What can I be reimbursed for?
If you have an HSA or an FSA, see this list of eligible expenses that can be reimbursed from your account.
If you have an HRA, eligible expenses are determined by your group. Talk to your employer or benefits administrator for more information.
Depending on your group settings, you have a few options for getting reimbursed for health care expenses from your account.
Online reimbursement claims
When you want to be reimbursed for an out-of-pocket health care expense, you can do so easily by signing in to CapitalBlueCross.com. Capital Blue Cross will process the request and reimburse you as long as there are sufficient funds in your account. Reimbursements can be sent to you as a check, but a more convenient option is setting up direct deposit with your checking or savings account so the money is automatically sent there. We recommend setting this up and saving a trip to the bank.
If a reimbursement request is greater than the account balance, the difference will pend for up to one year and be reimbursed as funds become available. When you submit a claim, you’re responsible for verifying that the expense is an eligible medical expense as determined by Section 213(d). You should keep appropriate receipts for all medical payments (provider name, date, reason, and amount). However, you do not need to submit this information with your withdrawal request.
To submit an online reimbursement claim:
- Sign in at CapitalBlueCross.com and click Login in the top right corner. Enter your username and password and click Sign In. Click the Account Summary link in the middle of the page, directly below your account balance.
- Choose Get Reimbursed from the I Want To… menu.
- If you have more than one account, select HSA account, then click Next
- Enter the amount you would like to request, then click Next
- Add or select a bank
- Add notes
- Select Distribution Reason
- Review and accept the terms by checking the I certify box
- Click Submit
You'll need documentation for the following items:
- Date of service or purchase
- Name of the person who received service or supplies
- Name of the service or supply provider
- Type of service or supplies you purchased
- The amount you were charged for service or supplies, or the amount that was not reimbursed by your insurance provider
Attachments must be less than 15MB in size and in one of the following file formats: JPG, PDF, TIFF, PNG, or BMP.
Automated Claim Payment
This option must be allowed by your group.
Automated claim payments are another reimbursement option offered by Capital Blue Cross. It allows your health plan to automatically send your medical claims from a provider to Capital Blue Cross for reimbursement. This means you don't have to seek reimbursement for your provider costs--Capital Blue Cross will reimburse you automatically.Read our article on Automated Claim Payment to determine if it is right for you.
Mail-In Reimbursement Claims
You can also request reimbursement by mailing in a paper form. This method will take longer. Please use the form on the Printable Forms Page.
Keeping a good record of expenses
When you request a reimbursement, you may be asked to provide proof that the purchase is an eligible medical expense. This might be a prescription, doctor's order, and/or receipt.
Any documentation you upload is stored in our My Records and Receipts electronic document storage tool.
If you are not required to upload documentation for a reimbursement, it is still a good idea to store supporting documentation in My Records and Receipts. This helps you prepare for a future IRS audit.
For more information about storing and maintaining your documentation, see Maintaining Documentation for Eligible Expenses.
Frequently asked questions
- Are claims incurred prior to setting up my HSA eligible to be reimbursed?
- No. Only claims incurred on or after the date that your HSA was activated are eligible regardless of the effective date of the HDHP. Your account is considered active when funded.
- What if I have another account paired with my HSA?
- When actively contributing to an HSA, the following limitations may apply (please see your Summary Plan Description for details):
HSA + FSA: The FSA is limited to vision and dental expenses until you have met your IRS minimum deductible with your insurance.
- My claim or reimbursement request was denied. What can I do?
- After receiving a complete or partial denial of a claim, we recommend you contact our Customer Service department for help in understanding what can be done to get your claim reimbursed.If the claim is still being denied after working with us, you can appeal the decision by filling out an Appeal Form. We recommend you work with your employer or benefits administrator to make sure you have complete and accurate information when making your appeal. Capital Blue Cross will perform a full and fair review of your claim and provide you with written notice of the decision within 30 days of receiving your appeal request.
- You can also designate another person to manage the appeal process on your behalf by completing an Authorization for Release of Information for them.