Employees often ask whether they can file a claim with their HSA for expenses that have already been partially reimbursed by insurance.
The answer is yes. Here are some quick examples of eligible claims:
Co-payment amounts such as 20% of a prescription cost or a dental expense that may have fallen outside of an insurer's reasonable and customary limits.
Eligible expenses that may have been exhausted under the core plan. For example, an employee has used up their annual limit for massage. They can submit the cost of additional massages to their HSA
Many benefits programs no longer cover the cost of prescription eyewear, so those claims can be submitted to the core plan, but may not be covered at all.
Below please find a quick guide to the proper documentation and knowing how to coordinate benefits to ensure that an employee is not inadvertently committing benefits fraud:
Use insurance first: HSAs are always secondary to any insured program whether it is an employee's spouse's program, your own organization's HSA, or more than one program, insurance must be used first.
Provide an Explanation of Benefits (EOB): When submitting a claim that was or could have been covered by insurance, upload a copy of the explanation of benefits provided by the insurance company. It explains what was submitted, what was covered, and what is eligible under the HSA.
Use the "amount not covered by insurance" expense type in the system and the system prompts you to include the EOB. The original receipt should also be included.
Questions? Reach out to support@getmyHSA.com for more information.
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