An Easy Way to Save on Health and Dependent Care Expenses

Enroll or re-enroll in reimbursement accounts during Open Enrollment from October 14 to October 25

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A stethoscope, a calculator and money.

Open Enrollment for 2025

Open enrollment for medical benefits begins Oct. 14 and ends Oct. 25. Eligible staff and faculty can adjust medical, dental and vision plans for coverage effective January 1, 2025.

Smalley now relies on the Health Care Reimbursement Account offered through Duke Benefits for co-pays and other eligible health care expenses not covered by insurance. Duke also offers staff and faculty a Dependent Care Reimbursement Account, which uses pre-tax deductions to help cover the costs of care for children or adult dependents.

Because contributions are deducted from pay before federal income, state income, and Social Security taxes are withheld, participants save on taxes – roughly 30 cents, on average, for every dollar contributed to the health and dependent care accounts.

Employees who wish to participate in the Health Care and/or Dependent Care Reimbursement Accounts must enroll (or re-enroll) during Open Enrollment, which runs from October 14 to October 25, or within 30 days of a qualifying life event such as marriage or the birth of a child.

Caitlin Smalley was able to use her health care reimbursement account to save on the allergy medications that allow her to enjoy the outdoors comfortably. Photo courtesy of Caitlin Smalley.

Participants can choose the annual amount of money they’d like to direct to their accounts; there are annual limits, depending on the account, and certain rules apply for rolling over unused funds.

While the deductions are taken from each paycheck, the full amount of funds designated for that year’s health care reimbursement account are available right away. For the dependent care reimbursement account, funds become available as deductions accrue.

“When I think about the value of the reimbursement accounts, I feel it’s about more than saving money, the pre-tax savings and lowering your taxable income,” said Duke Human Resources Benefits Plan Manager Saundra Daniels.  “I think of the convenience of having the funds readily available to pay for doctor and dentist visits, eyeglasses or contact lenses, and prescription drugs. And with the dependent care account, if you are able to wait until the end of the year to request your reimbursement, it’s a great end-of-year bonus. Or you can request reimbursement from your account as soon as the funds are available.”

To make using the health care reimbursement accounts convenient, participants use a Health Care Card, administered through HealthEquity, at the point of sale for eligible health care expenses.

Smalley, the Financial Care Counselor at Regional Pediatrics, uses her Health Care Reimbursement Account to cover the nearly $200 she spends monthly on medications that allow her spend time in nature. She also uses the account to cover costs associated with health care visits and health-related purchases such as sunscreen.

“Most people don’t realize that you can use it to pay for sunscreen,” said Smalley, who contributes around $2,500 each year to her health care reimbursement account.

With the medication she needs to quiet her allergies, Smalley said she’s spent the summer savoring the occasional walk on the American Tobacco Trail near her office and plenty of time reading on the back porch of her Burlington home.

“The account has been super helpful for me. I used to be miserable during the spring and summer,” Smalley said. “Now, I can go outside and be OK. It’s great.”

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