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Flex Worksheet
Flex Worksheet
Use this easy calculator to see
how much money you will save.
Simply fill in the estimated amount on the items you wish to save for.
Healthcare
Expenses
(estimated)
Healthcare
(cont.)
Co-pays to doctors & pharmacies
Oxygen, insulin, syringes & supplies
Over-the-counter drugs
(except vitamins)
Hearing aids, batteries & exams
Prescription drugs
Artificial limbs & braces
Office visits & checkups
Arches & orthopedic shoes
Prescribed sunglasses & eyeglasses
Walkers, canes & wheelchairs
Contact lenses, solutions & supplies
Physical & speech therapy
Eye exams, surgery & LASIK
Weight loss program
(prescribed by doctor)
Dental cleanings, fillings & x-rays
Quit-smoking program & medications
Sealants, crowns, bridges & dentures
Alcoholism & drug treatment
Braces, spacers, & retainers
Medical Alert bracelet & fees
Wisdom teeth, implants & oral surgery
Reconstructive surgery
(birth defect, disease)
Psychologist & psychiatrist fees
Wigs for hair loss caused by disease
Obstetrics & fertility
Special school for disabled child
Lab tests & body scans
Travel & mileage to doctor or hospital
Chiropractor & podiatrist fees
Dependent
Care Expenses
(estimated)
Nanny & babysitter thru age 12
Pre-K or nursery school
Before & after-school care thru age 12
Day camp thru age 12
Daycare for a disabled adult or child
Elder daycare for parent or dependent
Healthcare
Expenses
+
Dependent Expenses
=
Please
select your family’s income range:
Less than $30,000
$30,000 to $60,000
More than $60,000
YOU
SAVE
$
X
%
$