Category: Open Enrollment

The Health Care Flexible Spending Account (FSA) allows you to set aside money from your paycheck on a pre-tax basis to pay for eligible out-of-pocket health care expenses. (Eligibility is determined by the IRS).

Funds may be applied towards medical, dental, vision, hearing and prescription drug expenses – for you and your spouse and eligible tax dependents. GW’s FSAs are administered through PayFlex.

Remember, Internal Revenue Service (IRS) rules dictate that FSA plans are “use or lose” plans, meaning that if you have a Health Care FSA for 2019 and don’t spend your funds by the end of the grace period on March 15, 2020, you’ll lose them. Check out these creative ways to use up those Health Care FSA dollars:

1. Stock up on the essentials

Certain standard, over-the-counter medications* and supplies are eligible for FSA spending. This includes First Aid Kits and supplies – including bandages, wraps, adhesives, cold or hot packs, gauze, joint supporters, splints, tape and thermometers – as well as prescriptions for headache medicine, pain relievers, antacids, heartburn medicine and more. Over-the-counter sunscreen products and lip balm are also FSA-eligible. Remember, in order to be reimbursed through your FSA, sunscreen must be at least SPF 15 or higher and protect against two types of ultraviolet radiation: ultraviolet A and ultraviolet B.

*Note per IRS guidelines: Over-the-counter medicine drugs and medicine – such as Advil, Aleve, Anacin, aspirin, Doan’s, Excedrin, HeadOn, IMAK, Motrin and Tylenol – require a prescription from your healthcare professional in order to be reimbursed through the FSA.

2. Buy some new specs or shades

Once you get your prescription, you can use your Health Care FSA funds to buy new prescription eyeglasses, sunglasses, goggles and safety glasses. Other eligible expenses include the tinting of prescription eyewear, eye exams, eye patches, cataract surgery, Lasik surgery, Corneal rings and spec repair.

If you prefer contact lenses, those are also covered – this includes contact lens solution, supplies, exams (including fittings) and shipping and handling fees. Cosmetic contact lenses, such as to change eye color without vision correction, are not eligible.

You can also buy reading glasses with your FSA dollars – no prescription required!

3. Say bye to blemishes

Get clear skin! Acne treatments are FSA-eligible, as long as you have a prescription from your healthcare professional. Examples of eligible products include, but are not limited to, Acne Free, Acnomel, Bye Bye Blemish, Clean & Clear, Clearasil, Murad Acne Complex Kit, Neutrogena Acne Treatment, OXY, Pro-active Solution, Stri-Dex and SAPZYT Acne Treatment.

4. Try acupuncture

Acupuncture can be used to relieve discomfort associated with numerous conditions, including back and neck pain, menstrual cramps, headaches and osteoarthritis. Use your Health Care FSA dollars to cover the cost of acupuncture. You can even buy an acupressure mat with your funds, as long as a healthcare professional has provided evidence of its medical necessity.

5. Prep for childbirth

Expecting a baby? Childbirth classes are partially eligible for reimbursement with an FSA. Only the portion of the class that relates to the process of childbirth is eligible. Examples include breathing and relaxation techniques, stages and phase of labor, labor and delivery procedures and birthing positions. Class time not related to childbirth would not be eligible (e.g., breastfeeding, bottle feeding and newborn care).  If you have questions about how these classes are reimbursed, contact us at benefits@gwu.edu.

6. Get some ZZZs

For a better night’s sleep, with a prescription from your doctor, you can use your Health Care FSA funds to cover the expense of sleep aids. Eligible over-the-counter products include, but are not limited to, Breathe Clear, Breathe Right, nose cones and Snorezz. Nasal strips to alleviate snoring or reduce nasal congestion and earplugs are also qualified expenses.

7. Guide animals

The cost of a guide dog or other animal used by a physically, visually or hearing impaired person, or to assist a person with another disability, is an eligible Health Care FSA expense. Amounts paid for the care of a specially trained animal are also covered.

Tip: The costs of handicap license plates/placards and wheelchairs, scooters, and walkers (including the cost of maintenance) are eligible Health Care FSA expenses. You can also use your funds to cover the cost of a specially designed car to hold a wheelchair (to the extent that the cost of the special car exceeds the cost of a regular car).

View the full list of eligible, potentially eligible and ineligible health care expenses, and learn more about GW’s Flexible Spending Accounts, including eligibility information and how to submit a claim to PayFlex.

Open Enrollment is your annual opportunity to reflect upon your current benefit elections and make any needed changes for the upcoming year. During this period, you may add or remove eligible dependents, and change your benefit elections, with most changes going into effect on January 1, 2020.

With this year’s Open Enrollment period fast approaching, you may be reevaluating your current medical plan. Keep reading to learn more about GW’s medical plans and identify what questions to ask when deciding which plan to choose.

Medical Plan Options:

GW offers two medical plan options: GW Preferred Provider Organization (PPO) and GW Health Savings Plan (HSP). Both plans share the UnitedHealthcare (UHC) Choice Plus network, featuring more than 930,000 professionals*, 195,000 counselors and mental health practitioners**, and 5,600+ hospitals.

Both the GW PPO and the GW HSP allow you to visit your doctor of choice, with no requirements for selecting a Primary Care Physician to coordinate your care and no need to obtain referrals for specialty care. Both plans cover in- and out-of-network services (you pay less out-of-pocket for services received in-network), and include 100 percent coverage for in-network preventive care. Take a closer look at the coverage for some of the most common services provided under the GW PPO and GW HSP with this medical comparison chart (PDF).

There are a couple of things to keep in mind when examining the two medical plans. Carefully review the Summaries of Benefits and Coverage (SBCs) and Summary Plan Descriptions (SPDs) for both plans to understand what’s covered (and what’s not) under both plans. Moreover, while premiums may be lower for the GW HSP, your annual deductible and out-of-pocket maximum will be higher:

2019 Deductibles (In-Network)

• GW HSP: $2,000 (individual) and $4,000 (family)
• GW PPO: $750 (individual) and $1,500 (family)

2019 Out-of-Pocket Maximums (In-Network)

• GW HSP: $4,000 (individual) and $7,900 (family)
• GW PPO: $3,000 (individual) and $6,000 (family)

Making Decisions

There are several factors that you may be thinking about when it comes to your medical plan. For example, would you prefer to pay less per paycheck but pay more out-of-pocket at the time of a medical service (your deductible for medical and prescription under the HSP), or pay more per paycheck and less out-of-pocket at point of service (under the PPO)? Remember, under both plans, you’ll pay less if you use providers that belong to the plan’s network.  Tip: Check out this health costs worksheet (PDF) to compare your coverage options and estimate your potential costs.

In addition, depending on which plan you choose, you may be eligible to elect a Health Care Flexible Spending Account (FSA) or a Health Savings Account (HSA) to help offset the cost of qualified expenses.

FSAs and HSAs

The Health Care FSA and HSA allow you to set aside money from your paychecks on a pre-tax basis to pay for eligible out-of-pocket expenses. You are only eligible to participate in the HSA if you are covered under a high deductible health plan, such as the GW HSP. In contrast, you do not need to be covered under a GW health plan in order to elect the Health Care FSA.

Other major differences between the Health Care FSA and the HSA include the following:

• GW makes a matching contribution to your HSA (but not to your Health Care FSA). If you have individual HSP coverage, GW will match your HSA contribution on a dollar-for-dollar basis up to $600; if you have family HSP coverage, GW will match your HSA contribution on a dollar-for-dollar basis up to $1,200.
• FSAs are “use to or lose it,” meaning that you forfeit any unused balance at the end of the plan year, and you must re-enroll in the FSA each year. In contrast, HSA contributions will accumulate as they roll over from year to year and an HSA is employee-owned, meaning it stays with you even if you change medical plans, jobs or move to another state.
• HSA contribution amounts can be changed at any point throughout the year, while FSA contribution amounts can only be changed during Open Enrollment or if you experience a Qualified Life Event (QLE).

As you begin to prepare for Open Enrollment 2020 and start thinking about which medical plan may be right for you for, take into consideration whether the Healthcare FSA or the HSA would be a good fit for you and your family.

 

*As of September 30, 2018

**Optum national behavioral provider network count as of July 2018