posted: Mar. 25, 2013 @ 12:39p
I realize I am going out on a limb looking for some experts to "spoon feed" me, but I will at least say I've tried searching Google and FW, but can't get a clear understanding of the answer.
My Sig other has just incurred about $2-4K in medical expenses due to a surgery. (We haven't paid any of it yet). I've been trying to verify that it is too late for creating an FSA to be helpful. (Majority of expenses have already been incurred)
http://www.irs.gov/pub/irs-pdf/p969.pdf Pub969 page 16
"A cafeteria plan offering a health FSA must be amen-
ded to specify the $2,500 limit (or any lower limit set by
the employer). While cafeteria plans generally must beamended on a prospective basis, an amendment that isadopted on or before December 31, 2014, may be madeeffective retroactively, provided that in operation the cafe-
teria plan meets the limit for plan years beginning after
December 31, 2012."
"Generally, distributions from a health FSA must be paid
only to reimburse you for qualified medical expenses you
incurred during the period of coverage. You must be able
to receive the maximum amount of reimbursement (the
amount you have elected to contribute for the year) at any
time during the coverage period, regardless of the amount
you have actually contributed. The maximum amount you
can receive tax free is the total amount you elected to con-
tribute to the health FSA for the year."
Is the coverage period Annual or does it start when the plan is set up? I'm guessing it's too late in our case, as I'm sure everyone would do this after incurring medical expenses.
More specific details: Sig other broke collar bone in personal accident on property belonging to a friend of a friend. (Not auto insurance related). Collar bones are often not treated with surgery, but in this case it would not have healed properly on its own. Sig Other works for a small business that provides health insurance, but over the last year or two has switched to a plan with a $1000 deductible (Just under the amount required to qualify for an HSA). Pointless Emergency room visit + surgery (& Painkillers) = $3000 in copays and deductibles. Together we make $40000-$45000 per year.
Doesn't look like much, or any of the amount is going to be over the threshold to be tax-deductible. Looks like we're 100% out of pocket for the costs, but I wanted to check here first. - It does look like another surgery will be required to remove a loose pin, but I have no idea how much it will cost since deductible has already been met. Otherwise our medical expenses has been very low.
Thank You for all the good advice I've found on these forums in the past! (I just recently increased my Auto insurance limits and added uninsured motorist thanks to SIS.. Doing this cost me ALMOST NOTHING!)
Updates: General consensus is that submitting a claim prior to start date could work, but it is probable that it will be denied. I've also found that you may not be able to start a FSA mid-year without a qualifying life event.
Health insurance links:
HSA FAQ: http://www.fatwallet.com/forums/finance/542257/?start=0
FSA Dollars: http://www.fatwallet.com/forums/finance/1261432/