The PCA is like an expense account your employer puts money into. The amount of the PCA and list of eligible expenses varies by employer.You can use your PCA for medical expenses like doctor's office visits, as well as other eligible healthcare costs. Check with your employer for a complete list. In addition to services your health plan covers, like doctor's office visits, categories of eligible expenses can include:
However, your company may not include all of the categories above. You can't use the money for experimental treatments, cosmetic procedures, or insurance premiums.
The PCA is usually combined with a Preferred Provider Organization (PPO) plan. With this plan, you may have a higher deductible — but PCA funds can be used to "pay down" your deductible. You can also use PCA funds for pharmacy expenses. If you use all of your PCA funds, you pay additional medical expenses until you meet your deductible for the year. Once you've met the deductible, you pay only the coinsurance percentage for covered services specified in your plan.
If you don't use all of your PCA funds during the plan year, you may be able to carry over some or all of your money to the next year, as long as you enroll in the same type of Humana plan with the same employer. Your employer determines whether you have this option, how much can be carried over, and when funds are available. See your Summary Plan Document for details.
As of Jan. 1, 2011, over-the-counter medications such as pain relievers, cough syrup, and allergy medicines require a prescription to be eligible for reimbursement from a Flexible Spending Account or PCA. The HumanaAccess Card will not be able to be used to purchase OTC medications.
Troy used his PCA to pay all of his healthcare costs for the year. The amounts associated with his health plan – the doctor's visit and lab tests – apply to his deductible.
Mia has one doctor's appointment during the year and has outpatient surgery on her foot. Her daughter, Melissa, gets an ear infection. She goes to the doctor and fills one prescription. Their healthcare costs for the year total $2,150.
Mia used her PCA to cover all but $150 of her medical and prescription drug costs for the year. The amounts associated with her health plan — the doctor's visits and outpatient surgery — apply to her deductible.
Please note that the situations described on this page are fictitious in nature, and are solely used for illustration of the plan.
Here are some Humana tools that may be useful to members who have a Personal Care Account.
View a sample list of allowable and disallowable expenses according to the Internal Revenue Service.
(329 KB) Download PDF
With MyHumana Mobile, you can check your PCA balance on your mobile device. Use your existing MyHumana sign-in information to access this and more at m.humana.com .
* This webpage is not a complete disclosure of plan qualifications and limitations. Before applying for coverage, please refer to the Regulatory Pre-enrollment Disclosure Guide for a description of plan provisions which may exclude, limit, reduce, modify or terminate your coverage.
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