The December shopping season for most people means finding holiday presents. But for people with flexible spending accounts, it means buying prescription sunglasses, a long-awaited root canal or maybe even a bulk box of aspirin.

These workplace accounts, also called FSAs, allow workers to divert some of their pre-tax income to spend every year on family health care. The downside is that people forfeit back to their employers any money left in their accounts at year's end. Hence the Christmas rush of medical and dental expenses - whether they are needed or not.

Eileen Smith had more than $400 left in flex money last year and used it on an extra pair of red, wide-rimmed glasses. The spokeswoman for the Minnesota Council of Health Plans now admits the frames look a little ridiculous.

Changes in federal law this year allow employers to extend the "use it or lose it" deadline until March 15, which will reduce the pressure to spend the money frivolously by the end of the calendar year. But benefit consultants said most employers aren't making that change, leaving employees to scramble at the calendar-year deadline.

Administrators for dental and vision offices throughout the Twin Cities report the usual increase in patients seeking appointments in December. The need to exhaust flex money, and the free time offered by holiday vacation schedules, contribute to the increase, said Ron Klemz, executive director for Associated Eye Care, which has six clinics in the east metro.

MedSoft Outsource Solutions of Minneapolis is seeing increased use of flex money but also last-minute requests to reimburse health care goods and services obtained months ago.

"About half of what people do (with flex dollars) is wait until the end of the year," said Debra Edwards, MedSoft's FSA supervisor. "People send in all their receipts and go Christmas shopping" when their reimbursement checks arrive.

FSAs offer clear savings and tax advantages, but only one in five U.S. workers who are offered these accounts actually uses them, according to 2004 data from Mercer Human Resources Consulting. Some workers fear losing money they don't spend, and others dislike the paperwork hassles of keeping medical receipts and then filing them to gain their own money.

Federal law limits how money from FSAs can be used, as well. Cosmetic surgery is out. Health insurance premiums can't be paid with this money, but co-pays and co-insurance payments can.

Dr. Rhondi Meiusi is expecting her appointment calendar to fill up with eye checkups and vision-correction surgeries. The ophthalmologist with Edina Eye Clinic said December is her second-busiest month and is filled mostly with people needing eye exams so they can spend their last flex dollars on new glasses or contacts.

The busiest month, she said, is actually January. Many people don't want to risk having any leftover flex money, so they schedule their vision surgeries right away.

Mike Rowan increased his FSA at the University of St. Thomas to $2,500 this year because he was planning to have hip surgery. Bills from the September surgery are still coming, so he isn't sure whether he will have extra flex money. But if there is any, he has a backup plan.

Jeremy Olson can be reached at jolson@pioneerpress.com or 651-228-5583.

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