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Limited Purpose FSA from UBT

A Limited Purpose Flexible Spending Account (LPFSA) is an employer sponsored Flexible Spending Account that allows you to pay for eligible dental and vision expenses. An LPFSA is available to employees who are enrolled in a High Deductible Health Plan (HDHP) as well as an HSA. Establishing an LPFSA, can save you money on taxes by using your LPFSA dollars for your dental and vision expenses while preserving your HSA funds for other purposes, including saving those funds for the future.

LPFSA Tax Benefits

  • Save an average of 30% on qualified dental and vision expenses by using pre-tax dollars.
  • Maximize your tax savings by enrolling in both an HSA and LPFSA.
  • Your full election amount is available on day 1 of the plan year – like an interest-free, tax-free loan.
Federal Tax Rate Annual FSA Contribution Annual Tax Savings
15% $1,500 $340
15% $2,700 $612
25% $1,500 $490
25% $2,700 $882
35% $1,500 $610
35% $2,700 $1,152
For illustrative purposes only. Savings calculations are based on the Federal tax rate listed in the table and 7.65% FICA. Your tax situation may be different. Please consult your tax advisor.


LPFSA Contribution Limits

The Internal Revenue Service (IRS) has established a 2018 maximum contribution of $2,700.


LPFSA Eligible Expenses

Below is a quick reference list of expenses that can be reimbursed from a Limited Purpose Flexible Spending Account. For more detailed information, please refer to IRS Publication 502 titled “Medical and Dental Expenses,” online at (file will open in a new tab). For tax advice, please consult a tax or legal professional.

  • Bridges
  • Crowns
  • Dentures
  • Dental Surgery
  • Orthodontia
  • Root Canals
  • Contact Lenses
  • Eye Exams
  • Eyeglasses
  • Eye Surgery
  • Prescription Sunglasses
  • Vision Correction Procedures