Health account FAQs

Our health care toolbox provides the resources you need to make informed health care decisions. You'll also find helpful tools to easily manage your health care spending.


What is an HSA and how does it work?

An HSA is a pre-tax account established to pay for qualified medical expenses for those who are covered under a High Deductible Health Plan. With money from this account, you pay for healthcare expenses until your deductible is met. Then, in accordance with the terms of your healthcare plan, your insurance company pays for covered expenses in excess of your deductible. Any unused funds are yours to retain in your HSA and accumulate toward your future healthcare expenses or your retirement.

What are the general features and tax benefits of an HSA?

  • Your contributions are pre-tax or tax-deductible*
  • Interest earned is tax-free
  • Tax-free withdrawals may be made for qualified medical expenses
  • Unused funds and interest are carried over, without limit, from year to year
  • You own the HSA and it is yours to keep - even when you change jobs, health plans, or retire

*Contributions are tax-deductible on your Federal tax return. Some states do not recognize HSA contributions as a deduction. Your own HSA contributions are either tax-deductible or pre-tax (if made by payroll deduction). See IRS Publication 969. Consult a qualified tax adviser for advice.

Who qualifies for an HSA?

Generally, an eligible individual is anyone who meets all of the following criteria unless an exception would apply:
  • Covered under an IRS qualifying HDHP
  • Not covered by any other health plan that is not an HDHP
  • Not currently enrolled in Medicare or TRICARE
  • May not be claimed as a dependent on another individual's tax return

Who qualifies as a dependent?

A person generally qualifies as your dependent for HSA purposes if you claim them as an exemption on your Federal tax return. Please see IRS Publication 502 for exceptions.

What is a "High Deductible Health Plan" (HDHP)?

An HDHP is a health plan that satisfies certain requirements with respect to deductibles and out-of-pocket expenses. In 2019, for self-only coverage, an HDHP has an annual deductible of at least $1,350 and annual out-of-pocket expenses (deductibles, co-payments and other amounts, but not premiums) not exceeding $6,750 (as indexed). For family coverage in 2019, an HDHP has an annual deductible of at least $2,700 and annual out-of-pocket expenses not exceeding $13,500. HDHP qualifying deductibles and annual out-of-pocket-expenses are indexed for inflation on an annual basis. Visit and click on the corresponding year for updates.

What kind of other health coverage makes an individual ineligible for an HSA?

Generally, an individual is ineligible for an HSA if the individual, while covered under an HDHP, is also covered under a health plan (whether as an individual, spouse, or dependent) that is not an HDHP.

What can I use the HSA for?

The HSA can be used:
  • to pay for qualified medical, dental, vision and prescription drug expenses, including over-the counter drugs that have been prescribed by a doctor, as defined in IRS Publication 502
  • as supplemental income, but money withdrawn is taxable and if you are under age 65, it will be subject to a 20% penalty

Can I invest my HSA dollars?

Yes, you can invest your HSA dollars into a variety of mutual fund options to help build your HSA dollars to use for future medical expenses or save for retirement. For additional information, please review our HSA INVESTMENTS section below.

What other kinds of health coverage may an individual maintain without losing eligibility for an HSA?

An individual does not fail to be eligible for an HSA merely because, in addition to an HDHP, the individual has coverage for any benefit provided by "permitted insurance." Permitted insurance is insurance under which substantially all of the coverage provided relates to liabilities incurred under workers' compensation laws, tort liabilities, liabilities relating to ownership or use of property (e.g., automobile insurance), insurance for a specified disease or illness, and insurance that pays a fixed amount per day (or other period) of hospitalization.

In addition to permitted insurance, an individual does not fail to be eligible for an HSA merely because, in addition to an HDHP, the individual has coverage (whether provided through insurance or otherwise) for accidents, disability, dental care, vision care, or long-term care.

Can I use my HSA to pay for medical expenses for a spouse or dependent?

Yes, you may use your HSA funds without penalty to pay for qualified medical expenses for yourself, your spouse, or dependent even if they are covered under another health plan. Consult a qualified tax adviser for advice.

What if I use my HSA to pay for something other than a qualified medical expense?

If HSA funds are used for other than qualified medical expenses, the expenditures are subject to applicable income tax and, for individuals who are not disabled or over age 65, subject to a 20% tax penalty.

Are health insurance premiums qualified medical expenses?

Generally, health insurance premiums are not qualified medical expenses. Exceptions include qualified long-term care insurance, COBRA healthcare continuation coverage, any health plan maintained while receiving unemployment compensation under federal or state law, and for those age 65 or over (whether or not they are entitled to Medicare) any employer-sponsored retiree medical coverage premiums for Medicare Part A or B, or Medicare HMO. Conversely, premiums for Medigap policies are not qualified medical expenses.

What happens to the money in my HSA if I no longer have HDHP coverage?

Once you discontinue coverage under an HDHP and/or get coverage under another health plan that disqualifies you from an HSA, you can no longer make contributions to your HSA, but since you own the HSA, you can continue to use the remaining funds for future medical expenses.


Who may contribute to an HSA?

Anyone may contribute to the HSA of an eligible individual. If an employee establishes an HSA, for example, the employee, their employer, or both may contribute to the employee's HSA in a given year. If a self-employed or unemployed individual establishes an HSA, that individual may contribute to the HSA. Family members may also make contributions to an HSA on behalf of another family member as long as that other family member is an eligible individual.

Can I enroll in both an HSA and a health Flexible Spending Account (FSA)?

If you enroll in both an HSA and an FSA or Health Reimbursement Arrangement (HRA), you cannot make deductible contributions to the HSA for that coverage period if the FSA or HRA are general purpose arrangements that pay or reimburse for qualified medical expenses. However, you still may be able to make deductible contributions to an HSA even if you are also covered under an FSA or HRA if those arrangements are limited purpose FSAs or HRAs that restrict reimbursements to certain permitted benefits such as vision, dental or preventive care benefits. Other permissible combinations include suspended HRAs and post-deductible FSAs or HRAs. Contact your legal or tax adviser to review these situations.

How much can I contribute to my HSA?

In 2018, your annual HSA contribution may not exceed $3,450 for individual coverage or $6,900 for family coverage. For 2019, your annual HSA contribution may not exceed $3,500 for individual coverage or $7,000 for family coverage.

If I enrolled in an HDHP and HSA mid-year, what is my permitted contribution amount for that year?

As outlined in IRS Publication 969, under the last month rule, if you have HDHP coverage on the first day of the last month of your tax year (December 1 for most taxpayers), you are considered an eligible individual for the entire year. The maximum annual HSA contribution can be made for that tax year, regardless of when, during that year, the HSA was opened. For example, if an individual opens an HSA on June 1, the full contribution allowable by law can be made for that year. Penalties may apply if HDHP coverage does not continue for 12 months during the testing period. For the last-month rule, the testing period begins with the last month of your tax year (usually December 31) and ends on the last day on the 12th month following that month. If you fail to remain an eligible individual during the testing period, you may be subject to penalties. View IRS Publication 969 to read the entire requirement.

Can I change my contributions to my HSA during the year?

Generally, if you make contributions through an employer's cafeteria plan, you will not be subject to the change in status rules applicable to other qualified benefits. If this is the case, you will be able to make changes in your contributions by providing the applicable notice of change provided by your employer. If you do not contribute to your HSA through a cafeteria plan, you are free to start, stop, or modify your contributions at any time.

How do I make contributions?

Contributions can be made:

  • through payroll deduction with your employer
  • online by making a contribution from your personal checking account
  • mailing a personal check with the online HSA Contribution Form

My HSA deduction is shown in Box 12 of my W-2 as Code W. Why is it designated as an employer contribution when I have contributed the money to the account?

Consistent with applicable IRS guidelines, HSA deductions reported on your W-2 in Box 12 includes contributions made by the employer and employee contributions made through a section 125 cafeteria plan as a pre-tax salary deferral. When you prepare your taxes at year-end, you are required to complete an additional tax form -- the IRS Form 8889.

Will HSA contributions that I made via lockbox deposit or online via eContribute show up on my W-2?

No. Contributions made by either of these methods are considered after-tax contributions for purposes of W-2 reporting. In order to receive the tax benefit of after-tax contributions, you must claim them on your tax return.

When can HSA contributions be made? Is there a deadline for contributions to an HSA for a taxable year?

For an established HSA, contributions for the taxable year can be made in one or more payments at any time after the year has begun and prior to the individual's deadline (without extensions) for filing the eligible individual's federal income tax return for that year. For most taxpayers, this is April 15 of the year following the year for which contributions are made.

What happens when HSA contributions exceed the maximum amount that can be deducted or excluded from gross income in a taxable year?

Contributions by individuals to an HSA, or if made on behalf of an individual to an HSA, are not deductible when they exceed the limits. Contributions by an employer to an HSA for an employee are included in the gross income of the employee if they exceed the limits or if they are made on behalf of an employee who is not an eligible individual. In addition, if not withdrawn in a timely manner, an annually assessed excise tax of 6% is imposed on the accountholder for excess individual and employer contributions.

What are catch-up contributions for individuals age 55 or older?

For individuals age 55 and older, the HSA contribution limit is increased by $1,000 in calendar year 2009 and after.

If my spouse is age 55 or older, am I eligible to make the catch-up contribution?

No. The primary accountholder must be age 55 or older in order to make the catch-up contribution.

What happens to my remaining account balance at the end of the year?

Any remaining account balance automatically rolls over year after year.

Can I contribute funds from my Individual Retirement Arrangement (IRA) to my HSA?

During your lifetime, you are allowed a one-time contribution from one of your IRA(s) to one of your HSA(s). The contribution must be made in a direct trustee-to-trustee transfer. The IRA transfer will not be included in income or subject to additional tax due to early withdrawal. The transfer is limited to the maximum HSA contribution for the year and the amount contributed is not allowed as a deduction. Penalties may apply if HDHP coverage does not continue for 12 months.

Are rollover contributions from Archer MSAs and other HSAs permitted?

Yes. Rollover contributions from Archer MSAs and other HSAs are permitted. Qualifying rollover contributions must be made in cash and are not subject to annual contribution limits.

What happens to my HSA when I, or my Spouse, enrolls for Medicare?

If you have chosen to enroll in Medicare you are no longer eligible to contribute to your HSA. Any contributions made after your Medicare coverage begins may incur a tax penalty.

Note that Premium-free Part A coverage begins 6 months back from the date you apply for Medicare (or Social Security/RRB benefits), but no earlier than the first month you were eligible for Medicare. Please consult a tax advisor regarding your eligibility to contribute and any potential tax implications. For more information on Medicare, visit the State Health Insurance Assistance Program website, or contact by phone 1-800-MEDICARE.

If you are currently contributing to an HSA as a family plan, and your spouse enters in to Medicare alone while you remain in a high-deductible health plan (HDHP), then you would be deemed a self-only participant for your HSA contribution limits. You would be allowed to continue contributing to your HSA up to the appropriate IRS limit for self-only coverage, and use your HSA funds to pay or be reimbursed for qualified medical expenses.


How are distributions from an HSA taxed?

Distributions from an HSA used exclusively to pay for qualified medical expenses of the accountholder, his or her spouse, or dependents are tax exempt and not included in gross income.

In general, amounts retained in an HSA can be used for qualified medical expenses and will be excludable from gross income even if the individual is not currently eligible to make contributions to the HSA.

When can I initiate distributions from an HSA?

Once your account is funded and activated, you can initiate distributions from the HSA at any time.

What are the "qualified medical expenses" that are eligible for tax-free distributions?

Qualified medical expenses are expenses paid by the accountholder for diagnosis, cure, mitigation, treatment, or prevention of disease.

Examples of these expenses are prescription drugs, including over-the-counter drugs that have been prescribed by a doctor, transportation to care providers, qualified long-term care expenses, and certain health insurance premiums Such expenses are "qualified medical expenses" only if they are ineligible for insurance or any other type of coverage. For more information, view IRS Publication 502.

Can I use my HSA to pay for non-health related expenses?

Yes, however, any amount of a distribution not used exclusively to pay for qualified medical expenses of the accountholder, spouse or dependents is includable in gross income of the accountholder. Such distributions are subject to an additional 20% tax on the amount includable, except in the case of distributions made after the accountholder's death, disability, or attaining age 65.

How do I pay for medical services?

Medical services can be paid for with your Optum Payment Card, online Bill Pay, or distributing funds from the HSA to your personal bank account.

Is there a PIN associated with the Optum Payment Card?

We recommend that you choose credit when making purchases. You can choose debit, but you will need a PIN. You can get a PIN by calling customer service if you did not obtain one when activating your card.

Is there a daily transaction limit on my card?

There is no daily transaction limit on your card.

What happens if the HSA has insufficient funds for payment?

Payment card transactions will not be authorized if funds are not available.

Is tax reporting required for an HSA?

Yes. IRS form 8889 must be completed with your tax return each year to report total deposits and withdrawals from your account. You do not have to itemize to complete this form.

What are the tax rules of an HSA?

An HSA provides you triple tax savings by allowing:
  • tax deductions from gross income when you contribute to your HSA;
  • tax-free earnings through interest and investments; and
  • tax-free withdrawals for qualified medical expenses.

How are distributions taxed after the accountholder is no longer an eligible individual?

Distributions used exclusively to pay for qualified medical expenses are not taxed, whether or not the accountholder is eligible to contribute to an HSA at the time of distribution.

What happens to the HSA if I die?

If you are married and your spouse is a named beneficiary, s/he becomes the owner of the account and assumes it as his/her own HSA. If you are unmarried, your account will cease to be an HSA. It will pass to beneficiaries or become a part of your estate, and be subject to applicable taxes.

What are the income tax consequences for the beneficiary after the HSA accountholder's death?

Upon death, any balance remaining in the accountholder's HSA becomes the property of the individual named in the HSA as the beneficiary of the account. If the accountholder's surviving spouse is the named beneficiary of the HSA, the HSA is treated as though the surviving spouse were the accountholder, and distributions used for qualified medical expenses are not subject to income tax.

If, by reason of the death of the accountholder, the HSA passes to a person other than the accountholder's surviving spouse, the HSA ceases to be an HSA as of the date of the accountholder's death, and the person is required to include in gross income the fair market value of the HSA assets as of the date of death.

Who is responsible for determining whether HSA distributions are used exclusively for qualified medical expenses?

As the HSA accountholder, you must ensure that distributions are used for qualified medical expenses. Records of medical expenses should be maintained as evidence that distributions have been made for these purposes. You are responsible for ensuring contributions to the HSA do not exceed IRS limits.

If I change employers, what happens to my HSA?

Since you are the owner of the HSA, you may continue to maintain the account if you change employers.

How will HSA summaries be delivered and how frequently?

Periodic HSA summaries itemizing deposits and withdrawals will be available on-line or you may opt to receive paper statements at an additional fee. A monthly summary is provided for any month in which a transaction (other than interest) is made.

Can I reimburse myself with HSA funds for qualified medical expenses incurred prior to my enrollment in an HSA?

No. Qualified medical expenses may only be reimbursed, tax-free, if the expenses are incurred after the date your HSA was established.


When can I establish an HSA investment account?

You can establish your HSA investment account at any time. However, your HSA deposit account balance must first satisfy the investment threshold before your funds can be invested. The investment threshold is the minimum account balance required to be maintained in your HSA deposit account.

Can I set up an automatic transfer between my HSA deposit account and my HSA investment account?

Yes. We call this our Investment Sweep function that allows you to set a personal investment threshold at or above your program threshold. Once your threshold is set and your HSA deposit account balance exceeds the investment sweep threshold by $100 or more, funds will automatically sweep or transfer into your investment account. Likewise, if your deposit account balance falls below the sweep threshold by $100 or more, funds will be automatically swept or transferred back to your deposit account from your investment account.

How do I get started?

Once you log in to your account, you have the ability to set up HSA investments at any time. From the Home Page:

  • Select the Manage Investment Transfers link located to the right of your available account balance information.
  • Select the Define Investment Sweep Amount box and enter your designated amount at or above your program's investment threshold and select Save.
  • To establish your investment election percentages or access the investment account, select View Investment Details from the Account Summary page. You will be prompted to answer one of your predefined Security Questions.
  • Next, you will be presented with your HSA Investment Account page, and select your mutual fund options, view fund performances, transfer investments, etc. To change your investment elections, select Investment Elections under the Manage My Account section.

Note: Your HSA investment dollars will default to the Fidelity Government Money Market Fund, unless you elect to make investment elections.

What happens if my HSA deposit account balance falls below the investment threshold?

If your HSA deposit account falls below the sweep threshold by $100 or more and if your investment transfer threshold is enabled, funds will be automatically swept from your HSA investment account into your HSA deposit account. You can control the amount of your available account balance by enabling or disabling the investment sweep.

What investment options are available?

Your investment options include a variety of funds; individual mutual funds covering a wide range of asset classes, as well as target maturity and asset allocation funds to meet your HSA investing needs. Log into your HSA and select Investment Details to view your available fund options. You can view fund fact sheets, prospectuses, and fund performance information.

What is the difference between my HSA deposit account and the HSA investment account?

Your HSA deposit account is an interest-bearing, FDIC insured account used to pay for qualified medical expenses. The HSA investment account provides an option to invest excess funds over a designated threshold into an array of mutual funds for long term accumulation (not FDIC insured).

Are earnings or investment fund growth in my HSA considered taxable income?

No. Contributions, interest, investment earnings and withdrawals are not taxed provided you meet the IRS eligibility requirements and distributions from your HSA are used for qualified medical expenses. Current taxes and IRS penalties may apply to non-qualified distributions.

Are there any front-end load fees or transaction fees associated with investments?

The front-end load fees are waived for HSA accountholders. In addition, there are no transaction fees.

Can I access my investment account with my payment card?

No. Payment card purchases can only access your balance held in your interest-bearing HSA deposit account.

I have a large qualified medical expense that exceeds my HSA deposit account balance; what are my options to pay that expense?

It can be handled one of two ways:

  1. If Investment Sweep is enabled and you initiate a Bill Pay or Direct Deposit Reimbursement transaction, the system will automatically sell a pro-rata portion of your mutual fund holdings needed to fund the distribution.
  2. If you intend on paying the expense with your card, you would simply need to increase your personal investment threshold to satisfy your spending need. Note: It will take three (3) days for funds to be available from initiating investment transfers back to your deposit account.


What is a Flexible Spending Account (FSA)?

A Flexible Spending Account (FSA) is a tax-favored program offered by employers that allows their employees to pay for eligible out-of-pocket healthcare and dependent care expenses with pre-tax dollars. FSAs are exempt from federal taxes, Social Security (FICA) taxes and, in most cases, state income taxes.

The most common types of Flexible Spending Accounts are:

Medical Flexible Spending Account (Medical FSA): an account that provides pre-tax reimbursement of qualifying out-of-pocket medical expenses not covered by insurance. For a list of eligible Medical FSA expenses, view IRS Publication 502.

Limited Purpose Medical Flexible Spending Account (LPFSA): an account that provides pre-tax reimbursement of qualifying out-of-pocket expenses related to preventative care, dental, and vision expenses not covered by insurance.

Dependent Care Reimbursement Account (DCRA): an account that provides pre-tax reimbursement of dependent care expenses (e.g. daycare) incurred by eligible dependents.

What are the general features and tax benefits of an FSA?

  • Your contributions are pre-tax or tax-deductible*
  • Tax-free withdrawals are made to pay your out-of-pocket expenses related to healthcare and dependent care
  • Because of these tax advantages, the more you use your FSA, the more money you could save. The amount of savings will depend on your personal tax rate.

*Contributions are tax-deductible on your Federal tax return. Some states do not recognize FSA contributions as a deduction. Consult a qualified tax adviser for advice.

Why should I enroll in an FSA?

With an FSA, your out-of-pocket health and/or dependent care expenses are paid with tax-free dollars. You can save an average of 30% on all of your eligible expenses.

Whose expenses can I claim under my FSA?

You can use your FSA to pay for eligible expenses incurred by any of the following individuals:

  • yourself
  • spouse
  • qualifying child
  • qualifying relative

New rules allow a dependent to be eligible for the plan even when that dependent does not qualify to be claimed as your tax dependent on your tax return. Optum recommends that you check with your tax advisor before you make your election for the plan year.

What are eligible Medical FSA expenses?

Qualified medical expenses can be found in IRS Publication 502.

Due to frequent updates to the regulations governing FSAs and HSAs, this list does not guarantee reimbursement but instead is to be utilized as a guide for the submission of claims.

If you have any questions, please contact Optum Consumer Services at 877-470-1771 (Monday through Friday, 8:00 a.m. to 8:00 p.m. ET) or via e-mail at

Can I change my Flexible Spending Account (FSA) election mid-year?

Certain qualifying events allow employees to increase/decrease their election or begin/cease participation in a plan. Common qualifying events can be found on the FSA Status Change Form and include marriage, divorce, birth, death, or a change in the cost of dependent care.

The adjustment to the election must be consistent with the event. For example, an increase in the cost of daycare would not allow you to decrease your election (although if the increase made the cost of care unaffordable, one could justify no longer participating in the plan).

Please refer to your employer's Plan Document for further guidance on qualifying status change events applicable to your plan.

To request an election change, complete and submit the FSA Status Change Form to your employer. To download the form, and visit the Forms tab.

Am I eligible to participate in a Dependent Care Reimbursement Account (DCRA)?

You are eligible for this benefit if you have a dependent (whose expenses are eligible) who requires care to enable you to work. In addition, you must meet one of the following eligibility criteria:
  • You are unmarried
  • Your spouse works, is a full-time student, is actively seeking work, or is disabled (incapable of self-care)
  • You are divorced or legally separated and have custody of your child even though your former spouse may claim the child for income tax purposes. Your Dependent Care FSA can be used to pay for child care services provided the period the child resides with you.

Important Notes: Expenses are treated as having been incurred at the time the medical care was provided, not when you are formally billed, charged, or pay for the medical expenses. You cannot receive reimbursement for future or projected expenses. All submitted expenses are reviewed for eligibility according to Internal Revenue Code Section 125 guidelines.

What are eligible DCRA expenses?

Eligible expenses are daycare expenses for eligible dependents (see below) that are incurred so you and your spouse can work. To qualify, you and your spouse must be employed, or your spouse must be a full-time student.

If you're married and you file a joint return, or you file a single or head-of-household return, the annual IRS limit is $5,000. If you're married and file separate returns, you can each elect $2,500 for the calendar year.

Eligible dependents include:

  • Children under age 13 who are claimed as a dependent for tax purposes
  • Care of a disabled spouse or disabled dependent of any age

Ineligible expenses:

  • Costs already claimed as a dependent care tax credit on your income tax return
  • Nursing home, respite care or other residential care centers
  • Services provided by one of your dependents
  • Nighttime babysitting expenses that are not work related
  • Expenses while absent for work for more than two weeks at a time
  • Costs paid to your own dependents, under age 19, who are caring for your dependents
  • Expenses paid for schooling for kindergarten or higher

What is automatic dependent care reimbursement?

Automatic dependent care enables participants to be automatically reimbursed for dependent care expenses by filling out one form instead of filing multiple claims throughout your plan year.

Automatic dependent care works in one of two ways:

If the cost of child care per month meets or exceeds your monthly payroll deduction, reimbursement will be issued as payroll deductions post to your Dependent Care Reimbursement Account.

If the cost of daycare is less than your monthly payroll deductions, reimbursement will be made once per month at the end of the month.

To set up automatic dependent care reimbursement, complete the FSA Automatic Dependent Care Request Form. To download the form, log into your account and visit the Forms tab.

The FSA Automatic Dependent Care Request Form needs to be completed each plan year. Changes can be made at any time by submitting an updated FSA Automatic Dependent Care Request Form.

Can I use both the tax credit and the Dependent Care Reimbursement Account?

Maybe. If you have two or more qualified dependents and pay more than $5,000 per calendar year in daycare expenses, you can take the remaining amount and apply it toward the tax credit maximum. Based on your family's income level, you'll receive a credit for a percentage of that amount. For example, if your family's income is $33,000 a year, you have two dependents, and you spent $7,000 in childcare expenses, you would be eligible to take an additional tax credit of $250 ($1,000 x 25% tax credit percentage based on income level).

Where can I use my Optum Payment Card?

Optum Payment Cards can be utilized at healthcare-related merchants, such as hospitals and vision, dental, and doctor's offices. It can also be used at drugstores, pharmacies, and grocery stores that have implemented the IIAS (Inventory Information Approval System) or certified 90% of their gross sales are FSA eligible (see "Useful Links & Resources" on our website).

As always, save itemized receipts, bills, or statements any time the Payment Card is utilized.

The Payment Card may also be used at daycare providers that accept MasterCard or Visa and have a valid merchant category code signifying they are a daycare provider. The Payment Card may not be used if you pre-pay daycare expenses, since the IRS requires the expense must be incurred before reimbursement can be made from your dependent care spending account.

If I don't use my Optum Payment Card for a medical expense, how can I reimburse myself?

If you do not use your Optum Payment Card, you may file claims for reimbursement in two ways:

  • File an online claim. First, log in to your account. Click on the file claim link on your home page and walk through the steps to enter the details of the claim. Once you have filed your claim, you must agree to the terms and conditions and click the Submit button. To complete the reimbursement process, send your confirmation page along with your supporting documentation to us.
  • File your claim using the FSA Reimbursement Request Form (see Forms on our website). Follow the provided instructions to complete this form. Claims and copies of your supporting documentation can be submitted via e-mail, fax, or mail.
Fax number: 888-403-5029
Mail: Optum
 c/o Health Account Services
 P.O. Box 6122 Fargo, ND 58108-6122

Why may I be asked to provide documentation for a Optum Payment Card purchase? Wasn't my payment already approved?

Federal regulations require Optum to obtain itemized receipts for transactions that are not automatically substantiated at the point of sale.

Card transactions can be automatically substantiated without additional paperwork if they are:

  • Co-payment amounts tied to your health plan. These amounts need to be communicated to Optum by your employer.
  • Transactions that match the provider and dollar amount exactly for previously approved transactions (e.g., orthodontia claims, maintenance prescription drugs) and were noted by you as recurring on the request for substantiation notification.
  • Purchases made at merchants using the Inventory Information Approval System (IIAS). (See "Useful Links & Resources" on our website.)

In the event a charge does not meet these three criteria, Optum will send three requests for documentation. These requests are generally sent 5 days, 20 days, and 45 days after the date of purchase and will cease once documentation has been received.

Should a charge remain unsubstantiated 60 days after the date of the card transaction, the benefits payment card will be placed in a temporary hold status. The payment card will be re-activated as soon as the necessary documentation has been received to substantiate the expense.

What type of documentation is acceptable for reimbursement or substantiation?

Documentation for medical FSA expenses required by the IRS includes a third-party receipt or Explanation of Benefits containing the following information:

  • Date(s) of service or purchase made
  • Type(s) of service or name(s) of item(s) purchased
  • Dollar amount(s) (after insurance, if applicable)

For example: an Explanation of Benefits from your insurance company or itemized statements from the provider is excellent documentation.

Documentation for Dependent Care Reimbursement Account (DCRA) expenses required by the IRS includes a third-party receipt containing the following information:

  • Date(s) of service
  • Dollar amount
  • Name of daycare provider

In the event the provider is unable to provide a receipt with this information, he or she may simply sign the FSA Reimbursement Request Form or the confirmation page (if the claim was filed online). To download the form, log into your account and visit the Forms tab

Commonly submitted documentation that results in denials includes:

  • Statements only indicating a paid amount, balance forward or previous balance
  • Credit card receipts only reflecting a payment
  • Bills for dependent care/medical expenses where services have not yet been incurred

When submitting a receipt for a co-payment amount, please be sure the co-payment description is on the receipt. In some cases, you will need to ask for a receipt at the point of service. If "co-payment" is not clearly identified, have the provider write "co-payment" on the receipt and sign it.


Where do I send my documentation?

To ensure efficient processing, include the proper form or letter along with your documentation.

This can be submitted via e-mail, fax, or mail.
Fax number: 888-403-5029
Mail: Optum
 c/o Health Account Services
  P.O. Box 6122
Fargo, ND 58108-6122

What happens to my FSA if I terminate employment?

Participation in the FSA ends if you terminate employment. This means only expenses incurred prior to the date your participation in the plan ends are eligible for reimbursement. Claims for expenses incurred prior to the plan termination date must be submitted within the "run out" period.

What is the "run out" period?

The "run out" is a specified period of time after the end of the plan year, or following your termination in the plan, in which you may continue to submit claims incurred during your period of coverage. This is not a period when you are able to continue to incur new expenses, but rather it allows you time to gather and submit expenses before forfeitures are applied. For example, if your plan has a 90 day "run out" period, you will have 90 days from your date of termination to submit expenses incurred prior to the termination date.

How do I determine the date my expense(s) were incurred?

A service or expense must be incurred before it is eligible for reimbursement. An FSA expense is considered "incurred" when the service is performed, not when you pay for the service. In addition, the service must be performed during your participation in the plan. Services or expenses incurred before or after your plan participation dates do not qualify for reimbursement.

How do I access account information?

Please follow these steps to access your account online:

  1. Go to the Optum home page at

  2. Click the Participant Log In button found on the left side of the page
    • If you are a new user, click the "Create your new username and password" link.
    • If you forgot your username, click the "I forgot my username" link.
    • If you forgot your password, click the "I forgot my password" link.

How do I authorize my spouse and/or another individual to obtain information about my account?

Due to HIPAA regulations, Optum cannot disclose your personal health information (PHI) to any unauthorized representatives.

To authorize an individual or entity to discuss your account detail, complete the Authorized Representative HIPAA Form. To download the form, log into your account and visit the Forms tab. Once authorized via the form, any authorized representatives can discuss account details for one year.

What happens if I do not use all of the money in my account by the end of the plan year?

Generally speaking, money remaining in your FSA at the end of the plan year will be forfeited. This is commonly known as the "use it or lose it" rule. However, some plans may allow you to continue submitting claims beyond the end of the plan period for any eligible expenses you incurred before the deadline. Additionally, some plans may allow you to continue spending your FSA dollars through a defined grace period or allow you to carry over a portion of your remaining balance. Be sure to check your specific plan rules in your Summary Plan Description (SPD) by contacting your HR Department or requesting additional details from Optum Consumer Services.

Is there a daily transaction limit on my card?

There is no daily transaction limit on your card.


What is a Health Reimbursement Arrangement (HRA)?

A Health Reimbursement Arrangement (HRA) is an employer-sponsored plan that can be used to reimburse a portion of you and your eligible family member's out-of-pocket medical expenses, such as deductibles, coinsurance and/or copays. It is a financial reimbursement arrangement funded entirely by your employer that is paired with your medical plan.

What are the tax advantages of an HRA?

Reimbursements made from your employer through the HRA are not considered part of your income and are not taxed.

How do participants benefit from an HRA plan?

The HRA plan benefits participants by allowing them to be reimbursed up to a specified amount each year for certain eligible healthcare expenses. Each dollar that goes into the plan is provided by the employer for the purpose of healthcare expenses, so the benefit is free from federal, state and Social Security taxes.

What are the tax benefits of an HRA?

Contributions made to your HRA are 100 percent employer-funded, free of federal, state and FICA taxes. The distributions for medical expenses are also tax free. An HRA plan may save you money through lower premiums and tax-free medical reimbursements.

Who owns the HRA?

Your employer owns the arrangement and determines the scope of how it is set up and used including the amount you and each employee will receive. The HRA is not portable; if you change jobs, the arrangement and any funds stay with the employer.

Who can contribute to an HRA?

Only your employer can contribute pre-tax or tax-deductible dollars to your HRA.

How can HRA funds be used?

Your employer may decide what types of medical expenses can be reimbursed through the HRA. Typically, reimbursable expenses can include deductibles, copays, coinsurance costs, prescription drugs, or other types of out-of-pocket costs. Contact your employer or check your Evidence of Coverage or summary plan description materials for details about your specific HRA.

How can I be reimbursed for out-of-pocket expenses?

Most HRA programs allow for payment card issuance to provide for a convenient way to pay for qualified expenses. In the event you can not use your payment card, you can file a claim in two ways:

  • File an online claim. First, log in to your account. Click on the file claim link on your home page and walk through the steps to enter the details of the claim.

Once you have filed your claim, you must agree to the terms and conditions and click the Submit button. To complete the reimbursement process, send your confirmation page along with your supporting documentation to us.

  • File your claim using the HRA Reimbursement Request Form (see Forms on our website). Follow the provided instructions to complete this form. Claims and copies of your supporting documentation can be submitted via e-mail, fax, or mail.
Fax number: 888-403-5029
Mail: Optum
 c/o Health Account Services
  P.O. Box 6122
Fargo, ND 58108-6122


What happens if I don't cash my reimbursement check?

We use a positive pay system to ensure only valid reimbursement checks are processed. A file is sent to Optum on a daily basis. Only checks that match the file are processed. Checks remain on the positive pay file for 180 days. An exceptions list is sent to Optum daily showing checks presented for payment that do not match the file.

If I change employers, what happens to my HRA?

If you leave the company or move to a different employer, your HRA does not go with you. Since your employer funds the HRA, your employer owns any amount that remains after you leave. An exception may be if you elect COBRA continuation coverage. Check your plan details for more information.

Do I still need to keep my receipts and documentation for prescriptions and office visits, plus the Explanation of Benefits that are sent to me?

Yes. Throughout the year, you should keep your original receipts and documentation for prescriptions and health-related expenses for all transactions (including payment card transactions), so you'll have them if needed to verify a claim. The IRS requires that all transactions be validated, including the payment card transactions.

In most cases involving payment card transactions, the electronic data we already have will be sufficient to accommodate this requirement. If we need additional documentation, we'll contact you and you'll be asked to provide documentation with receipts. Failure to respond promptly to a request can result in the expense being labeled as 'ineligible', in which case, you would be obligated to reimburse your account. In addition, your payment card could become deactivated.

Is there a daily transaction limit on my card?

There is no daily transaction limit on your card.