What is a Limited Purpose Medical FSA?

A Limited Purpose FSA is a Medical FSA designed to allow Health Savings Account (HSA) participants an opportunity to set aside pre-tax funds to pay for out-of-pocket vision, dental and preventive care services.

What specific expenses are eligible for reimbursement from a Limited Purpose Medical FSA?

Vision Care: Out-of-pocket expenses for LASIK surgery, eye exams, eye glasses (frames & lenses), contact lenses & solution, prescription sunglasses, safety glasses and over-the-counter reading glasses.

Dental Care: Out-of-pocket expenses for dental cleanings, fluoride treatments, extractions, x-rays, fillings, crowns, bridges, dentures, denture adhesives, implants and orthodontia.

Preventive Care: Out-of-pocket expenses for periodic health exams, tests and diagnostic procedures in conjunction with evaluation, well-baby care, immunizations for adults and children, tobacco cessation and weight loss programs for obesity.

May I be reimbursed for expenses incurred by my dependents?

Yes, your federal tax dependents may have their expenses reimbursed from your Limited Purpose Medical FSA regardless of whether or not they are covered under your health plan.

When may I use funds in my Limited Purpose Medical FSA for general out of pocket medical expenses?

Your FSA remains limited to vision, dental & preventive care until you have incurred the minimum out-of-pocket deductible expenses as required by the IRS.

These amounts are $1,300 for self-only coverage and $2,600 for those with family coverage. Please keep in mind that your employer may restrict your Limited Purpose Medical FSA to simply qualified vision and dental expenses (with no post-deductible feature).

If my spouse is not enrolled in an HSA-qualified health plan and does not contribute to an HSA, may I use money in my limited medical FSA for his/her general medical expenses?

No. Current IRS regulations prohibit this practice.

How do I file a claim with GDI?

You may enter your claim via our secure Participant Portal. Use the Log In feature at the top of this page. If paper is your preference, please complete the Limited Purpose FSA claim form and submit it according to the instructions on the form

How will GDI know that I have met my minimum deductible and am now eligible to be reimbursed for general medical expenses?

You will need to obtain an “EOB” (Explanation of Benefits) from your health insurance carrier as it will indicate that you have met the mandatory amount of deductible expenses. This information is required each time you submit a reimbursement request for general medical expenses.