FSA Calculator
Please fill out the form below with an estimated dollar amount for each associated expense in order to determine your potential tax savings when enrolled in your company's Flexible Spending Account program.
For details on other FSA eligible expenses please click
here
.
Estimated Health Care Expenses
Health Insurance Deductible(s)
$
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Co-Insurance and Co-Pays
$
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Vision Care (contacts, glasses, etc)
$
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Prescription/Over-the-Counter Drugs
$
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Medical Appliances, Wheelchairs, Crutches
$
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Dental Exams & Cleanings, X-Rays, etc
$
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Braces & Retainers, Fillings, etc.
$
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The current IRS limit for this account is $2,750.00*
Estimated Dependent Care Expenses
Babysitters/Daycare Centers/Nursery School
$
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After School Programs/Day Camp
$
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Elder Care
$
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The current IRS limit for this account is $5,000.00*
Estimated Individual Premium Expenses
Non-Employer Sponsored Health premiums*
(i.e., Dental, Vision and Accident policies)
$
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*The cost for an individual's health insurance policy
(i.e., coverage for hospital, doctor and diagnostic services) is not eligible.
The limit for this account is $10,000.00*
Estimated Adoption Expenses
Reasonable & Necessary Adoption Fees
$
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Court Costs
$
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Attorney's Fees
$
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Travel Expenses
$
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The current IRS limit for this account is $14,300.00*
Yearly Pay Cycle
select
52 Deductions
48 Deductions
26 Deductions
24 Deductions
Monthly
Total Annual Expenses
Savings Per Paycheck
Annual Tax Savings