Limited Purpose FSA

What is it?

A Limited Purpose Health Flexible Spending Account (FSA) is a restricted Health FSA and the only type of FSA that employees with Health Savings Accounts are eligible to have.

 

How does it benefit you?

Many Health Saving Account holders save their HSA funds to cover the cost of their medical expenses when they retire.  By enrolling in a Limited Purpose Health FSA, you can use pre-tax dollars to pay for eligible expenses now and save your HSA contributions for retirement.

 

Eligible Expenses

Expenses reimbursed through a Limited Purpose Health FSA are restricted to dental, vision and preventative medical expenses that are not covered under your health plan. 

  • Artificial teeth/dentures
  • Braces
  • Braille – books and magazines
  • Contact lenses and eyeglasses
  • Dental fees
  • Lasik eye surgery
  • Over-the-counter medications (OTC Marketing Flyer)
  • Preventive medical services (as outlined in your high deductible health plan)
  • Seeing eye-dog and maintenance 

Manage Your Account Online

Create your online account so you can submit claims, check your account balance, sign up for direct deposit and more. Download our mobile app to conveniently access your account anytime, anywhere. You can also manage your account when you log into your account from any of your mobile devices.

How to Log Into Your Account

Watch Video

Download P&A’s Mobile App

Download on Google Play    Download on the App Store

Letter of Medical Necessity Form
pdf (53.9kB)
Download
HIPAA Authorization Form
pdf (46.7kB)
Download
Benefits Card Order Form
pdf (74.3kB)
Download

Contribute

First, you need to determine your anticipated medical expenses in the upcoming year.  Consider what you typically spend in a year on medical, dental and vision expenses for you and your family.  Calculate the total amount and set it aside, up to a maximum of $2,750*, into your FSA.

With a Health FSA, your total annual election is available at the beginning of your plan year, so you can be reimbursed for purchases right away and budget for large expenses over the entire year!

*Please note: the max contribution amount is subject to change annually by the IRS.

Rules to Know

Grace Period or Carry Forward

Some employers may opt to add a grace period or carry forward provision to the plan. Either option gives you the ability to use funds from the prior plan year for a portion of the new year. Please check your Summary Plan Description (SPD) to see if your plan includes either of these options.

“Use or Lose” Rule

You will forfeit unused funds at the end of the year (or at the expiration of the grace/carry forward period if applicable). Make sure you contribute funds you’re confident you’ll spend in the coming year!

FSA Calculator

Not sure how much to contribute to your account? Our FSA calculator can help you figure it out.

Learn More
FSA Eligible Expense List

It may be helpful to understand the list of FSA eligible expenses in thinking through how much to contribute.

View List
OTC Eligible Expenses

In 2020 Congress expanded the list of FSA eligible expenses to include over the counter (“OTC”) items as well.

Learn More

Use Your P&A Benefits Card

P&A Benefits Card

When you enroll in an FSA, you’ll receive a P&A issued Benefits Card in the mail. Use your P&A Benefits Card to purchase expenses wherever MasterCard is accepted. When you swipe the card, your money is automatically deducted from your account.

P&A Group Benefits Card

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Additional cards can be ordered at no extra cost by logging into your P&A MyBenefits Account. You can also contact customer service to order extra cards.

After you use your Benefits Card, you may be occasionally requested to provide documentation of your purchase. This request is to ensure the plan is in compliance and you’re using it to purchase IRS-approved eligible expenses. Examples of acceptable documentation include an Explanation of Benefits (EOB) from your insurance carrier or an itemized receipt.

Store Locator

View a list of providers who will accept the P&A Benefits Card.

View List

If you are unable to use your Benefits Card, pay for your expense out-of-pocket and submit a claim to P&A.

How to Submit a Claim

If you’re unable to use your Benefits Card, you can pay out-of-pocket for your expense and submit a claim for reimbursement.

How To Submit A Claim

Watch Video

Ways to Submit a Claim

With P&A, there are numerous ways to submit a claim for reimbursement.

Mobile App

Download P&A’s mobile app and upload your claims directly from your phone.

MyBenefits Account

Log into your P&A MyBenefits account and click Upload Claim/Documentation to submit a claim.

Mail or Fax

Mail a claim form to P&A Group at 17 Court Street, Suite 500 Buffalo, NY 14202 - or fax a claim form to toll-free (877) 855-7105. Claim forms are available inside your My Benefits account.

All claims must be accompanied with a receipt/proof of purchase that includes the date(s) of service and service(s) rendered. Estimates or statements with previous balances are not sufficient. Additional information may be requested if a receipt/proof of purchase contains an estimate, previous balance or does not contain service and services rendered. 

FSA Eligible Expense List

Unsure of what expenses are eligible for reimbursement?

View List
OTC Eligible Expenses

In 2020 Congress expanded the list of FSA eligible expenses to include over the counter (“OTC”) items as well.

Learn More

Sign up for Direct Deposit

Enroll in direct deposit and have your reimbursement deposited directly into your designated checking or savings account. With direct deposit, P&A’s typical turnaround time is less than 24 hours from the point a claim is approved. If you don’t enroll in direct deposit, a reimbursement check will be mailed to your home, which can take anywhere from 10-15 business days.

To sign up for direct deposit, log into your account and go to Direct Deposit under Quick Links.

Manage Your Account Online

Create your online account so you can submit claims, check your account balance, sign up for direct deposit and more. Download our mobile app to conveniently access your account anytime, anywhere. You can also manage your account when you log into your account from any of your mobile devices.

How to Log Into Your Account

Watch Video

Download P&A’s Mobile App

Download on Google Play    Download on the App Store

Letter of Medical Necessity Form
pdf (53.9kB)
Download
HIPAA Authorization Form
pdf (46.7kB)
Download
Benefits Card Order Form
pdf (74.3kB)
Download

Contribute

First, you need to determine your anticipated medical expenses in the upcoming year.  Consider what you typically spend in a year on medical, dental and vision expenses for you and your family.  Calculate the total amount and set it aside, up to a maximum of $2,750*, into your FSA.

With a Health FSA, your total annual election is available at the beginning of your plan year, so you can be reimbursed for purchases right away and budget for large expenses over the entire year!

*Please note: the max contribution amount is subject to change annually by the IRS.

Rules to Know

Grace Period or Carry Forward

Some employers may opt to add a grace period or carry forward provision to the plan. Either option gives you the ability to use funds from the prior plan year for a portion of the new year. Please check your Summary Plan Description (SPD) to see if your plan includes either of these options.

“Use or Lose” Rule

You will forfeit unused funds at the end of the year (or at the expiration of the grace/carry forward period if applicable). Make sure you contribute funds you’re confident you’ll spend in the coming year!

FSA Calculator

Not sure how much to contribute to your account? Our FSA calculator can help you figure it out.

Learn More
FSA Eligible Expense List

It may be helpful to understand the list of FSA eligible expenses in thinking through how much to contribute.

View List
OTC Eligible Expenses

In 2020 Congress expanded the list of FSA eligible expenses to include over the counter (“OTC”) items as well.

Learn More

Use Your P&A Benefits Card

P&A Benefits Card

When you enroll in an FSA, you’ll receive a P&A issued Benefits Card in the mail. Use your P&A Benefits Card to purchase expenses wherever MasterCard is accepted. When you swipe the card, your money is automatically deducted from your account.

P&A Group Benefits Card

Watch Video

Additional cards can be ordered at no extra cost by logging into your P&A MyBenefits Account. You can also contact customer service to order extra cards.

After you use your Benefits Card, you may be occasionally requested to provide documentation of your purchase. This request is to ensure the plan is in compliance and you’re using it to purchase IRS-approved eligible expenses. Examples of acceptable documentation include an Explanation of Benefits (EOB) from your insurance carrier or an itemized receipt.

Store Locator

View a list of providers who will accept the P&A Benefits Card.

View List

If you are unable to use your Benefits Card, pay for your expense out-of-pocket and submit a claim to P&A.

How to Submit a Claim

If you’re unable to use your Benefits Card, you can pay out-of-pocket for your expense and submit a claim for reimbursement.

How To Submit A Claim

Watch Video

Ways to Submit a Claim

With P&A, there are numerous ways to submit a claim for reimbursement.

Mobile App

Download P&A’s mobile app and upload your claims directly from your phone.

MyBenefits Account

Log into your P&A MyBenefits account and click Upload Claim/Documentation to submit a claim.

Mail or Fax

Mail a claim form to P&A Group at 17 Court Street, Suite 500 Buffalo, NY 14202 - or fax a claim form to toll-free (877) 855-7105. Claim forms are available inside your My Benefits account.

All claims must be accompanied with a receipt/proof of purchase that includes the date(s) of service and service(s) rendered. Estimates or statements with previous balances are not sufficient. Additional information may be requested if a receipt/proof of purchase contains an estimate, previous balance or does not contain service and services rendered. 

FSA Eligible Expense List

Unsure of what expenses are eligible for reimbursement?

View List
OTC Eligible Expenses

In 2020 Congress expanded the list of FSA eligible expenses to include over the counter (“OTC”) items as well.

Learn More

Sign up for Direct Deposit

Enroll in direct deposit and have your reimbursement deposited directly into your designated checking or savings account. With direct deposit, P&A’s typical turnaround time is less than 24 hours from the point a claim is approved. If you don’t enroll in direct deposit, a reimbursement check will be mailed to your home, which can take anywhere from 10-15 business days.

To sign up for direct deposit, log into your account and go to Direct Deposit under Quick Links.

Participant News

PPE is FSA Eligible; HSAs and Some HRAs Also Affected

April 6, 2021
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How to Use Your FSA Before the 3/15 Grace Period

March 2, 2021
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FSA Changes Provided in COVID Relief Bill

January 11, 2021
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Four Things Every 2021 FSA Participant Should know

December 22, 2020
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HSA or FSA: What Should You Choose?

October 19, 2020
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Use Your Health FSA to Get Back-to-School Ready

August 24, 2020
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