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Flexible Spending Account


FSA Calculator

Calculate Next Year's Contribution
Wondering how much to contribute to your Flexible Spending Account (FSA) next year? Follow the steps below to find out! See examples of FSA savings (PDF)

Remember, you can't change your FSA contribution during the plan year unless you experience a qualifying event (such as marriage or divorce, birth, death or adoption of a dependent, or change in employment status for you or your spouse).
 
 Step 1: Estimate Your Health Plan Copays
Enter the number of doctor visits you anticipate during the year for each member on your policy:
$
$
$
$
$
$
$


 Step 2: Estimate Your Medication Expenses
Enter your family's monthly out-of-pocket medication expenses:
$
$
$
$
$


 Step 3: Estimate Your Medical Expenses
Enter your family's annual out-of-pocket medical expenses:
$
$
$


 Step 4: Estimate Your Dental Expenses
Enter your family's annual out-of-pocket dental expenses:
$
$
$
$


 Step 5: Estimate Your Vision Care Expenses
Enter your family's annual out-of-pocket vision expenses:
$
$
$
$


 Step 6: Estimate Your Dependent Care Expenses
Enter your family's weekly dependent care expenses if you also plan to participate in a Dependent Care FSA:
$
$
$


 Step 7: Enter Your Number of Pay Periods
 
Enter your number of pay periods in the year
and click 'Calculate':

 Your Results: Summary of Your FSA Account Estimates
 
Based on your estimates above, here are the expenses you plan to submit through your FSA:
 
   Annually  Per Pay Period
Total Health Care Account Contributions:  
$
 
$
Total Dependent Care Account Contributions:  
$
 
$
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