Health Care Payment Card Faqs Why Did I Receive
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Health Care Payment Card FAQs Why did I receive this card? The payment card is offered as an enhancement to your benefits package. It provides a convenient way to access your account funds and pay for qualified medical expenses quickly and easily. Is this a regular credit card? No, the payment card is a stored value restricted use card that provides access to funds from your health accounts. It is provided to give you quick access to the funds in your account and should only be used at eligible locations for qualified plan expenses. What can I purchase with my card? Health account funds are mandated by the IRS to be used for health care expenditures only, but there are literally thousands of products and services that meet the approved health care expenditures requirements in Section 213(d) Medical Expenses as defined in the IRS code. Depending on your account, these expenses may include deductibles, coinsurance, copays, prescription drugs, over-the- counter treatments, vision care and dental care. Refer to HSA Qualified Medical Expenses, HRA Qualified Medical Expenses, or FSA Qualified Medical Expenses to determine what is approved for your account(s). Where can I use my card? Your payment card can be used nationwide at qualified health care providers (doctors, hospitals, etc.) that accept Visa. The card is programmed to work at merchant locations that are designated as health care merchants based on their Merchant Category Code (MCC). And, depending on your plan, your payment card may also be accepted for qualified expenses at certain supermarkets, grocery stores, department stores and wholesale clubs that comply with an IRS-required inventory control regulations, called IIAS (Inventory Information Approval System). IIAS compliant stores automatically check to ensure items purchased with a payment card are qualified health account expenses, reducing the need to submit receipts or worry about rejected claims. How does the card work? Provide your card to a qualified merchant or provider, and they will swipe your card like any other credit or debit card to pay for your purchase. If asked, select "credit," to use it without a personal identification number (PIN), or "debit" to use a PIN. There is a preset PIN associated with your card, which is the last 4 digits of your card number. To select a different PIN, call 888.999.0121. Funds for eligible expenses will be transferred directly to the provider or merchant from your health account. Please ask for an itemized receipt in case it is required for substantiation. An itemized receipt should include the date of service, name and address of the provider, the cost and description of the service provided. What are the benefits of the card? The main benefit of the payment card is convenience. It allows you immediate access to your health account funds. Rather than paying for qualified expenses with personal funds, then filing a claim and then waiting for reimbursement, using the card will allow you to access your funds directly and pay the provider. While you may still need to send receipts for substantiation purposes, you will not have to wait for your money to be reimbursed to you. Another benefit is that when you swipe the card, a claim is created for you and eliminates the need for you to fill out a claim form online or manually by paper. When our claims system recognizes a card swipe, it also automatically sends a reminder about receipts. You can use that reminder as the claim fax cover sheet, attach your receipts and fax it to the claims department. If you use another form of payment, it will be up to you to remember to send the receipts and file the claim. An additional benefit is that some payment card purchases can be auto-substantiated without you needing to submit receipts. Examples of transactions that should not require receipts include: 1. Copayments that match your employee's group health insurance plan; 2. Copayments that match your employer's group pharmacy benefit; 3. Recurring expenses of the same dollar amount and same location that have been previously substantiated; 4. Purchases made at certain supermarkets, grocery stores, department stores and wholesale clubs that automatically provide substantiation through an inventory control system. Do I still need to keep my receipts? YES! Third party documentation is required any time you use your payment card or request reimbursement except for the instances listed above. Therefore, always hold on to your receipt* in case further documentation is requested. The receipt must contain the following information: . name of patient (if applicable) . date of service . name and address of service provider/merchant; . description of the service or expense provided . amount charged *Please note that non-itemized cash register tapes, credit card receipts and cancelled checks are not acceptable forms of documentation since they don't include the required service details. How will I know if I need to submit a receipt for substantiation? If a receipt is needed, you will be notified by email or letter. You can also review if your claim requires receipts by logging into your account online or on the mobile app. You need to submit receipts if you see a notice. What if I don't submit my receipts? You must provide the receipts within the time requested or the transaction will be deemed ineligible, and you will be required to refund the amount of the transaction. If you fail to submit required receipts, your payment card will be suspended. If you fail to reimburse the account, the amount of the ineligible expense(s) may be withheld from your pay or added to your taxable wages. Make sure to keep your receipts in case IRS requires you to present them for verification during tax return. Will the card know which expenses are eligible and which are not? While the card can identify a health care location based on the Merchant Category Code, it cannot identify the items or services purchased. That is why in some instances, you will be required to send in documentation to verify that the card was used to pay for an eligible expense. Always save your receipts! May I use my health care payment card to pay for eligible over-the-counter (OTC) items? If you are enrolled in a Health Care Flexible Spending Account (HCFSA), you can use your payment card to pay for OTC items. Many OTC items are eligible for purchase with your HCFSA, but you can use your payment card for only the first category listed below. 1. Eligible - Insulin and health items that do not contain any medicine or drugs (bandages, contact lens solution, hearing aid batteries, diagnostic and testing products, reading glasses, etc.) are eligible and do not require a prescription, letter of medical necessity or doctor’s directive. These items can be purchased with your payment card. 2. Eligible with Prescription - Over-the-counter items that contain a drug or medication (cold and allergy medicine, pain relievers, sleep aids, etc.) require a valid prescription in order to be reimbursed. These items cannot be purchased with your payment card, due to the documentation requirements. Pay using personal funds and request reimbursement online or on the mobile app. 3. Eligible with Letter of Medical Necessity or Doctor’s Directive - “Dual Purpose” items can be used for a medical reason or for general health purposes and require a prescription, letter of medical necessity or doctor’s directive in order to be reimbursed. These items Include products such as dietary, fiber and weight loss supplements, vitamins and orthopedic shoes. These items cannot be purchased with your payment card, due to the documentation requirements. Pay using personal funds and request reimbursement online or on the mobile app. What happens if I use the card for an ineligible expense? Depending on your account, if you use the card for an ineligible expense, you will be required to reimburse your account for that transaction or pay income taxes and an additional penalty tax. What happens if I'm at a legitimate provider and my health care payment card doesn't work? You should first check to see how the card was swiped. If your card is swiped as a "debit" transaction, you will need to provide a PIN. There is a preset PIN for your card, which is the last 4 digits of your card number. If you changed your PIN to a different number, be sure to use your updated PIN. Or, to use your card without a PIN, select "credit" at the payment terminal. If the card still does not work, pay for the charge another way and contact Customer Service afterwards to determine the reason for the denial. You can go online or use the mobile app to request reimbursement for any eligible expenses in which the card was not used. What are some reasons my card may be denied? The IRS has set up rules regarding when payment cards can be used. The payment card utilizes the merchant code of the provider to determine if the location typically sells or dispenses legitimate health care expenses. Valid locations include pharmacies, doctor's offices and hospitals. If the card is not approved, then the provider is either not a qualified merchant or they have not properly set-up their merchant code. Your card will also be denied if the amount requested from your card is more than your available balance. You can check your available balance online, on the mobile app, or by calling 855-687-2134. If your balance is less than the cost of the service or expense, you can ask the merchant to swipe the card for the available amount and then use another form of payment to pay the difference.