How your FSA works 

Ever wonder why Priority Health sends you a check for $2.50 out of your Flexible Spending Account (FSA) without you requesting it?  Ever wonder how to get reimbursement for a dental or vision expense out of your FSA?  Do you wonder if an FSA would fit your needs?

How do I set one up and why would I?

  • At open enrollment, if you are on the Core Plan, you decide on an amount per pay to be deducted pretax throughout the calendar year to be used for uninsured health care expenses.  This amount cannot be changed during the year unless you have a qualifying event as outlined by the IRS.
  • You should budget this for the calendar year’s expected expenses, but if you have not used it all, you can use for qualified expenses through 3/15 of the following year.
  • You can use the entire amount which you committed up front, even before it is deducted from your check, and you get the pretax advantage with these funds.
  • If you opt out of NMC’s medical plans, you can still set up an FSA for your health care expenses with another plan.
  • If you are on a high deductible health plan, you cannot be covered by both an HSA and an FSA.  You can, however, have a Limited FSA, but there are special IRS guidelines on how you can use these funds.

How do I get the money reimbursed?

  • If you are on the NMC Core Plan, Priority Health will automatically reimburse you from your FSA for both medical and prescription claims that they process.
  • For expenses not processed by Priority, such as dental, vision, or non-NMC medical plans, you must submit a request form and documentation to substantiate your request.
  • If you have other insurance coverage for the expense you are requesting, you must include an Explanation of Benefits (EOB) from that insurance company so that Priority knows what has already been covered – you cannot submit just an invoice for these types of expenses.
  • If you would prefer not to be automatically reimbursed, you can call Priority Health’s Customer Service Department and have your account changed to manual reimbursement only.
  • If you have other medical coverage for you or your dependents such as Medicare, Medicaid, spouse’s or military insurance, then Priority Health requires that your FSA have manual reimbursement and will set it up that way.
  • You can access Priority Health’s online Withdrawal Request Form for your FSA at, and for your Limited FSA at

If you have any questions about this or other benefits, feel free to contact HR at 995-1362 or 995-1025.