There are also HSA plans, which are not "use it or lose it", but require high deductible insurance plans. I consider the two options targeting two entirely different audiences. If you have high or very predictable medical costs, you only contribute to an FSA what you will use in a year. If you are young, with no pre existing conditions, and generally take care of your own health, you can save some money on premiums with the high deductible plan and HSA, you are unlikely to need to make any claims so the high deductible never comes into play, and you get to keep the HSA through retirement when you are sure to have more medical costs and you get to benefit from the triple tax advantage.
This is side stepping the issue. The solution is very simple and straight forward: you simply buy whatever is "FSA approved", and submit a claim. Can't be any more straight forward. Or as OP presented, you use the same card, but then it gets deducted from your paycheck minus tax.
We have to see who's benefitting from this elaborate gambling scam that steals money from people.
