MedFlex Plan

In addition to paying the premium cost for benefits pre-tax, employees may set aside dollars in their MedFlex Plan to pay for a variety of eligible expenses. Here are some of the qualified medical expenses that might be included:

• Deductibles, co-payments and other expenses not covered by insurance.
• Prescription drugs and medical supplies
• Over-the counter drugs that are medically necessary like pain relievers, allergy medications or antacids
• Dietary supplements and vitamins with a doctor’s letter of medical necessity
• Dental services, orthodontics and dentures
• Eyeglasses, contacts and laser eye surgery
• Hearing exams and hearing aids
• Weight loss program, if prescribed by a doctor
• Smoking cessation programs and over-the counter stop smoking kits

What expenses are not covered?

• Expenses paid by insurance or other coverage
• Cosmetic surgery
• Health club membership (except by physician order)
• Suntan Lotion and Hair Care Products

For a more complete list of over-the counter medicines and supplies that are eligible, click here.
For a more complete list of eligible medical expenses, click here.

How does it work?

• This plan is governed by Federal law and must meet certain requirements.  
• Before the plan year begins, the employee determines how much will be set aside into the plan.
• Employees need to use our expense planning tools to conservatively estimate expenses since any unused balances for the plan year are forfeited.
• Elections cannot be changed for 12-months unless there is a change in status or the required contributions to pay premiums for the elected benefits change significantly during the plan year.
• Each pay period, contributions are deducted from employee’s pay on a pre-tax basis.
• The employee pays the provider and/or makes qualified purchases using the DirectPay Benefits Card™ , or pays with personal funds and files a request for reimbursement.  Reimbursements may be filed either online, for faster service, or by paper form.
• For some expenses, participants must submit itemized receipts. Except for certain physician and Rx co-payments, receipts and/or Explanation of Benefits (EOB) must be submitted to verify that the transactions were for qualified expenses. Qualified items charged to your DirectPay Benefits Card at a participating IIAS merchant and Walgreens do not require substantiation.
• Should it be needed, the employee’s entire annual election, less any reimbursements that have already been received, is always available to pay for qualified expenses.
• Employees can not transfer money between health and dependent care accounts.
• Only expenses actually incurred during the plan year qualify for reimbursement. As an option, an employer can extend the period when claims may be incurred an additional 2 ½ month grace period after the plan year ends. There also is typically a runout period during which employees may submit claims for expenses incurred during the plan year (and grace period, if elected).