What is the advantage of using the PayFlex Debit Card?
The debit card will automatically deduct directly from the participants FSA account and provide participant's online access to real-time account information allowing
them to check the balance at any time.
How does the debit card work?
As the participant incurs eligible healthcare expenses, they can use the debit card as a form of payment. Simply swipe the card to pay for services or items from a
healthcare-related merchant or one that has implemented an Inventory Information Approval System (IIAS) and the transaction will be automatically approved at point of sale.
Do I need to submit claim forms when I use my debit card?
While most transactions are automatically adjudicated, participants are urged to save all receipts in the event that PayFlex requests documentation to substantiate
the claim or in the event they need to provide them to the IRS.
Why did I receive a Request for Documentation letter?
During the plan year, participants may receive Request for Documentation letters because PayFlex may need to verify that the debit card transactions on their account
were eligible expense(s) per IRS requirements. Documentation letter requests are mailed on the 25th of each month and participants will have 60 days from the letter
date to submit the documentation. Failure to submit documentation by the end of the notification period will result in the temporary suspension of the debit card.
Documentation should be faxed to (866) 556-5551.
When documentation is requested for my expenses, what should I provide?
Acceptable documentation consists of one of the following:
||An Explanation of Benefits (EOB) is our preferred form of documentation, which is provided to the participant by the insurance provider.
||An itemized receipt is also acceptable, but it must show the date of purchase or service, amount of purchase or service,
description of item or service, name of merchant or service provider, and name of patient.
*Please note that a cancelled check or credit card receipt alone is not acceptable documentation.
Will my transaction be denied if I don't have enough money in my account to cover the expense?
Transactions exceeding the available balances will be denied. However the participant can ask the merchant to charge the debit card for the
amount available in the FSA account and the remaining balance can be paid with another form of payment. Participants can verify their account
balance by contacting PayFlex or viewing online.
Can I use my debit card for online purchases?*
Yes, participants can use the debit card to purchase eligible expenses online. Participants can buy items such as glasses, contacts,
prescription drugs, durable medical equipment and eligible over-the-counter items. If an item is not identified as "FSA eligible"
participants will need to use another form of payment.
Can over-the counter (OTC) items be purchase with the debit card?*
Certain OTC medicines and supplies are eligible if the merchant location has implemented the IIAS system as required by the IRS.
OTC items that are not eligible for purchase through the debit card may be paid with another form of payment and participants can
submit a claim for reimbursement.
Can I use my debit card for dental expenses?
Yes, participants can use the debit card for dental expenses if allowed by the employer. However, participants can only use it for the amount
of the dental expense that is not covered by insurance. According to the IRS, expenses paid by another source, such as insurance, cannot be
reimbursed through the healthcare account. Participants should wait to receive the final amount from the insurance provider stating the
financial responsibility to pay the provider. Using the debit card to pay for dental expenses before the insurance provider has determined
the amount of financial responsibility could result in an overpayment from the healthcare account.
If my employer offers a grace period, may I use my debit card for transactions incurred during the grace period?
If the grace period has been elected by the employer, participants may use the card to pay for eligible expenses during the grace period.
Expenses incurred during the grace period will be applied toward the prior year's balance to spend down the balance. Once the prior plan year's
balance has been exhausted, the remaining claims will be applied toward the current plan year.
What is an inventory information approval system (IIAS)?
An inventory information approval system (IIAS) is a system that identifies whether a product or service purchased with a healthcare card is an
eligible or ineligible healthcare expense according to IRS 213(d). An IIAS is required at merchants such as drug stores, pharmacies, grocery
stores, hospitals, etc. in order for healthcare cards to be accepted.
What if the merchant has an inventory information approval system and my card is still denied?
If the debit card is being denied, it may be due to one of the following reasons:
The balance does not cover the entire cost of the participants' eligible expense AND the merchant may not allow the participant to use the debit card for just a portion of the expense based on the available balance.
The debit card may be temporarily inactive. We may need additional documentation from the participant to verify that the card was used for an eligible expense.
The item may not be eligible for payment by the debit card and the participant may be required to submit a claim for reimbursement.
What should I do if my drug store or pharmacy chose not to implement an inventory information approval system (IIAS)?
If your drug store or pharmacy has not implemented an IIAS, you can continue to purchase eligible healthcare expenses from that location with
another form of payment and submit a claim for reimbursement.