Limited Purpose Flexible Spending Account
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A Benefits Debit Card allows you to pay for eligible medical expenses. Remember, if you have elected an LPFSA, your expenses would be limited to those related to dental and vision. So, if your employer has elected to offer the Benefits Debit Card, you may use the Card for dental and vision expenses only. 

Please note – if you use your Benefits Debit Card to pay for eligible dental and vision expenses, you must submit a receipt* for every transaction.

If you have a Benefits Debit Card, you may use it at dental and vision offices.

Additionally, many merchants also accept the card. To view a list of participating stores, visit Sigis Store Locator. If you have an LPFSA, you will only be able to use the card for dental and vision expenses.

Log in to your online account and select Access My Reimbursement Account. Then, click the Card icon in the top navigation bar. Next to the lost or stolen card, click Report Lost or Stolen. Once complete, you will have the option to order an additional card.

Request a New Card

If you received a notification or letter in the mail requesting documentation but failed to provide it to American Fidelity, your Benefits Debit Card will be temporarily blocked.

Learn How to Unblock Your Card 

If you have both an LPFSA and an HSA, you may use your red Benefits Debit Card for both accounts. Eligible vision and dental expenses will be deducted from LPFSA first, since those funds expire at the end of your plan year. When your LPFSA funds have been used up, your HSA funds will be deducted.

If you have an unsubstantiated LPFSA claim, your card will remain blocked for all accounts—including your HSA—until approved documentation is submitted.

Learn How to Unblock Your Card 

The Internal Revenue Code (IRC) regulations have requirements stating that expenses must be substantiated using itemized receipts, third party statements, or an Explanation of Benefits. To comply with IRC guidelines, we request documentation of your expense to verify the eligibility of the purchase.

Your documentation should include:

• Itemized receipts for an expense
• Original date of service
• Description of service rendered or expense
• Charges for the service or expense
• Provider of the service or expense
• Recipient of the service or expense

You will receive a request for documentation via mail if you used your Benefits Debit Card to make a Limited Purpose FSA purchase, or if you submitted an out of pocket reimbursement claim without a receipt. You also may receive this letter if the documentation you submitted wasn’t sufficient.

These letters are sent the day after a purchase is made or when the claim is reviewed and determined to be missing documentation or containing insufficient information. So, when receiving this letter, you may have already submitted the necessary documents.

You will receive this letter if your Benefits Debit Card was used for an expense incurred outside the plan year, an ineligible expense, or if the documentation you submitted was insufficient.

When the documentation cannot be provided or the expense is ineligible, you have three options:

• Submit a different itemized receipt to offset the transaction amount.
• Contact American Fidelity to make a credit card payment.
• Submit a check in the amount of the transaction to be applied to your Healthcare FSA account.

The fastest way to file a reimbursement claim is through your online account, or on our mobile app, AFmobile^®.

• Online
  1. Log in to your online account
  2. Click on the Access My Reimbursement Account button
  3. Choose Add Claim from the Claims dropdown
  4. Complete the claim form
  5. Click the Submit button
• AFmobile
  1. Touch the Submit Reimbursement button on the AFmobile dashboard
  2. Complete the Claim Form
  3. Click the Submit button
• Fax or Mail
  1. Download and complete a Healthcare FSA and HRA Reimbursement Claim Form and include all applicable receipts and documentation. Please note, paper claim filing is not the fastest option. File a claim online or through AFmobile to get your money faster.

Eligible expenses generally must have been incurred during the current plan year. Log in to your online account or check with your employer for specific rules applicable to your plan.

Once your claim and all required documentation have been received, the turnaround time for claims processing is generally 5-7 business days.

The fastest way to receive your reimbursement is through direct deposit. Enroll in direct deposit online by logging in to your online account, navigating to your Reimbursement Account portal, and selecting My Profile. Or, you may also elect to receive a mailed check.

 You may view your account information at any time by logging in to your online account. Then, select Access My Reimbursement Account and click Claims Activity.

You can also view your account information from our app, AFmobile^®. You will be able to view your account balance from the dashboard, or, click on your reimbursement account to view a complete transaction history.