Healthcare Flexible Spending Accounts (FSA)

When you have both a health saving account (HSA) and a healthcare FSA

You can enroll in both the health savings account and healthcare flexible spending account, but there are rules for coordinating your accounts, defined by the IRS.

How it works

  • You can use your HSA funds for any eligible health expense, but your FSA funds can only be used for dental and vision expenses until your annual HDHP deductible is met.
  • Your IU Benefit Card is used for both accounts. This debit-type VISA card is “stacked,” meaning funds will automatically be drawn from your HSA when used at medical or pharmacy providers, and from your FSA when used at dental and vision providers.
  • Once you meet your deductible, and provide proof of meeting your deductible to WEX, you can use your Healthcare FSA funds for medical and prescription expenses incurred from that date forward.
  • You also have the option to pay for expenses out-of-pocket, then submit claims for reimbursement to WEX. 


Special considerations

If your spouse is enrolled in the healthcare FSA through IU or an HRA/FSA through another employer that is unrestricted (and the account could be used to cover your HDHP deductible), you are not eligible for tax-free HSA contributions.

How your annual HDHP deductible is tracked

Anthem tracks your annual HDHP deductible. You can review the progress towards your deductible using the explanation of benefits (EOB) statements mailed to your home, or by logging in to anthem.com or the Sydney Health app.

Once you meet your deductible, and provide proof of meeting it to WEX, your IU Benefit Card will automatically draw all expenses from your healthcare FSA first, then from your HSA once your FSA funds are exhausted.