At the doctor’s office…

1. Receive services

Present your insurance ID card, and pay any required copays. Your FSA debit card is a convenient method of payment.

Your health plan has a network of providers that it recommends, however you can use FSA funds to pay any qualified medical expense even if it is not covered by your insurance. This provides significant tax savings on out-of-network services.

2. Provider bills health plan

Provider submits a claim to your health plan for services rendered.

3. Health plan sends EOB

An explanation of benefits (EOB) is sent to you outlining the negotiated/allowed charges and summarizing your year-to-date deductible and co-insurance totals. In some cases, your health plan may send a copy of your claim to HealthEquity, which will appear in the member portal.

4. Provider sends invoice

The provider sends you an invoice, or statement, reflecting the allowed charges. Make sure the amount matches the EOB sent to you by your health plan, if not, contact your health plan.

5. Pay invoice with FSA

You can pay with your FSA debit card or set up an online payment that is sent directly to the provider or as a reimbursement to you if you pay out-of-pocket.

At the pharmacy…

1.Obtain prescription

Obtain a legal prescription from your doctor for needed medication and submit it along with your insurance ID card to a pharmacy.

2. Pharmacy verifies insurance coverage

The pharmacy checks with your health insurance on-the-spot to determine the amount you owe for the prescription.

3. Pay for your prescription

The pharmacy fills your prescription and you pay the determined amount owed. Your FSA debit card is a convenient method of payment. You may be required to submit your receipt to verify the expense.

Over-the-counter medication

As of January 1, 2020, members can use health account funds to pay for over-the-counter (OTC) medications without needing a prescription.