Please see your benefit plan documents to find out which health care expenses are eligible under your HRA. If you have a Flexible Spending Account (FSA) or Health Reimbursement Account (HRA), you can submit your claim and eligible expenses.To determine if the FSA expenses you wish to submit are eligible, check the list below. If you have elected a debit card, you will determine the order in which expenses are paid. To determine if the expenses you wish to submit are eligible, follow Your HCSA also pays for dental and vision expenses.

If your MRA has been exhausted, the plan will look at your HCSA and use any available funds If you are covered under the JPMorgan Chase Medical Plan and you haveĮlected automatic claim payment, your MRA is the first source of payment for medical and prescriptionĭrug expenses. These SNP plans provide benefits beyond Original Medicare, and may include transportation to medical appointments and vision exams. UnitedHealthcare Dual Complete Special Needs Plans (SNP) offer benefits for people with both Medicare and Medicaid. Use this form when you pay for a covered expense out-of-pocket and you want to request reimbursementįrom your MRA, HCSA, or DCSA. UnitedHealthcare Dual Complete® Special Needs Plan. Employers may choose to limit which expenses they allow under their HRA plans.

To determine if the FSA expenses you wish to submit are eligible, check the list below. If you have a Flexible Spending Account (FSA) or Health Reimbursement Account (HRA), you can submit your claim and eligible expenses.

United healthcare timely filing form