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The Vanguard Group

Health care FSA: Q&A

Last updated: 31 Mar 2014  BenefitsMailbox, Ext. 34BEN or 800-407-8576
 

Claims submission and reimbursement

How can I access the money in my flexible spending account (FSA)?

You can access your health care FSA funds by:

  • Submitting a paper claim form with a receipt.
  • Using Aetna's Streamline system.
  • Using an FSA debit card for prescription copays, coinsurance, and eligible over-the-counter expenses.

If you are enrolled in the HDHP, you can only access FSA funds by submitting a paper claim form. See Limited FSA usage with the HDHP for more information.

What is the deadline for incurring expenses that can be reimbursed through an FSA?

If you are enrolled in the FSA as of December 31 of the plan year, you can incur expenses to be reimbursed from each year's FSA until March 15 of the subsequent year. Funds not used by this date will be forfeited. For example, if you have an FSA for 2013, you will have until March 15, 2014, to incur expenses as long as your FSA benefit was still active on December 31, 2013.

What is the deadline for submitting a health care claim for reimbursement?

The deadline for submitting a claim for reimbursement of each year's FSA-eligible expenses is May 31 of the subsequent year. Note: May 31 is the date by which Aetna must receive the request, not the postmark date.

What if there are funds remaining in my 2013 FSA and I begin contributions to a 2014 account?

At the beginning of the year, any funds remaining in your 2013 account will be used first to reimburse expenses incurred prior to March 15, 2014, until the funds are exhausted or the deadline to make a claim has passed. Eligible expenses incurred after March 15 will be reimbursed with funds from your 2014 account.

If you enroll in the HDHP for 2014, you must deplete your 2013 FSA by December 31, 2013, to be eligible for your HSA contributions. See Limited FSA usage with the HDHP for more information.

How can I check the account status for claims processed by Aetna?

You can access all your FSA account activity through the Aetna Navigator website in Take action.

What happens to the money in my FSA if I waive coverage during a permitted election change?

You can continue to use the funds remaining in your FSA to pay for eligible expenses incurred prior to the effective date you waived coverage. However, you will not be reimbursed for any expenses incurred after the effective date for which the FSA benefit was waived. You would still have until May 31 of the following year to submit claims for eligible expenses incurred prior to the effective date you waived coverage. See FSA reimbursement forms under Take action to access the paper claim forms and instructions for completing them.

What happens to the money in my FSA if I no longer work for Vanguard?

You can continue to use the funds remaining in your FSA after leaving Vanguard to pay for eligible expenses incurred prior to your termination date. For the health care FSA, you can elect to continue contributions through COBRA and incur expenses through the end of the year. To access the funds, you must first pay for the expense out of pocket, and then you must submit a claim form and receipt for reimbursement. You may submit claims for charges incurred prior to the termination date until May 31 of the following year. See FSA reimbursement forms under Take action to access the paper claim forms and instructions for completing them.

How do I submit paper claim forms?

After making an out-of-pocket purchase for an eligible health care expense, mail or fax a completed claim form to Aetna along with an itemized receipt, statement, or Explanation of Benefits (EOB). Once the claim is approved, the money will be reimbursed from the FSA into the same bank account where Vanguard deposits your paycheck.

Note: If you request reimbursement for a copay or coinsurance, you must have a receipt that specifically states the expense was for a copay or coinsurance. Aetna will return any receipts that do not include this information.

How does Aetna's Streamline system work?

The Streamline system automatically passes medical and dental claims to the FSA, eliminating the need to submit a paper claim form.

Note: Orthodontia claims will not Streamline. You must submit a paper claim to Aetna to receive reimbursement for those expenses.

For example, when you go for a regular office visit, you'll present your Aetna ID card and pay the required deductible or coinsurance. Without requiring you to submit an FSA claim, Aetna will automatically reimburse the deductible or coinsurance amount to the bank account where your paycheck is deposited and will update your prior year's FSA balance first, if applicable.

The Streamline feature is not available for crew members enrolled in the HDHP. See Limited FSA usage with the HDHP for more information.

Can I opt out of Streamline reimbursements?

Yes. You can turn off and turn on Streamline reimbursements at any time during the year through the Aetna Navigator website in Take action or by contacting Aetna Member Services at 800-938-0512. Once Streamline is turned off, claim submissions must be made using a paper claim form. The Streamline process will automatically turn on at the beginning of each new plan year.

Follow these steps for changing Streamline reimbursements through Aetna Navigator:

  1. Visit the Aetna Navigator website in Take action.
  2. Click Flexible Spending Account Health Care.
  3. Select Streamline Claims.
  4. Choose Cancel under Take Action.

I am in the Aetna HealthFund with the health reimbursement arrangement (HRA). If I contribute to an FSA, which account does Aetna use first when paying medical claims?

For all medical claims, Aetna will always deplete the money in your HRA first. This is true even if you have a remaining balance in your FSA from the prior year. Once your HRA funds are exhausted, Aetna will then process reimbursements from your FSA using the Streamline feature. If you have chosen to turn off Streamline reimbursements, you can use a paper claim form to request reimbursement.

How do I submit a claim for orthodontia expenses?

You must submit a paper claim along with receipt of payment to Aetna. Orthodontia claims will not be reimbursed through Streamline. Click here to access the paper claim form and visit Section 4 on the back of the form for more information.

If I'm a U.S. citizen working outside of the United States, can I receive reimbursement from my health care FSA?

Yes, your health care expenses are reimbursable. Simply submit a claim form. See FSA reimbursement forms under Take action to access the Aetna health care FSA form. You can also fax the form to 888-238-3539. If you pay in foreign currency, please indicate the currency so Aetna can complete the conversion.