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FSA HRA Reimbursement Form - HealthEquity

FSA HRA Reimbursement Form - HealthEquity 2025

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The document is an FSA/HRA Reimbursement Form that provides instructions for participants to submit claims for healthcare and dependent care expenses. It includes sections for participant information, details of incurred expenses, and requirements for documentation. The form must be completed and submitted via mail, fax, or email to HealthEquity Claims, with specific guidelines on required signatures and supporting documents. Additionally, it notes changes effective January 1, 2011, regarding over-the-counter item reimbursements.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How do I get money off my HealthEquity card?

Online Reimbursement Log into HealthEquity. Find Reimburse Myself Upload your receipt. Get paid.

How do I get reimbursed from FSA HealthEquity?

You can have a payment sent directly to a provider or reimburse yourself for qualified out-of- pocket medical expenses. Simply sign in to your HealthEquity account and select View Claims under the Claims Payments tab. HealthEquitys system will give you the option to Pay Provider or Reimburse Me.

How does HealthEquity HRA work?

Your Health Reimbursement Arrangement (HRA) is funded by your employer and your employer sets the rules for how those funds can be used. You cannot contribute to your HRA. It is owned, defined, and completely funded by your employer. Its one of the ways your employer helps you make healthcare more affordable.

How do I file for FSA reimbursement?

How do I submit a Federal Flexible Spending Account Program (FSAFEDS) online claim? You can submit your claim online by logging into My Account Summary at .FSAFEDS.com , clicking on My Claims, and selecting Online Claim Submission. You must upload an image of your supporting documentation in .

How do I get reimbursed for HSA purchases?

As long as you opened your HSA before the expense was incurred, your reimbursement will be tax-free. You can: Transfer money online from your HSA to your personal bank account using an electronic funds transfer (EFT) Mail yourself a check through the transfer money feature.

How long does it take for HealthEquity to reimburse funds?

Reimbursement is typically processed within 3 - 5 business days from the time the claim was submitted for processing. Please remember that not all plans reimburse all expense types. Consult your plan documents first before submitting a claim.

How do I get reimbursed for FSA expenses?

Employers may make contributions to your FSA, but they arent required to. With an FSA, you submit a claim to the FSA (through your employer) with proof of the medical expense and a statement that it hasnt been covered by your plan. Then, youll get reimbursed for your costs.

Can you have an HRA with an FSA?

Using an HRA and an FSA together is a smart way to take advantage of employer-sponsored health benefit plans. They allow you to access more tax-free money for the qualifying medical expenses you incur for yourself, your spouse, and your dependents.

FSA HRA Reimbursement Form - HealthEquity 2025

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