

The rules were optional for employers, and experts didn't expect the majority of companies to have enacted them. But it is possible that workers at generous companies have accumulated as much as $8,850 in their FSAs due to multiple rollovers during the pandemic. And because the flexible pandemic rules are sunsetting, the maximum amount that employers can allow their workers to carry over into 2023 accounts is only $570.

So there's potentially a lot of money on the line. Even before these temporary rules were in place, data from the Employee Benefit Research Institute show that more than 4 in 10 workers ended up forfeiting some of their money in 2019, losing an average of $369 per person. A Money analysis estimates that workers enrolled in FSA plans that year lost a total of $3 billion.

Because of the potential for elevated account balances throughout the pandemic, that number could be even higher for 2022 FSAs.

FSA deadlines: Check in with your employer ASAP

To avoid being part of those forfeiture statistics, you should reach out to your company's HR department as soon as you can.

While the broader FSA rules are set by the IRS, your employer has a lot of leeway in determining the finer details.

For one, your employer is ultimately in charge of setting the exact date of the annual spending deadline. The most common deadline is Dec. 31, but companies can theoretically set that date to whenever they want.

They also determine whether to allow you to roll over any unused FSA funds (up to $570) into next year’s account or whether to give you a 2 ½ month grace period to use up remaining funds. Companies aren’t allowed to offer both a rollover and a grace period, and they aren’t required to offer either option.

Once you have this information, you can check your balance through your FSA administrator and make a game plan to use up remaining funds.

FSA eligible items: What's covered?

Another core caveat of FSAs is that not all health-related expenses are covered. The accounts are intended to supplement out-of-pocket costs not covered by health insurance plans. These costs may include office visits, copays, lab work and similar expenses.

Additionally, lots of items typically found at the pharmacy are eligible, such as sunscreen, over-the-counter meds and contraceptives. Not everything at your local CVS is eligible, however. According to the FSA Store, an e-commerce site that sells only FSA-eligible items, toothpaste, tooth brushes and floss, for example, aren’t qualifying medical expenses.

Still, pandemic legislation has expanded this list considerably. According to Zack Peckham, chief financial officer at Health-E Commerce — which is the parent company of the FSA Store — pandemic legislation has increased the number of products you can buy with FSA dollars to more than 10,000.

Newly eligible items include menstrual supplies like tampons, cups and liners as well as at-home COVID-19 tests, hand sanitizer and face masks.

“There’s more eligible products than there have ever been before because of the CARES Act,” Peckham told Money earlier this year.

More from Money:

How to Save on Marketplace Health Care Plans

IRS Warns Tax ‘Refunds May Be Smaller in 2023’

Savers Are Finally Waking up to the Power of HSA Investing to Cover Their Medical Bills