Am I required to submit documentation for every HCFSA claim or Benefits Debit Card transaction?

Yes, all HCFSA expenses are required by the Internal Revenue Code (IRC) regulations to be substantiated and adjudicated. This means documentation in the form of itemized receipts, third-party statements, or an explanation of benefits (EOB) must be provided and reviewed for eligibility. 

We request this documentation to comply with the Internal Revenue Code (IRC) regulations.

To be reimbursed for an expense, documentation must accompany your reimbursement claim form. Documentation will be reviewed to determine if the expense is eligible. If the expense is eligible, your reimbursement will be processed with either a check or direct deposit being sent to you. (If you submit your request online, “pay the provider” is an option.)

When a Benefits Debit Card is used for an expense, some of the transactions may have processes that handle substantiation and adjudication automatically. Because not all Benefits Debit Card transactions have the automated process, retain your expense documentation to submit upon request.

When you will not need to submit documentation: When your Benefits Debit Card is used for an eligible expense at a merchant with the Inventory Information Approval System (IIAS), the details needed to verify and approve the transaction will automatically be provided. This will also occur when a Benefits Debit Card transaction is for a dollar-amount co-pay that matches a co-pay in our system provided by your employer or when there is a recurring expense that you have already properly documented. No further documentation will be required.

When you will need to submit documentation: When you pay for an expense out-of-pocket and submit a reimbursement claim online, through our mobile app, or via mail or fax, documentation must be included for the eligibility of the expense to be verified. When your Benefits Debit Card is used for an expense, and it is not at an IIAS-merchant, is not a matching co-pay, and is not a recurring expense – an itemized receipt or documentation must be provided for the eligibility of the expense to be verified. Keep in mind, the date of service must be within the plan year (or grace period, if applicable).

Learn more: Why is Substantiation Required for Certain Debit Card Expenses?