Your Flexible Spending Account (FSA) After Job Loss

Do you have a flexible spending account (FSA) that reimburses you for medical expenses like your health insurance deductible, copays, and coinsurance? Are you about to get laid off, quit your job, or retire? Knowing what will happen to your flexible spending account when you lose your job will help you make smart choices.

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Your FSA Is Linked to Your Job

Your ability to use your FSA is linked to your job. However, if you're eligible for COBRA continuation coverage of your FSA, you may be able to continue using your FSA even after you lose or quit your job.

If COBRA extension of your FSA is available, it's important to remember that your former employer will not be matching FSA contributions on your behalf, even if they did so when you were employed. Instead, you'll be making those contributions with after-tax money, plus a 2% administrative fee.

So there is no ongoing tax advantage to electing COBRA for an FSA, other than the ability to request reimbursement for funds that were still remaining in the FSA when the job loss occurred.

Money in FSA When Job Ends

Money left unused in your FSA goes to your employer after you quit or lose your job unless you are eligible for and choose COBRA continuation coverage of your FSA.

Even if you're able to continue your FSA with COBRA, your FSA money can't be used to pay for monthly COBRA health insurance premiums, nor can it be used for non-COBRA health insurance premiums such as those offered through each state's health insurance exchange.

If you're not eligible to continue your FSA via COBRA, you'll want to try to use up the money in your Flexible Spending Account before your job ends so you don’t lose the money.

Using up FSA Money and Even More

Let's say you're leaving your job in March, and you want to use up your FSA. The good news is that it may be possible to take more money out of your FSA than you put into it. How?

Your FSA will pay for eligible medical expenses up to the amount you committed to contributing for the entire year, even if you haven’t contributed that much yet. The IRS caps the amount that employees can contribute to their FSAs each year, and employers can impose lower caps if they choose to do so.

Employees can choose to contribute up to the maximum amount allowed under their plan, but they have to establish their contribution amount prior to the start of the plan year and can't change it during the year unless they have a qualifying event.

2020 COVID-19 Modified Rules

For 2020 only, to address the COVID-19 pandemic, the IRS has relaxed these rules:

  • Employers are allowed (but not required) to give employees the option to start, stop, or change their FSA contribution amounts mid-year, without a qualifying event.
  • The IRS is also allowing employers to extend grace periods or plan years that were scheduled to end at some point in 2020, giving employees until the end of 2020 to use remaining FSA funds.

Let’s say you agreed to contribute $2,000 over the course of the year. By February, you’ve contributed about $333 when you break your wrist. Your FSA will reimburse you for the entire $2,000 you promised to contribute that year (assuming you have that much in documented out-of-pocket medical costs), even though you’ve only made $333 in FSA contributions so far.

If you then quit your job or get laid off in early March, you don’t have to pay the $1,667 difference back. It doesn’t even count as taxable income.

What happens with the $1,667 you were supposed to contribute but didn’t? Your employer takes a $1,667 financial hit for it. But, don't feel too guilty. These employer costs are offset by the unused funds forfeited to the employer by other employees at the end of the year.

Depending on the employer's rules, up to $500 can be carried over to the next year in an FSA, or your employer can allow employees an extra two and a half months after the end of the year to use up remaining FSA funds—but other than those exceptions, FSA funds remaining in the account are forfeited each year.

Ways to Use FSA Funds

If you're not sick, no worries. There are a variety of ways to use up your FSA money quickly. Here are some possibilities that will help you avoid forfeiting the money that's left in your FSA when you leave your job.

Get Checkups

Get a checkup—or several. Be sure you're up to date on your annual physical, and check in with other doctors who oversee any treatment you're receiving.

Under the ACA, there's no cost for a wide array of preventive care (as long as your plan isn't grandfathered), but there are additional services that can be provided during a wellness visit that will incur charges.

Buy New Glasses

Now is a great time to have your eyes checked and to buy yourself as many pairs of glasses (or contacts) as you think you'll need for the near future. And don't forget sunglasses! As long as the sunglasses include your vision correction prescription, you can use FSA funds to buy them.

Restock Medicine and Personal Care Items

A lot of the items for sale on the shelves in your local drugstore can be purchased with FSA funds. And thanks to the CARES Act that was enacted in 2020, this list is expanded to include non-prescription and personal care items.

OTC and Menstrual Products Now FSA-Eligible

Rules implemented in 2020 as a result of the COVID-19 pandemic have expanded the list of FSA-eligible products, Over-the-counter medications and menstrual products can now be purchased with FSA funds.

This rule change is permanent. It's not just for the duration of the COVID-19 emergency period, and it's retroactive to the start of 2020.

Before the CARES Act, over-the-counter medications could only be purchased with FSA funds if your doctor wrote a prescription for the medication, but that's no longer the case.

FSA Store has a search tool where you can enter the type of product you need and it will let you know whether you can use FSA money to buy it. There's a very wide range of FSA-eligible products that we all use on a regular basis, and that can be stockpiled if you're needing to use up FSA funds.

Things like bandages, thermometers, shoe inserts, condoms, pregnancy tests, sunscreen, tampons and menstrual pads, as well as over-the-counter medication, can all be purchased with money that's sitting in your FSA—definitely a better option than just forfeiting the money.

Mental Health Therapy

People often find themselves wanting to see a mental health therapist, but unable to find one that accepts their health insurance. But you can use FSA money to pay for mental health care, as long as it's considered medically necessary (ie, it's to treat a mental health problem, rather than for general wellness).

Depending on the circumstances, you might need to obtain a letter of medical necessity in order to use your FSA funds, so make sure you ask questions and understand what's needed before you count on your FSA funds for therapy. 

Elective Treatments

Were you considering any type of surgical or other medical treatment but putting it off for a more convenient time? Now is the time. Depending on your plan, you may be able to use the money in your FSA to pay for medically necessary treatments like acupuncture and chiropractic care. 

You Can Take an HSA With You

If your employer offers an HSA-qualified high deductible health plan (HDHP) and you enroll in it, you'll have the option to put money into a health savings account (HSA).

An HSA lets you save pre-tax money to pay for medical expenses, just like an FSA. But the tax advantages of an HSA are much stronger than those of an FSA. There are numerous differences between FSAs and HSAs, despite the fact that they're both a tax-advantaged way of paying for medical expenses.

If you have an HSA and you leave your job, the money goes with you. That's true even if the money in your HSA was deposited by your employer on your behalf (as opposed to your own contributions).

And there's no "use it or lose it" rule with HSAs, so if you haven't needed to use your HSA funds for medical expenses and you (and/or your employer) have been contributing money to the HSA for several years, you could have a good stash of savings in the account.

When you leave your job, all of that money is still yours. If you switch to a new HDHP (or keep your existing HDHP via COBRA), you can continue to put money into your HSA.

If you switch to a new health insurance plan that isn't an HDHP (maybe new employer only offers a health plan that isn't HSA-qualified), you can't contribute any more money to your HSA (until you have HDHP coverage again). But you can continue to withdraw money from the HSA to cover your out-of-pocket medical expenses under your new plan.

If you have an HSA, you don't need to scramble to use up the money in the account when you're planning to leave your job—or at the end of each year.

Another benefit of an HSA over an FSA is that if you have money in your HSA when you leave your job, you can use HSA funds to pay for COBRA premiums or health insurance premiums paid while you're receiving unemployment benefits. FSA funds can never be used to pay any sort of health insurance premiums, regardless of the situation.

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Article Sources
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  1. WageWorks. Healthcare FSA carryovers and COBRA continuation. Updated June 22, 2016.

  2. Internal Revenue Service. IRS provides tax inflation adjustments for tax year 2020. Updated November 6, 2019.

  3. Internal Revenue Service. Notice 2020-29: COVID-19 guidance under § 125 cafeteria plans and related to high deductible health plans.

  4. WageWorks. 2020 reference guide: your flexible reimbursement accounts.

  5. Internal Revenue Service. Notice 2013-71 and Notice 2015-87.

  6. U.S. Congress. H.R.748, CARES Act. (section 4402). Updated March 27, 2020.

  7. WageWorks. HSA frequently asked questions.