Free Guide to Understanding Your FSA Account Balance

Understanding Your FSA Account Basics

A Flexible Spending Account (FSA) is an employer-sponsored benefit program that allows employees to set aside pre-tax dollars for qualified healthcare and dependent care expenses. According to the IRS, approximately 30 million Americans participate in FSA programs annually, making it one of the most widely used workplace benefit options. The basic premise involves contributing a portion of your paycheck before taxes are deducted, which reduces your taxable income and can result in significant savings throughout the year.

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The primary appeal of FSA accounts stems from the tax advantages they offer. When you contribute to an FSA, those dollars avoid federal income tax, Social Security tax, and Medicare tax. For someone in the 24% federal tax bracket, this means a $2,500 FSA contribution could save approximately $600 in taxes annually. However, FSAs operate under specific rules and limitations that vary by employer and plan type. Understanding these parameters is essential for maximizing your account's value and avoiding common pitfalls.

FSA accounts come in two main varieties: healthcare FSAs and dependent care FSAs. Healthcare FSAs can be used for medical, dental, and vision expenses not covered by your health insurance plan. Dependent care FSAs, sometimes called Dependent Care Flexible Spending Accounts (DCFSA), help cover costs for childcare or adult dependent care that allows you to work. Some employers offer both options, while others may only provide one. The contribution limits and rules differ between these two account types, and many workers can benefit from understanding both programs.

Practical Takeaway: Review your employer's benefits documentation or speak with your HR department to confirm which FSA options are available to you. Write down the specific contribution limits, plan year dates, and any employer matching programs that might apply. This baseline information will help you make informed decisions about how much to contribute in the upcoming year.

Calculating and Monitoring Your Account Balance

Your FSA account balance represents the total amount of pre-tax dollars available for you to spend on qualified expenses during the plan year. Most employers use a calendar year (January 1 through December 31) for their FSA plans, though some may operate on a different fiscal year. The balance calculation is straightforward: it equals your total contributions divided by the number of pay periods, multiplied by the number of pay periods that have elapsed in the year.

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For example, if you contribute $2,400 to a healthcare FSA over a calendar year with 26 pay periods, your contribution per pay period is approximately $92.31. After 13 pay periods (mid-year), your available balance would be approximately $1,200. However, once you spend money from your account on qualified expenses, that amount is deducted from your balance immediately. If you submitted receipts for $300 in dental work, your balance would drop to $900.

Most employers provide online access to FSA account portals where you can view your balance in real time. These platforms typically show your contribution history, available balance, pending reimbursements, and transaction history. Some employers also send quarterly statements or annual summaries. It's important to check your balance regularly—at least quarterly—to ensure you're on track with your spending and to verify that all claims have been processed correctly. Processing times for reimbursement claims typically range from 5 to 15 business days, though some claims may take longer if additional documentation is required.

Many account administrators also offer mobile apps that can help you track your balance on the go. These applications often include features like receipt scanning, expense categorization, and push notifications when your balance reaches certain thresholds. By staying actively engaged with monitoring your account, you can make better decisions about future contributions and reduce the risk of unexpected balance surprises at year-end.

Practical Takeaway: Set a calendar reminder to review your FSA balance once each month. Compare your contributions to date against your actual spending to determine whether you're on track. If you're significantly over or under your anticipated spending, you may want to adjust your approach or plan additional expenses before year-end.

The "Use-It-or-Lose-It" Rule and Grace Period Options

One of the most important—and sometimes frustrating—aspects of FSA accounts is the "use-it-or-lose-it" rule. Generally, any funds remaining in your FSA account at the end of the plan year cannot be carried over to the next year. This means if you contribute $2,500 but only spend $2,000, the remaining $500 typically forfeits to your employer. According to IRS data, approximately $3 billion in FSA funds go unused each year, making this one of the biggest sources of consumer loss in benefit programs.

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However, employers are not required to follow this strict rule. Many employers now offer a grace period, which extends the spending deadline to 2.5 months into the following plan year. For a calendar year FSA with a grace period, you would have until March 15 of the following year to spend your remaining balance. This provides significantly more flexibility for planning and prevents some of the year-end scrambling that workers often experience. Approximately 30-35% of employers now offer grace periods, though this varies by company size and region.

Some employers offer an alternative called carryover, which allows employees to roll over up to $570 (as of 2024) of unused FSA funds into the next plan year. This amount adjusts annually for inflation. Carryover and grace periods are mutually exclusive—employers must choose one or the other, not both. It's critical to understand which option your employer provides, as this significantly impacts your contribution strategy. If your plan doesn't offer either grace period or carryover, you need to be more conservative with your contribution estimates.

Planning to avoid forfeiture requires estimating your healthcare and dependent care expenses accurately. Many people underestimate their expenses, particularly for routine medical care, prescriptions, and vision expenses. To improve your estimates, review the previous year's receipts and consider predictable upcoming expenses like annual dental cleanings, vision exams, or prescription refills. If you anticipate a major expense like dental work or surgery, this is an excellent year to increase your FSA contribution.

Practical Takeaway: Immediately confirm with your HR department whether your plan offers a grace period or carryover provision. If neither option is available, be conservative with your contribution—estimate lower rather than higher to minimize forfeiture risk. If a grace period or carryover is available, you can contribute with more confidence, knowing some flexibility exists.

Qualified Expenses and Strategic Spending

Understanding what expenses can be paid from your FSA is fundamental to using your account effectively. For healthcare FSAs, qualified medical expenses include items and services that treat or prevent a medical condition. Common examples include deductibles, copayments, prescription medications, dental work, vision care (including glasses and contacts), mental health services, and medical equipment like crutches or blood pressure monitors. However, the rules are surprisingly detailed, and some items that seem medical may not qualify.

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The IRS maintains a comprehensive publication listing qualified medical expenses, but many items exist in gray areas. For example, cosmetic procedures don't qualify, but reconstructive procedures do. Vitamins and supplements generally don't qualify unless prescribed by a physician for a specific medical condition. Toothpaste and mouthwash don't qualify, but dental work and orthodontia do. Health club memberships don't qualify, but weight loss programs prescribed by physicians for a specific medical condition may. Over-the-counter medications require a prescription to be reimbursable (as of 2020), with the exception of menstrual products, which became eligible in 2021.

Strategic spending within the final months of your plan year can help you use your remaining balance. Many people schedule dental cleanings, vision exams, or other preventive care procedures in November or December when they realize they have excess FSA funds. Others purchase over-the-counter items like pain relievers, antacids, or first aid supplies that they would purchase anyway. Some people stock up on prescribed items like inhalers or epipen refills. While these strategies prevent forfeiture, they should still align with actual healthcare needs and not just represent wasteful spending.

For dependent care FSAs, qualified expenses include daycare for children under 13 and care for adult dependents who are incapable of self-care. Expenses must be necessary for you and your spouse (if married) to work or seek work. School tuition for kindergarten and above doesn't qualify, nor does overnight camp. However, before-school and after-school childcare does qualify. Adult day care centers