Limited Use FSA

Set aside money for eligible dental and vision expenses. Available to eligible colleagues.

EligibilityEnrolling in BenefitsMaking Changes During the YearSelecting a Medical PlanHealthcare AdvocateContact a Benefits ProviderYour Rights and Protections Against Surprise Medical Bills

The Limited Use Flexible Spending Account (LUFSA) administered by PayFlex works the same way as the HCFSA does, except it can only be used for dental and vision expenses.

The IRS has rules about eligible expenses. Learn more on the IRS website and speak with your tax advisor.

Saving and Using Your LUFSA Dollars

  • In 2023, you can save from $100 to $3,050.
  • When you use network dentists or eye doctors, your out-of-pocket expenses will be automatically deducted from your LUFSA.

Keep things simple with the PayFlex Mobile® app, where you can manage your account, make payments, withdrawals and deposits and use a bar code scanner to see if an item is an eligible expense. Learn how here.

To learn more about managing your PayFlex account and to download the PayFlex Mobile® app, visit to

Claim Forms & Guidelines

FSA claims can be quickly processed online through the Payflex website or app. For a hard copy of the LUFSA claim form, click here. For the FSA Claim Filing Guidelines, click here.  To learn more about reimbursement, read this Reimbursement Quick Reference Guide.

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