How to submit a claim for a one-time medical expense.
Your company’s HRA can be set up to reimburse for premiums only, or both premiums and additional medical expenses, as outlined by IRS Publication 502. If your company's HRA is set up to reimburse you for one-time medical expenses, you can submit those claims through your member portal. (Helpful Tip: You can tell if your company allows for the submission of medical expenses if the ‘add expense button shows on your portal after your Proof of Coverage is approved!)
Note: If you have a monthly insurance premium, you can set that up as a recurring expense. See the instructions here for how to submit your premium as a recurring expense.
When you pay out of pocket for a copay at the doctor's office, your prescription medications, and much more, you can submit those receipts through the portal for reimbursement. A more robust list of eligible expenses is listed here for your convenience.
To submit an expense, please follow the instructions below.
Once you click the ‘add expense’ button, the following will appear. Please fill out each section to the best of your abilities. Remember to select the correct family member that the medical expense was for (if you are the only person on your profile, you will still need to select your name).
For your one-time medical expense claim to be approved, our Claims team needs to be able to see the following:
· Patient name
· Medical provider/hospital /pharmacy name
· Date of service (not to be confused with billing date, this refers to the date the service itself was provided)
· Specific services provided
· Cost of service
A few helpful reminders for you:
Any unclaimed allowance each month rolls over and accumulates throughout the year. This is referred to in your portal as Current Year Balance. This balance may be used to reimburse for expenses taking place within that given year.
If you have a bill larger than your monthly allowance, you only need to submit it once. We'll keep track and your expense will be paid out until fully reimbursed, or you max out your yearly allowance.
If you incur a medical expense in a previous year but do not get billed until the following year, the eligibility of the expense depends on the date of service, not the date of billing.
If your Current Year Balance is $0 you will need to wait until you have funds to submit further Medical Expenses. Not to worry – any claims that accumulate while your balance is $0 will still be eligible.
As a note your, "Add Expense" button will be greyed out if you do not have any available balance.
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