File a Flexible Spending Account
Reimbursement Claim

The fastest way to file a Flexible Spending Account (FSA) claim is through your online account or the mobile app, AFmobile®. Download AFmobile from the Apple App Store or Google Play Store.

Healthcare FSA or Limited Purpose FSA Claim

When using your Benefits Debit Card or paying out of pocket, you must provide documentation for each eligible expense, such as an itemized receipt or Explanation of Benefits (EOB).

Also, eligible Healthcare FSA and Limited Purpose FSA expenses for you, your spouse, or other eligible dependents must be incurred during the plan year. For specific plan information, log in to your online account.

Required Documentation

For a doctor visit or medical procedure, documentation should include:

  • Original date of service
  • Type of service rendered (checkup, physical, surgery, etc.)
  • Charges for the service
  • Provider of the service (physician name or facility)
  • Recipient of service

For drugs and medication, documentation should include:

  • Copy of the physician’s prescription for over-the-counter drugs and medication
  • Receipt or documentation from the pharmacy showing the prescription number and date filled

Learn How to Unblock Your Card 

Dependent Care Account Reimbursement Claim

Eligible services must be received and paid for before filing for a Dependent Care Account (DCA) reimbursement.

Required Information

When filing a DCA claim, you must provide the following during the claim process:

  • The tax ID of the care provider, or
  • The individual Social Security Number of the care provider

View a List of DCA Eligible Expenses 

FSA Store

FSA Store

You may purchase FSA-eligible items online at the FSA Store. Browse medical supplies, over-the-counter medication, prescriptions, and more.

Visit FSA Store

Need help?

If you have questions about your reimbursement account, log in to your online account or visit the support section.

If you need to file a paper claim, download and print a claim form here.
NOTE: Paper claim filing is not the fastest option. File a claim online or through AFmobile to get your money faster.