HSA Frequently Asked Questions
HRA Frequently Asked Questions
How does an HRA work?
This is how an HRA works:
Your employer sets up an HRA for each participant.
The HRA account is funded entirely by your employer; you don’t contribute any money to your HRA account.
Each plan year, your employer contributes a specified amount to each participant’s HRA. As long as there is money in your account, you can use the funds toward eligible HRA expenses.
Depending on your employer’s plan design, you may roll over HRA dollars that aren’t used during a plan year.
How do I benefit from an HRA?
You will appreciate your HRA because you don’t contribute any money into your account, you also don’t pay taxes on the money in your account or your reimbursed expenses.
What expenses are covered under an HRA?
Eligible expenses are those that you pay for out of your pocket for medical care that’s provided to you, your spouse, and eligible dependents. Generally, IRS rules state that medical care includes items and services that are meant to diagnose, cure, mitigate, treat, or prevent illness or disease. Here are some examples:
- Your health plan deductible (the amount you pay before your plan starts paying a share of your costs)
- Your share of the cost for doctor’s office visits and prescription drugs
- Your share of the cost for eligible dental care, including exams, X-rays, and cleanings
- Your share of the cost for eligible vision care, including exams, eyeglasses, contact lenses, and laser eye surgery
- Some HRA plans allow qualified health insurance premiums as eligible expenses.
- Expenses reimbursed under your HRA cannot be reimbursed under any other plan or program. Only your out-of-pocket health care expenses are eligible for reimbursement. Plus, expenses reimbursed under an HRA may not be deducted when you file your tax return.
Check outEligibleExpensesfor more details.
Are over-the-counter medicines eligible expenses?
Yes, if your plan allows them. However, OTC medicines now require a prescription to be an eligible HRA expense. IRS rules changed on January 1, 2011 because of health care reform legislation. The new rules state that OTC medicines and drugs are no longer eligible for reimbursement under an HRA unless prescribed by a doctor (or another person who can issue a prescription) in the state where you purchase the OTC medicines.
What over-the-counter items are still eligible expenses?
If your plan allows, these items such Band-Aids and thermometers are eligible for reimbursement through your HRA.
What expenses are not covered under an HRA?
- Cosmetic surgery and procedures, including teeth whitening
- Herbs, vitamins, and supplements used for general health
- OTC medicines that you don’t have a prescription for (except insulin)
- Family or marriage counseling
- Personal use items such as toothpaste, shaving cream, and makeup
- Prescription drugs imported from another country
- Expenses that are reimbursed by another plan or program, including a health care plan
- Any other item or service that isn’t used for medical care as defined by IRS rules
What is the maximum amount I can be reimbursed by my HRA?
The maximum reimbursement amount you can receive is equal to your account balance at the time your reimbursement request is processed.
What if an expense is eligible for reimbursement under both my HRA and health FSA?
The answer depends on how your employer designs your plan. If you have both an HRA and a health flexible spending account (FSA), review your Summary Plan Description (SPD) to find out which account pays first. You may not choose which account will cover the expense. Your expense will be reimbursed by the plan that’s set up to pay first, and when the money for that account is depleted, funds from the other account will be used toward future eligible expenses.
Important: Expenses reimbursed under your HRA may not be reimbursed under any other plan or program, including your health FSA – and vice versa. Your HRA and health FSA, while separate accounts, provide reimbursement of qualified medical expenses that are defined by your employer and the IRS. This means you can’t submit a claim for an eligible FSA expense and then request reimbursement for the same expense from your HRA. There’s no “double-dipping.”
How do I request reimbursement?
Just log in to your online account to file a claim for reimbursement.
Appropriate documentation includes:
- For office visits – Your health plan’s Explanation of Benefits (EOB) statement or an itemized receipt or bill from the provider that includes the patient’s name, a description of the service, the original date of service, and your portion of the charge.
- For prescription drugs – A pharmacy statement or receipt including the patient’s name, the Rx number, the name of the drug, the date the prescription was filled, and the amount.
- For over-the-counter medicines – A written or electronic OTC prescription along with an itemized cash register receipt that includes the merchant name, name of the OTC medicine or drug, purchase date, and amount; OR a printed pharmacy statement or receipt that includes the patient’s name, the Rx number, the date the prescription was filled, and the amount.
- For over-the-counter health care-related products – An itemized cash register receipt with the merchant name, name of the item/product, date, and amount.
For qualified insurance premiums – a copy of the insurance premium billing notice AND proof of payment (such as a copy of front and back of check, credit card confirmation, etc.) for qualified insurance policies. Itemized bills must include the name of the insurance provider, name of participant/insured, amount charged, and coverage dates.
Please Note: Credit card receipts, canceled checks, and balance forward statements do not meet the requirements for acceptable documentation unless submitted along with an insurance premium billing notice.
Where can I get a reimbursement request form?
Just log in to your online account and find the form by clicking the Access a Form quick link.
How do I keep track of my account activity?
Your HRA information is available any time day or night by logging in to your online account.
Is there a deadline for submitting claims?
In most cases, yes, there is a time limit for filing claims. Find the details for your plan by reviewing the Summary Plan Description which can be found by logging in to your online account. (SPD).
What if I stop working for this employer?
Your plan participation will end automatically. Expenses for services you have after your termination date typically are not eligible for reimbursement.