Health Care FSA
Receive reimbursement for eligible health and dental out-of-pocket expenses.
The Health Care Flexible Spending Account Maximum will remain at $2,750 for the plan year 2022.
The Dependent Care Flexible Spending Account Maximum will remain at $5,000 per household for the plan year 2022.
Related FSA documents and forms
- Instructions on How to Submit an Online FSA Claim (pdf)
- HCSA Letter of Medical Necessity (pdf)
- FSA Transportation Worksheet (pdf)
- FSA Salary Reduction Form (pdf)
- Request for Reimbursement from your HCSA (pdf)
- Request for Reimbursement from your DCSA (pdf)
- Dependent Care Receipt Template (pdf)
For detailed University of Iowa program information, please review the Flexible Spending Account Program Guide (pdf).