|
Health Care Flexible Spending Account
- Dependents
- Your Contributions
- Availability of Funds
- Eligible Expenses
- Expenses Not Eligible for Reimbursement
- Tax-Deductible vs. Tax-Free
|
|
Health Care Flexible Spending Account
Q. What is the advantage of using the Health Care Flexible Spending Account?
A. You save money — as shown on pages 23-25 — by using pre-tax dollars for unreimbursed, out-of-pocket medical,
dental and vision expenses.
You cannot be reimbursed for amounts paid by any insurance provider or health care plan.
Dependents
You may claim reimbursement of eligible health care expenses for your dependent
family members even if they are not covered under ExxonMobil's medical, dental
or vision plans. Your
dependents for the purposes of the Health Care Flexible Spending Account include:
- Your spouse.
- Generally, anyone related to you or a member of your household for whom you provide
over one-half of his or her support during the year.
- Your natural or adopted children whom you cannot claim as dependents
for income tax purposes (or who are not in your custody) due to divorce or legal separation,
or due to the fact that both parents will live apart for at least six months of the year.
Your Contributions
You may elect to contribute up to $5,000 to the Health Care Flexible Spending Account for the plan year.
If you and your spouse both work for ExxonMobil:
- Each of you can enroll in this account up to the $5,000 limit —
a total of $10,000 for your family.
- You may file claims as an employee or as a dependent of another employee participating in the Plan,
but you may not be reimbursed for more than 100% of your out-of-pocket expenses.
| You can contribute up to $5,000 a year on a pre-tax basis. You may use your account for out-of-pocket expenses
not covered or not fully reimbursed by any health plan. |
Availability of Funds
Although your election directs funds to this account on a monthly basis, your total projected plan year contributions are
available to reimburse you for expenses incurred from the beginning of the plan year.
Charges Spanning More than One Plan Year
If doctors require payment in advance for services rendered during more than one plan year, ask
them to specify the dates services were rendered and the charges for those services. With adequate
documentation, you may be reimbursed for expenses incurred for services provided during the
plan year. Orthodontia, however, is treated differently. Reimbursement is based on your
treatment plan, not your payment schedule, even if you pay the total cost in advance.
Orthodontia is unlike most other kinds of health care treatment because:
- It usually spans more than one plan year; and
- Frequently the length of treatment is different from the payment schedule.
Contact Aetna when estimating your annual orthodontia election.
|
Eligible Expenses
Only expenses for goods bought or services provided during the plan year while you are a
participant are eligible for reimbursement. These expenses include your deductible, co-payments
and other out-of-pocket expenses under your group health plans.
The following are covered expenses:
- Services provided by:
- Acupuncturist.
- Advanced clinical practitioners
(an advanced practical registered nurse or a nurse practitioner with a master's degree).
- Audiologists.
- Certified social workers.
- Chiropractors.
- Christian Scientist practitioners.
- Dentists.
- Doctors of medicine.
- Guides for a blind person.
- Nurses.
- Optometrists or opticians.
- Osteopaths.
- Physical and occupational therapists.
- Podiatrists.
- Psychologists.
- Speech language therapists.
- Medical and dental treatment or services:
- Abortion.
- Acupuncture.
- Ambulance services.
- Artificial insemination.
- Artificial limbs.
- Artificial teeth.
- Braille books and magazines.
- Chemical dependency treatment centers.
- Diathermy (electromagnetic heat therapy).
- Drug addiction treatment.
- Fees for special homes for the mentally retarded.
- Fertility enhancement.
- Healing services.
- Hydrotherapy.
- Medical care in a nursing home. Note: Custodial care is not reimbursable.
- Mental health services.
- Nursing care for medical services only. Note: This excludes
the care of a healthy person. It includes medical care for an elderly person unable to move about
or a person subject to dizziness or seizures. It also includes board and wages for a nurse,
including Social Security taxes you pay on the wages.
- Orthodontic appliances and services (see page 11, Orthodontia).
- Over-the-counter drug expenses — may include dietary supplements and vitamins directed
by a physician for a specific diagnosis.
- Oxygen and oxygen equipment.
- Physical or occupational therapy.
- Radial keratotomy, laser or similar surgery to correct vision.
- Routine eye examinations.
- Sterilization.
- Temporomandibular joint (TMJ) syndrome.
- Transplants.
- Weight loss programs, when accompanied by a physician's statement documenting the medical
necessity for the treatment of a specific disease and not for general health.
- Equipment and supplies:
- Canes or other walking supports.
- Diabetic supplies including those purchased over the counter.
- Eyeglasses and contact lenses and supplies.
- Hearing aids, hearing aid batteries and equipment for the hearing impaired,
such as closed captioned devices and special telephone equipment.
- Medications prescribed by a physician, including birth control pills and devices, allergy medications,
vitamins and mineral supplements if prescribed for a particular medical condition.
- Prescription orthopedic footwear, including arch supports and inlays.
- Guide dogs.
- Special hand controls and other equipment installed in a car in order for a disabled person to operate a car.
- Special equipment, furniture or fixtures in your home, including installation, primarily to provide medical
care for you or an eligible dependent living in your home. If the improvement increases the value of
your home, only the portion of the cost in excess of the increased value may be reimbursed.
- Wheelchairs, wheelchair lifts and their installation.
- Wigs and false eyelashes when natural hair is lost as the result of a disease.
- Special schools and lessons:
- Cardiac rehabilitation classes.
- Charges by special schools to teach Braille to a blind child, signing/lip reading to a
deaf or hearing impaired child, remedial language training to correct conditions caused by birth
defects, remedial reading for children suffering from dyslexia, and speech therapy.
- Job placement classes for handicapped dependents.
- Smoking cessation programs and prescription drugs to
alleviate nicotine withdrawal symptoms.
- Tuition and fees for special schools, if recommended by your doctor,
for a child with severe learning disabilities.
- Travel:
- Transportation expenses to and from a school recommended by a
doctor as a medical treatment.
- Transportation, including air fare, when medically necessary for a spouse to accompany a
spouse or one parent to accompany a child requiring surgery or medical treatment.
- Travel expenses incurred en route to medical treatment sites, including transportation
(either the actual cost or, if unsubstantiated, up to IRS limits).
- Miscellaneous:
- COBRA costs for dependent children under any plan to which ExxonMobil contributes.
- Capital improvements to your home to help the delivery of medical care.
If the improvements increase the value of your home, only the portion of cost in excess of the
increased value may be reimbursed.
- Charges exceeding annual or lifetime maximums paid by a health care plan.
- Fees paid to health institutes for physician prescribed exercises, rubdowns and
similar treatments designed to alleviate a physical or mental defect or illness.
- Halfway house residency.
- Lead based paint removal.
- Legal fees necessary to treat mental illness.
- Meals and lodging provided with medical care at a hospital or
similar institution.
- Non-professional administration of patterning exercises.
- Qualified over-the-counter medications:
Many nonprescription, over-the-counter medications and medical care items are qualified for
reimbursement under the Plan, including:
- Acne treatment.
- Allergy medicines.
- Analgesics, such as fever and pain reducers like aspirin,
acetaminophen, or ibuprofen.
- Antacids.
- Antibiotic creams and ointments.
- Antidiarrheal liquids and pills.
- Antifungal creams and powders.
- Anti-itch creams.
- Arthritis pain-relieving creams.
- Baby care products, such as diaper rash ointment,
Pedialyte®, PediaSure® and teething gel.
- Braces and supports.
- Canker and cold sore remedies.
- Cold medicines.
- Contraceptives.
- Diabetic supplies and equipment.
- Ear care products.
- Eye care products.
- Eye drops and eye wash products.
- Feminine care.
- First aid products.
- Hemorrhoidal preparations.
- Home diagnostic tests or kits.
- Hot and cold packs.
- Incontinence products.
- Joint-support bandages and hosiery.
- Laxatives and fiber therapy.
- Lice treatments.
- Motion sickness medicine.
- Pain relievers.
-
- Smoking-cessation medicine.
- Stomach and digestive relief.
- Tooth and mouth pain relief.
- Urinary pain relief.
- Vaporizers and humidifiers.
- Wart and corn removers.
In addition, certain nonprescription, over-the-counter medications and medical
care items are qualified for reimbursement under the Plan when directed by a doctor. Each
calendar year, you must provide written documentation from your doctor stating your medical
condition and indicating that the over-the-counter medication will treat or alleviate your
condition. After you have provided the documentation from your doctor, you may submit claims
for the medication for the rest of the calendar year. The following are some examples of
expenses that are qualified for reimbursement when directed by a doctor:
-
- Acne medications.
- Herbs and other supplements.
- Sleep-induction medicine.
- Vitamins and minerals (except multivitamins).
- Water-retention products.
- Weight-loss products.
Be sure to budget carefully because any unused amounts must be forfeited.
For more details about eligible and ineligible expenses, you may:
- Call Aetna Member Services to ask about specific expenses; or
- Refer to IRS Publication 502, Medical and Dental Expenses, available from the Internal Revenue Service and from the IRS Internet site at:
www.irs.ustreas.gov.
Expenses Not Eligible for Reimbursement
The following expenses are not eligible for reimbursement under the Health Care
Flexible Spending Account:
- Services:
- Antiseptic diaper services.
- Baby-sitting fees enabling you to get medical care.
- Cosmetic surgery.
- Custodial care.
- Ear piercing.
- Electrolysis.
- Household help.
- Lessons or meetings:
- Childbirth classes.
- Dancing or swimming lessons, even if recommended by a doctor.
- Recreational exercise programs or health club dues.
- Meetings of Alcoholics Anonymous and similar groups.
- Tuition allowing problem children to attend a particular school for a
beneficial change of environment.
- Wellness programs for general health or nutrition courses.
- Travel:
- Depreciation of a car as part of transportation expenses.
- Transporting a disabled person to and from work.
- Transporting people to care for a healthy child to enable parents to be with a hospitalized
child or a spouse to be with a spouse.
- Trips for a change of environment to boost the morale of an ailing person.
- Trips or vacations taken for a change of environment or
general improvement in health, even if advised by a physician.
- Equipment and supplies:
- Air conditioners.
- Bottled water.
- Cosmetics.
- Elastic hosiery.
- Electricity or special power sources to operate equipment.
- Exercise equipment, unless prescribed by a physician for a specific medical condition.
- Hot tubs or whirlpool baths.
- Maternity clothes.
- Natural foods such as herbal tinctures and wheat grass, even
when prescribed by a naturopath.
- Non-allergic foods for individuals with allergies.
- Occupational therapy supplies.
- Orthopedic pillows.
- Toothpaste and other non-prescription hygienic supplies.
- Vitamins and dietary supplements, unless prescribed by a physician
for a particular diagnosis.
- Fees:
- Auto insurance premiums, even if some portion would pay for medical coverage.
- Boarding school fees paid for healthy children while a parent is recuperating from an illness.
- Deductions from your pay for short-term disability insurance under state laws.
- Divorce costs, even if recommended by a psychiatrist.
- Marriage or family counseling.
- Medicare Part A premiums.
- Medical expenses for the natural mother of a child you adopt.
- Scientology fees.
- Telephone calls to a doctor, hospital or pharmacy.
- Miscellaneous:
- Contributions or premiums to health plans except those listed under Eligible Expenses.
- Earnings lost as a result of an automobile accident.
- Expenses and premiums for long-term care.
- Expenses reimbursed by any insurance plan or policy or by any individual, plan or company.
- Illegal operations or drugs.
- Medical bills for a former spouse.
- Self-hypnosis.
Tax-Deductible vs. Tax-Free
If you itemize on your federal tax return, you have a choice about the tax treatment of your health care expenses:
- If you itemize your deductions the federal government offers a
federal income tax deduction for unreimbursed eligible health care expenses
that exceed a stated percentage of your adjusted gross income. Tax laws
determine what this percentage will be. See
the IRS Publication 502 on the IRS web site for more details (www.irs.gov).
- The Health Care Flexible Spending Account offers tax-free reimbursement from the first dollar of your
eligible expenses (maximum $5,000) even if you don't itemize.
Many people find the Health Care Flexible Spending Account offers a greater
advantage. However, because tax laws are complicated and change from time to time, you should
consult your personal tax advisor to find out which approach is best for you.
You cannot claim a tax deduction on expenses reimbursed to you from the spending account.
|
