Can someone explain FSA and using it towards surgery (self pay)

Hi, 

Can someone please explain fsa and how you can use it towards the cost of surgery. Enrollment period is next month for insurance through my job. I want to have my procedure in mexico. Does fsa loan you the money prior and reimburse theirselves by withdrawing money feom.future paychecks?

I will start by saying you should ask your HR department how exactly it works at your company, but the long/short of it as I understand it.

With an FSA account, your employer must make 100% of your annual amount available to you at any time during the offering period.  That is to say if you sign up to contribute $3000 over the course of the calendar year, they must make $3000 available to you on January 1.  They will continue to make deductions from your paychecks over the course of the year (whether or not you use the funds).  So, theoretically, if you sign up right now, you will have the full amount your signed up for available to you on January 1.

As far as how your FSA reimburses you, I think that is different from plan to plan.  I think my company's old plan gave us an FSA card that we could use for eligible medical expenses.  Other companies require you to pay the expense out of pocket and then submit to the FSA plan administrator for reimbursement.

All that said, I'll say again that you should contact your HR specialist and ask them for information.

Just to be sure -- the above applies to FSA, not HSA.  HSA is an entirely different set of rules.

I work in HR/Benefits and we offer an FSA to our employees. I would triple check with your vendor and/or HR department to make sure that this surgery will qualify. I know that on our plan any type of "cosmetic" surgery will be denied. I am guessing your insurance does not cover the surgery which is why you are going to Mexico- so I would triple check on the policy.

Also, most companies supply a debit card that can be used towards medical expenses. The debit card will be fully loaded with the amount you elect for the year (up front) and then you basically pay the money back per paycheck.

With the debit card, you just swipe the card at the point of sale and then they may ask for documentation to substantiate the claim. If the claim is denied for any reason, you will need to pay it back (which is why it is important to verify that this will be covered).

If the company does not offer debit cards then you will have to pay out of pocket and then seek reimbursement from the vendor. 

Let me know if you have any additional questions. I would be happy to help :)

Thanks that was very informative. I do not have health insurance this year. I'm patiently waiting for November's enrollment period to open up. I have to go the self pay route. I'm trying to find a way to finance my surgery. I want to go to Dr. Alvarez I'm Piedras Negras but he is almost  $9000. I've applied for grants and hoping I'm blessed with one. Just wanted to see if obtaining an fsa could help a little as well.

My insurance did not cover my sleeve so I did self pay.  I did my own checking  into covered FSA expenses and then double checked with our benefits department at work to confirm the surgery was not a covered expense.  I did not use any of my FSA benefit for the sleeve itself, but did use it for some of the pre-op stuff that would have normally been covered anyway (blood work, ekg, etc).  Double and triple check though!

Thank you will do. I don't have insurance this year so I'm waiting for enrollment in November to apply. I'm going to discuss this with HR