Flexible Spending Accounts (FSAs) allow you to save on eligible health care and dependent care expenses by using pre-tax dollars. Your FSA is administered by WageWorks.
Because your contributions are deducted from your paycheck before taxes are applied, FSAs reduce your taxable income, helping you keep more of what you earn.
You can enroll in an FSA during Open Enrollment, or within 30 days of a Qualifying Life Event (QLE).
Boston Children’s offers two types of FSAs:
Health Care Flexible Spending Account
The Health Care FSA helps you pay for eligible out-of-pocket medical, dental, and vision expenses for you and your eligible dependents
Dependent Care Flexible Spending Account
The Dependent Care FSA can be used to pay for daycare, preschool, summer day camps, and in-home care for dependents unable to care for themselves.
You may choose to participate in a Health Care FSA, a Dependent Care FSA, or both. Our FSA plans are administered by HealthEquity/WageWorks. Health Care FSA and Dependent Care FSAs are separate — funds can’t be transferred between accounts.
If you want to participate in an FSA, you must elect to do so each year. If you do not make an active election during Open Enrollment, you will not participate for that year.
Funds Don’t Roll Over
Any funds left in the account after that time are forfeited. Funds don’t roll over — you must re-enroll each year during Open Enrollment.
You Cannot Enroll in Both a Health Care FSA and an HSA!
IRS regulations don’t allow you or your covered spouse to contribute to a Health Care FSA and an HSA at the same time, in the same plan year; nor can either of you be enrolled in Medicare.
You can still participate in the Dependent Care FSA.
Health Care FSA
The Health Care FSA helps you pay for eligible out-of-pocket medical, dental, and vision expenses for you and your eligible dependents. Examples include:
Copays, deductibles, and coinsurance
Prescriptions
Dental expenses
Orthodontia treatments
Eyeglasses and contacts
Prescribed weight loss and smoking cessation programs
Other out-of-pocket health care expenses
You can find a full list of eligible expenses in IRS Publication 502. For 2026, you may contribute from $260 to the IRS maximum of $3,400. The full amount you elect is available on January 1 (or your benefits eligibility date) — even though contributions are deducted from each paycheck throughout the year.
When you enroll, you’ll receive a Health Care Debit Card, which can be used at pharmacies, clinics, and dental offices. Most eligible expenses can be paid directly with the card. In some cases, WageWorks may request documentation, such as itemized receipts, to verify expenses. Alternatively, you can choose to pay out-of-pocket and submit a reimbursement request.
Did You Know?
Your Healthcare FSA can be used for out-of-pocket expenses like sunscreen, first aid, menstrual products, and more.
How Much Should I Contribute?
Estimate your contributions with the online FSA calculator at HealthEquity > Employees > Calculators.
Dependent Care FSA
If you have eligible child or adult day care expenses that enable you and your spouse (if applicable) to work, the Dependent Care FSA may be right for you.
This account can be used to pay for daycare, preschool, summer day camps, and in-home care for dependents unable to care for themselves. Eligible dependents are children under age 13, or disabled adult dependents living with you at least 8 hours a day You can find a full list of covered services in IRS Publication 503.
For 2026, you may contribute up to $7,500 per household if you’re married and file jointly, or if you are single and head of household. If you are married and file separately, the maximum is $3,750.
Unlike the Health Care FSA, funds in the Dependent Care FSA are only available as contributions are made from your paycheck. Reimbursements are made based on your account balance at the time of the claim. To be reimbursed, you’ll need to provide documentation, including receipts showing the date of service, the provider’s tax ID number, and the name of the dependent who received care.
How Much Should I Contribute?
Estimate your contributions with the online FSA calculator at HealthEquity > Employees > Calculators.
How FSAs Work
Remember: You cannot contribute to both an HSA and an FSA, according to IRS regulations.
You decide how much you contribute on a pre-tax basis, up to the annual IRS limit.
When you enroll in either or both of the FSAs, you’ll receive a Health Care Debit Card, which can be used at providers such as pharmacies, clinics, and dental offices.
When you have an eligible expense, you can either use your Flex Card or you can pay out-of-pocket and submit a reimburse request. Remember to save all receipts if you are going to submit expenses for reimbursement.
In some cases, when you use your Debit Card, WageWorks may request documentation to verify expenses.
Important Note: “FSAs are use-it-or-lose-it”
FSAs are subject to IRS rules, including the “use-it-or-lose-it” provision: if you haven’t used all your funds by December 31, you have until March 15 of the following year to incur eligible expenses, and until March 31 to submit claims for reimbursement. Any funds left in the account after that time are forfeited. Funds don’t roll over — you must re-enroll each year during Open Enrollment.
Any funds left in the account after that time are forfeited. Funds don’t roll over — you must re-enroll each year during Open Enrollment.
Health Care FSA versus HSA
Feature
HSA
Health Care FSA
Eligibility
You must be enrolled in the Blue Essentials HDHP + HSA
You are eligible if you are enrolled in the Blue Basic HMO, Blue Plus HMO, or Blue Premium HMO plans.
If you are not enrolled in Boston Children’s medical coverage, you can still contribute to an FSA.
Boston Children’s contribution
$500 for employee only coverage, $1,000 for all other levels of coverage
N/A
Investing Your Balance
You can invest your balance at any time.
N/A
Use it or lose it
N/A – your account balance will roll over year after year
Yes – you must use all of the money in your account for expenses incurred no later than March 15 of the following year. Any remaining balance in your account after March 15 will be forfeited
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