Consumer-driven health plan (CDHP) is a high-deductible plan that also includes a tax-free health savings account (HSA), health incentive account (HIA) or health reimbursement account (HRA). You may put tax-free money into your account, or your employer might put money in - sometimes as a reward for steps you’ve taken for better health, depending on your plan. Then you use that money for your share of care costs, like your deductible or coinsurance.
It’s called consumer-driven because it puts you in the driver’s seat of your health and health care spending. With your checkups and preventive care likely covered at 100%, and tools to help you stay healthy and shop around for quality care at more reasonable costs - you might be able to cover all your costs with the money in your account.
Health Savings Account (HSA) plan is a high-dedutible plan that also includes a tax-free HSA. You can put tax-free money into it. Then use that money for your share of care costs, like your deductible or coinsurance. You can see all of the types of costs you can cover with money in your HSA. But remember that only cost your plan covers will go toward paying down your deductible.
It gives you the flexibility of a PPO - you can often go to doctors in and out of your network, though you’ll get better rates with in-network doctors. HSA plans tend to have lower monthly premiums than similar PPOs, and sometimes even HMOs.
It’s sometimes called a consumer-driven health plan (CDHP) because you’re in more control of your care spending at first. With your checkups and preventive care likely covered at 100%, and tools to help you stay healthy and shop around for quality care at more reasonable costs - you might be able to cover all your costs with the money in your account.
A health savings account (HSA) is a bank account that can be used to pay for health expenses. You or your employer can put tax-free money into your HSA. You’ll use that money to pay for your share of care costs, like your deductible or coinsurance. If you don’t use all the money, it stays in there next year and beyond. You can also take it with you if you change health plans. View IRS rules on paying costs with money in your HSA.
You (or sometimes your employer) can put tax-free money into your health savings account (HSA). Then you use that money to pay for your share of care costs, like your deductible or coinsurance. Some people cover for all their care costs with their HSA dollars - since your checkups and other preventive care are already covered at 100%. Also, your plan comes with tools to help you find quality care at a lower cost.
If you still have money left in your account, it stays in there for next year and beyond. And you can also take it with you if you change health plans. View IRS rules on paying costs with money in your HSA.
A health incentive account (HIA) is a health account set up by your employer health plan. You earn dollars in your account when you take certain steps to improve your health. You use that money to pay for your share of care costs, like your deductible or coinsurance. If you don’t use all the money, it stays in there next year as long as you’re still at the same job.
Your employer puts money into your health incentive account (HIA) when you take certain steps to improve your health. You use that money to pay for your share of care costs, like your deductible or coinsurance. If you don’t use all the money, it stays in there next year as long as you’re still at the same job.
Yes. The three main types of FSAs are:
1. Health care FSA for qualified medical, dental, vision, or other health care costs, including insurance deductibles, co-payments, and co-insurance.
2. Dependent care FSA for child, elder, or other dependent care.
3. Limited-purpose FSA for qualified dental and vision care costs only when combined with a Health Savings Account (HSA) or a Health Reimbursement Account (HRA).
1. Health care FSA for qualified medical, dental, vision, or other health care costs, including insurance deductibles, co-payments, and co-insurance.
2. Dependent care FSA for child, elder, or other dependent care.
3. Limited-purpose FSA for qualified dental and vision care costs only when combined with a Health Savings Account (HSA) or a Health Reimbursement Account (HRA).
To be eligible for an FSA, your employer must offer it. You don’t have to participate in your employer’s health plan. But you must elect to participate in the FSA during your employer's open enrollment.
For dependent care FSAs, you must also have children under the age of 13 (if divorced, you must be the custodial parent). Or if you have an adult you can claim as a dependent on your tax return, who’s physically or mentally unable to care for themselves.
For dependent care FSAs, you must also have children under the age of 13 (if divorced, you must be the custodial parent). Or if you have an adult you can claim as a dependent on your tax return, who’s physically or mentally unable to care for themselves.
Yes, you will need to elect to participate in the FSA each plan year during your employer's open enrollment.
Qualified individuals must meet one of the following criteria; children under the age of 13 or any adult you can claim as a dependent on your tax return that is physically or mentally unable to care for him/herself.
You must be the custodial parent, even if you don’t claim your child as a tax dependent, to use your Dependent Care FSA.
Typically anyone whose employer offers a Dependent Care FSA can participate. As a rule, your Dependent Care FSA can only cover expenses incurred during work hours. Ask your employer benefits team to verify eligibility.
Qualified medical expenses include medical, dental, vision and prescription expenses. Make sure to check IRS Publication 502 for the complete list of what is covered by your Health Care FSA.
The IRS does not allow Health Care FSA funds to be used for over-the-counter (OTC) medicines without a prescription. We encourage you to talk to your doctor and request a letter of medical necessity for any over-the-counter medicines or supplies that you frequently need to utilize. Also check IRS Publication 502 for a complete list, including OTC items, of what is covered by your Health Care FSA.
To qualify, dependent care must be essential for you and a spouse (if applicable) to work, look for work or attend school full-time. Typical eligible expenses include:
- Before and after school care programs
- Preschool or nursery school
- Extended day programs and summer day camp
- Babysitter (in or out of your home)
- Nanny and au pair services
- Day care and elder care facilities
Expenses not related directly to care of the dependent (i.e. tuition, food, etc.) are not eligible. Examples include:
- Educational expenses (summer school and tutoring)
- Tuition for kindergarten and above
- Overnight camp
- Field trip expenses and fees
- Housekeeping services
- Dependent care expenses incurred if your spouse does not work, unless your spouse is a full-time student or disabled
The work-related expense test is the standard the IRS uses to determine if expenses are work related for a Dependent Care FSA. An expense is not considered work-related just because you had it while you were working. Expenses are considered work-related only if both of the following are true:
- They allow you (and your spouse if filing jointly) to work or look for work
- They are for a qualifying person’s care
The IRS limits contributions to your Health Care FSA to $2,550 per year. If you are married, each spouse may contribute up to $2,550 to his or her own Health Care FSA, even if both have the same employer.
Your spouse can contribute $2,550 to his/her separate Health Care FSA.
The entire amount you’ve elected to put into your Health Care FSA is available on day one of your plan, even if you’re contributing a portion each month. You can use your funds by logging in to this site. You’ll see info on your FSA — you can select health care claims you want to pay with those dollars. You can also pay expenses then submit a reimbursement form with a receipt.You must use your FSA dollars by the end of your plan year. Most plans will give you a grace period of a month or more to submit expenses that you incurred during your plan year. If you don’t use all of the money in your account, you forfeit it.
Unused funds typically don’t roll over. There may be a run-out period when you can continue to submit expenses from the plan year, or your employer may allow up to $500 to carry over to the next plan year. Any balance after that is forfeited to your employer. Some plans offer a grace period that lets you both continue to make purchases and submit reimbursement requests after the end of the plan year. After that, any unused balance for the previous year goes back to your employer.
The run-out period is the time limit for submitting receipts to your Health Care FSA for expenses incurred during the plan year.
All Health Care FSA carryover funds will be available no more than thirty days after the run-out period.
Does the carryover amount limit my future year Health Care Flexible Spending Account (FSA) election?
No.
No, your employer offers a Limited-Purpose FSA, which can be used with an HSA. Your Limited-Purpose FSA can be used for qualified dental or vision expenses only.
You can contribute $5000 per household into your Dependent Care FSA each plan year.
No, Dependent Care FSA contributions cannot total more than $5000 per plan year, per household.
Your Dependent Care FSA withholdings are reported on your W-2.
Once you log in to anthem.com, you have access to your complete FSA info. You can view balance and transactions, pay a claim or get reimbursed and more.
The reimbursement claim form is available through your online account.
You must submit documentation. It can be an itemized receipt, invoice, explanation of benefits or other, but must include the patient name, name of the provider/pharmacy, the service/item purchased, date of the service/transaction, and dollar amount. If used for prescribed over-the-counter items, you must also include a letter of medical necessity detailing the condition being treated, medication type and dosage, and duration of the treatment. Letters of medical necessity must be renewed each year.
Substantiation means to provide a receipt that clearly shows eligible items or services were purchased with your FSA. Substantiation may be requested to document some FSA debit card transactions.
You can submit a claim to your FSA that occurred anytime within the plan year up until the run-out period. Any claims submitted after this date will not be approved.
You can only enroll and set how much you’re putting into it during your enrollment period at your company. However, if you have a change in your life such as getting married or divorced, a new child, moving residence, etc. - contact your company’s Human Resources. You may qualify for a special enrollment period, and you’ll be able to make changes to your FSA.
Your employer decides if your FSA has a run-out period. During a run-out period you can submit a claim for expenses from the FSA plan year. Unused funds will be forfeited.Talk to your company’s Human Resources to see how your company’s FSA works, as soon as possible. You can also call us at the number on your Anthem ID card.
You can get your FSA reimbursement by check or direct deposit.
Reimbursements can be requested as often as a qualified expense is incurred during the plan year and before the end of the FSA run-out period (or grace period if applicable).
FSA plans typically include a time past the plan year for reimbursement requests for expenses during the plan year (known as a run-out period) or expenses up to the end of the extension (known as a grace period). Consult your HR department for details.
The deadline for using Dependent Care FSA funds is the last date of the plan year.
Elections for Dependent Care FSAs are made during open enrollment and cannot be changed unless you experience a qualifying life event. For more information contact your HR department.
Once we receive enrollment data from a state health insurance exchange marketplace, we process the information as quickly as possible and mail a payment letter to you as the customer. This payment letter serves as your receipt of enrollment. When everything works smoothly, this should only take about 10 days. However, sometimes processing the data can take time, especially if we need to go back and make sure any of the information is correct. There can also be issues with the initial application that keeps us from being able to process it, which will need to be corrected at your state’s health insurance exchange marketplace. If you’ve been waiting longer than a couple of weeks to receive your letter, you will want to check on the status of your application - either with us or with the health insurance exchange marketplace. Click on the Contact Us tab to speak with an Anthem representative.
You should receive your ID card within about 10 days of paying your first premium. If you need care and you haven’t gotten your ID card yet, ask your doctor to call us to confirm your benefits -and to make sure they’re in your health plan network.
Yes, if you have individal or family coverage. You can make your initial premium payment securely through our website.
Call us at the number on the back of your Anthem ID card. There is a grace period to help you avoid having your coverage canceled. If you pass the grace period, your policy is canceled from the date you stopped paying. Any claims you had during that time will be denied and you will be responsibile for full payment of the health care services you received. You can re-enroll during the next yearly open enrollment.
Log in and go to your profile. You can change your preferences for how we communicate with you.
Once you receive your payment letter, it will share directions for you to pay the first month’s premium. Payment of the first monthly premium is required to start the policy according to the details shared in your letter. You must take this step to activate your policy before your health insurance identification cards (ID cards) can be mailed.
If you’re the primary person on your policy, you can view your info as well as some of your dependents’. When dependents are over 18, we have certain privacy rules in place that may restrict your access. But you can always change that by having that dependent log into their own profile and change who can view their info.
Log in and send us a message through your Message Center.
To report issues with the listings in our Provider Directory, you can:
- call the Member Services phone number on the back of your ID card.
- send an email to ProviderDirectoryDiscrepancy@Anthem.com.
- call us at 1-844-839-4049.
