Will I have a PayFlex Card for my account?
If your employer’s Plan allows, you’ll automatically receive a PayFlex Card® that you can use for eligible expenses.
Can I buy Over-the-Counter (OTC) items with the card?
Certain OTC items may be eligible. For a listing of eligible expenses, visit Resource Center
and click on Planning Tools
Your PayFlex Card® can’t be used to purchase OTC drugs and medicines. If you have a prescription from your physician for your OTC drug or medicine, you can purchase it with another form of payment. Afterwards, just submit a claim for reimbursement.
Do I need to submit claim forms when I use my PayFlex Card®?
You don’t need to submit a claim when using the card. However, documentation of your expense(s) might be requested in order to meet IRS guidelines. You need to comply with these guidelines by using the card only for qualifying expenses, and providing appropriate documentation upon request.
Do I still need to save my receipts?
Yes, you should save your receipts. You might be requested to verify you used your PayFlex Card® for an eligible expense. You should keep copies of all itemized receipts (not just your credit card receipt) and Explanation of Benefits (EOB) for every card purchase.
How do I access my account information & view my PayFlex Card® transactions online?
Login to your PayFlex account and select Financial Center
from the top navigation bar. Select an Account
from the drop down menu to view account information and card transactions.
How does my PayFlex Card® work?
As you incur eligible health care expenses, you can use your PayFlex Card® as a form of payment. You can use your card as "credit" or "debit." When you choose "debit", you’ll need to enter a Personal Identification Number (PIN). To create a PIN, please call 1-888-999-0121.
If you’re paying for eligible services or items at a healthcare-related merchant or one that has an inventory information approval system, your transaction will be automatically approved at the point of sale. You should always keep your detailed receipts and Explanation of Benefits (EOB) in the event that you need to provide them to the IRS. Remember that a doctor’s prescription will be needed to verify the medical necessity of over-the-counter medications.
Your card is valid for a five-year period. Each year you enroll, the card will reflect the new plan year election amount(s). The card can only be used for expenses incurred during the plan year, unless your employer has elected the grace period, allowing an extra 2 ½ month period to utilize your Flexible Spending Account (FSA) dollars.
I just received my PayFlex Card® in the mail. Do I have to use the card for all of my health care expenses?
No, you don’t need to use your card for all health care expenses. To use funds in your account, you can use another form of payment for your expenses Monday-Friday, 7:00am - 7:00pm (CT) and Saturday, 9:00am - 2:00pm (CT)
then submit a claim for reimbursement.
If my employer offers a grace period, may I use my PayFlex Card® for transactions incurred during the grace period?
If you have elected to participate in the program for the next plan year
, you can use your card to pay for eligible expenses during the grace period. Expenses incurred during the grace period will be applied toward your prior year’s balance first helping to “use up” your prior year’s balance. Once the prior plan year’s balance has been exhausted, the remaining claims will be applied toward the current plan year.
If you didn’t elect to participate in the program for the next plan year
, you can continue to use your PayFlex Card for your eligible expenses during your employer's grace period.
What are the benefits of using a PayFlex Card®?
There are four key benefits:
What happens if I have a $1,000 balance in my account and I use my PayFlex Card® to pay for a $1,500 health care expense?
Immediate payment of your expenses from your savings or reimbursement account
Increased personal cash flow
Reduced paper claim filing
Ease of use of your pre-tax funds
Transactions for more than your available balance will be denied. However, in this case you could ask the merchant to charge your PayFlex Card® for the amount available in your account ($1,000) and pay the remaining balance ($500) with another form of payment. Or pay the entire bill with another form of payment and submit a claim for reimbursement for the remaining balance in your account.
What if the merchant has an inventory information approval system and my card is still denied?
If your card is still being denied, it may be due to one of the following reasons:
What is a PayFlex Card®?
Your balance does not cover the entire cost of your eligible expense AND your merchant may not allow you to use your PayFlex Card® for just a portion of the expense based on your available balance.
Your card could be temporarily inactive. We might need additional documentation from you to verify you used your card for an eligible expense. Login to your PayFlex account to view your card status and find out if you have outstanding transactions requiring documentation. If you have transactions requiring documentation, you can upload your documentation online.
The PayFlex Card® is your account debit card. You can use it to pay for your eligible health care expenses. It is accepted at healthcare-related merchants, like physician and dentist offices, hospitals, pharmacies, hearing and vision care providers. Your card will also be accepted at discount stores and grocery stores that have an inventory information approval system (IIAS). All qualified merchants must accept MasterCard® in order for your card to work.
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 health care card is an eligible or ineligible health care expense according to the IRS guidelines. An IIAS is required at merchants such as drug stores, pharmacies, grocery stores, hospitals, etc. in order for health care cards to be accepted.
What should I do if my card is denied?
If your card is denied because the merchant does not
have an inventory information approval system, you have two options:
1) Use another form of payment
to purchase your health care item and submit a claim for reimbursement.
2) Purchase from another merchant.
A listing of merchants accepting the card is available using the links below.
Listing of merchants with IRS-approved IIAS
Listing of drug stores and pharmacies
What should I do if my card is lost or stolen?
Contact us as soon as possible
to report a lost or stolen card to limit any potential loss or liability as outlined in your cardholder agreement. We will cancel your card and send you a new one. If you’re still worried about identity theft after cancelling your card, you can use MasterCard’s Identity Theft Resolution Services at no cost. They can help you with the process of restoring your identity. Identity Theft Resolution Services include:
24/7 access to MasterCard’s certified resolution specialists
Internet monitoring to proactively detect stolen personally identifiable information and compromised confidential data online
Assistance from a specialist with notification to all three major credit reporting agencies to place blocks on cardholders’ records and obtain free credit reports
Assistance with completing paperwork to alert various parties of the potential fraud
Education about how identity theft can occur and protective measures to avoid further occurrences
To learn more about the Identity Theft Resolution Services, call the MasterCard Assistance Center at 1-800-MC-ASSIST (1-800-622-7747).
MasterCard® is a registered trademark of MasterCard International Incorporated.
What should I do if my drug store or pharmacy doesn’t have the inventory information approval system (IIAS)?
If your drug store or pharmacy doesn’t have the IIAS, you can continue to purchase eligible health care expenses from that location with another form of payment and submit a claim for reimbursement.
What should I do if my provider does not accept MasterCard®?
If your provider does not accept MasterCard®, you will need to use another form of payment and submit a claim for reimbursement.
When documentation is requested for my dental expenses, what should I provide?
Acceptable documentation includes one
of the following:
An Explanation of Benefits (EOB) is our preferred form of documentation, which is provided to you by your insurance provider.
An itemized receipt is also acceptable, but it needs to 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. NOTE: If the documentation you provide indicates "estimated" or "pending" insurance payment, PayFlex® will not be able to approve the card transaction until final documentation is received. The final documentation, which is generally your insurance company's EOB, must show your financial responsibility.
Note: A cancelled check or credit card receipt alone is not
Where can I use my PayFlex Card®?
Your PayFlex Card® is accepted at most healthcare-related merchants, such as physician and dentist offices, hospitals, pharmacies, hearing and vision care providers. Your card is also accepted at discount stores and grocery stores that have an inventory information approval system (IIAS). All qualified merchants must accept MasterCard® in order for your card to work.
View a listing of merchants
that accept your PayFlex Card®.
Why did I receive a Request for Documentation letter for my dental expense?
The PayFlex Card® is set up to approve copayments that match your employers' dental plan. Most likely you received this letter because your expense did not match your employer's dental co-pay. When an expense does not match your co-pay, the IRS requires that PayFlex review your documentation to verify that the dental expenses are eligible. There are some dental expenses that fall under the ineligible category such as teeth whitening and dental veneers. As a result, PayFlex is required to make sure you’re not using your health care dollars for ineligible expenses.
NOTE: Even if your expenses are clearly for a dentist, there still might be times you’ll need to provide an itemized statement or Explanation of Benefits (EOB) to verify that you used your card for an eligible dental expense. We recommend that you keep all itemized receipts and EOBs.
Why did I receive a Request for Documentation letter?
Per IRS requirements, you are required to verify you used your PayFlex Card® for eligible expenses during the plan year. You received a Request for Documentation letter because we need to verify that the transactions listed on your letter were eligible expenses. To keep your card active, respond to this letter promptly by providing the requested documentation. You can respond online by uploading your documentation. To get started, login to your PayFlex account and click on Learn More
next to the claim substantiation alert message.
Why isn’t my PayFlex Card® working?
If your card isn’t working, it could be due to one of the following reasons:
Will I receive a statement of my PayFlex Card® transactions?
Your card is temporarily inactivated – we haven’t received requested documentation to approve your expense.
You have insufficient funds – your eligible expense is more than your remaining balance.
There’s a problem with the merchant – for some reason, the merchant is not recognizing your expense as an eligible expense.
You’re using an invalid merchant – the merchant does not accept MasterCard® or doesn’t have an inventory information approval system.
A statement including your PayFlex Card® transactions is only available online. Login to your PayFlex account and select Financial Center
on the top navigation bar. Then select an account from the drop down menu to view your recent transactions.