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authorization form
Qualified expenses
Receipt information
Status changes

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Check your Summary Plan Description for the benefit(s) available in your plan.
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Adult and Elder Care expenses that DO qualify for reimbursement |
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Only expenses necessary for you and your spouse (if married) to be gainfully employed can be claimed. |
- Housekeeper and nurse's fees, for services provided inside your home, are eligible to the extent they are attributable to elder care expenses and expenses of incidental household services.
- Elder care expenses incurred for services outside your home, providing they are incurred for the care of a dependent that regularly spends at least 8 hours per day in your home.
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- Food and incidental expenses may be eligible if part of dependent care charge.
- Expenses paid to a relative (e.g. child) are eligible. However, the relative cannot be under age 19 or a tax dependent of the participant.
- FICA and FUTA payroll taxes of the day care provider are eligible.
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Adult and Elder Care expenses that DO NOT qualify for reimbursement |
- Overnight stays at medical or recreational facilities.
- Food, transportation, and incidental expenses (diapers, activities, etc.) are not eligible if charged separately from dependent care expenses.
- Expenses paid to a housekeeper, maid, cook, etc., are not eligible, except where incidental to adult dependent care.
- Mass transit and parking.
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Limitation on Qualified Expense |
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Adult and Elder Care reimbursement may not exceed the smaller of the following limits: |
- The maximum allowed under the plan.
- $5,000 (if you are married and filing a joint tax return or are single, head of household) and $2,500 if you are married and separate returns are filed.
- Your taxable compensation (after all compensation reduction elections). If you are married, your spouse's actual or deemed earned income.
- If you are married, your spouse's actual or deemed earned income.
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