Health Care Expense Calculator
Worksheet to Determine Eligible Expenses
Use this worksheet to help you decide how much to put into your health care spending account. Follow these steps:
- Enter the annual health care plan deductibles and copayments (where they apply) for you and your family.
- Review your out-of-pocket expenses for the past year to help estimate upcoming expenses. Keep in mind:
- If the expenses are covered by a medical or dental plan, enter your share of the costs. For example, if the expense is $200 and your coinsurance is 20%, you would enter $40.
- If the expense is not covered by a medical or dental plan, enter the whole amount.
- View list of ELIGIBLE HEALTH CARE EXPENSES