FSA Calculator

The Healthcare FSA can provide cost savings on a wide variety of healthcare expenses. Use the calculator below to help determine how much money you and your family spend for out-of-pocket healthcare expenses during the plan year - the12-month period in which you may make an annual election (not necessarily the calendar year). You can only be reimbursed for service dates that occurred during your plan year.

The calculator will help you estimate your expenses. No data is captured and this does not enroll you in an FSA program. The calculator fields do not represent all eligible healthcare expenses (please visit FSA Eligible Expenses for a more complete list). In an FSA, any unused funds do not roll over to the next year, so please estimate conservatively!

Enter your data below and click the submit link at the bottom to view your results.

Enter amounts in whole dollars - no decimal points, or dollar signs (For example: 500).

Enter your Annual Household Income:	$
Select your Marital Status:
Select the number of Exemptions:
Enter the number of Pay Periods you have per year:

Please enter your annual FSA eligible medical expenses into the fields below(Example: 500).

1. Medical - Deductibles, Copayments, Coinsurance, Routine Exams.

Physician/Doctor:	$
Osteopathic Physician:	$
Chiropractor:	$
Podiatrist:	$
Other Health Practitioner:	$

2. Prescription - Prescription Drugs(Covered & Non-Covered), Copayments, Coinsurance.
Pharmacy:	$

3. Hospital - Deductibles, Copayments, Coinsurance.
Hospitals:	$

4. Dental/Orthodontist - Deductibles, Copayments, Coinsurance, Routine Exams.
Dentist/Orthodontist:	$

5. Vision - Prescription Eyeglasses & Contacts Lenses, Deductibles, Copayments, Coinsurance.
Optometrist:	$
Ophthalmologist:	$

6. Supplies - Contact Lens Supplies, Medical and Dental supplies
Medical/Dental/Vision:	$
Orthopedic Goods:	$
Hearing Aids:	$

7. Laboratory - X-Ray/ Lab Fees
Medical/Dental laboratory:	$
The tax savings computation is based on 2010 Tax Tables, assumes various tax deductibles, and does not consider state and local taxes. Actual savings will vary based on your individual tax situation. Please consult a tax professional for more information on tax implications of an FSA.

submit

Here are the results from the data submitted from the FSA Calculator.

Your Contribution Amount
Your Annual FSA Contribution Amount:	$
Your Per Pay Period FSA Contribution Amount:	$

Your Savings
Description	With FSA	Without FSA
Your Annual Taxable Income is:	$	$
Your Annual Pre-Tax Contribution Amount:	$	$0
Your New Annual Taxable Income:	$	$
Federal & Social Security Taxes:	$	$
Total Post-Tax Dollars Spent on Eligible FSA Expenses:	$0	$
Your Take Home Income:	$	$
YOUR SAVINGS:	$	$0
The Purchasing Power of Your Annual Contribution has Increased By:	%	0%
The FSA Calculator provides your estimated tax savings and should not be used for tax advice. Actual savings are based upon your individual tax status. Additional savings can result, depending on your state and local government taxes.