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Get Reimbursed for Expenses with an HRA
A health reimbursement arrangement (HRA) is a tax-favored, employer-sponsored account that you can use to pay for qualified medical care expenses not otherwise reimbursed by your employer’s health plan. The HRA is a fully-funded, employer-sponsored benefit. You do not contribute to it. Your employer will determine what items your HRA can pay for, but generally, the type of things that an HRA might be used for would include:
And we make it easy to do! With our medical claims integration feature, an option available through your employer, CDPHP can pay claims directly to the provider out of the HRA – leaving you with less paperwork and no hassles!
When your HRA includes the CDPHP integrated claims feature, your payment of medical claims is automated. When you get care that is billed to CDPHP, payment will automatically be deducted from your HRA and sent to your provider on your behalf.
If your HRA is designed to pay for dental care and/or prescriptions, you may have a debit card to pay for those services.
To be reimbursed for claims that you paid for out-of-pocket, you will need to complete a claim form and send it in to be reimbursed. Download the HRA Claim Reimbursement Form.
Can I submit a claim for a medical service prior to paying for it?
No, the service must be rendered before you can request payment.
How do I know how much is contributed to my HRA each plan year?
At the beginning of each plan year, your employer will notify you of the amount they will contribute to your HRA for that plan year.
How do I submit an expense for reimbursement?
You may download a form here, complete it, and mail it to:
CDPHP Health Funding, P.O. Box 6130, Albany, NY 12206-0130.
Or, submit your form via secure email when you log into the member site at www.cdphp.com.
What supporting documentation do I need to submit with my claim form?
Your supporting documentation must include:
• Name of provider
• Date of service/date product was purchased
• Type of service/product (drug name required for prescription claims)
• Your out-of-pocket expense for the service/product (amount not otherwise reimbursed)
• Name of employee or dependent for whom the service/product was provided
Do I need to send original documentation with my reimbursement request form?
Copies of statements, bills, or receipts are sufficient.
Can I use my HRA to pay for over-the-counter (OTC) drugs?
In order to be eligible for reimbursement under your HRA, an OTC remedy would have to be prescribed by your doctor. Take the prescription to the pharmacy counter of a participating retail store when you buy the item. A prescription number must be assigned to the purchase. This way, your original purchase and refills (if any) will be eligible for payment for the item with no further need for substantiation.
What happens if I use my HRA to pay for an item or service that was already covered by another source?
This practice, known as “double-dipping,” could have serious tax implications and/or result in the revocation of your health funding arrangement. By using your HRA, you are agreeing that you have not been and will not be reimbursed from any other source for those expenses. If you are covered by another form of insurance in addition to CDPHP, please let us know by completing a coordination of benefits form, which can be found here.
What happens to any amount left in my HRA that I do not use by the end of the plan year?
Unused fund balances may be carried over to the next coverage period depending on your employer’s plan design. The amount of the carryover is determined by your employer’s plan design.
Will I get a new debit card at the start of each new plan year?
No, assuming that your plan doesn’t change and you remain eligible for the benefit, your card is good for three years.
Can my spouse or dependent use my debit card?
Yes, as long as your spouse or dependent is on your insurance plan, per your HRA Plan Document. If you would like a covered spouse or adult dependent to have his or her own debit card, please complete a Debit Card Request form. Please note that you will be limited to receiving one additional card.
What do I do if my card is lost or stolen?
Call the CDPHP Health Funding Department at (518) 641-3770 or 1-877-793-3960. They will deactivate the old card and reissue you a new one.
Can I send in claims for my card transactions?
No. Because you have already used your account by paying with your card, you cannot receive reimbursement again from your account for the same service.
What do I do if the card is accidentally used for ineligible expenses?
If this happens, please contact the CDPHP Health Funding Department at (518) 641-3770 or 1-877-793-3960. Your debit card may be deactivated and you may need to send in an overpayment check to reimburse your account.
Where can I learn more?
Log in to the secure member site to learn more about using your HRA. If you have questions that you can’t resolve by reviewing the resources online, don’t hesitate to call the CDPHP Health Funding Department at (518) 641-3770 or 1-877-793-3960.
Why do I need to provide documentation for debit card purchases?
Federal regulations require CDPHP to obtain itemized receipts for transactions that are not automatically substantiated at the point-of-sale. In the event a charge does not meet the necessary criteria, CDPHP will send a request for documentation. If you are unable to substantiate questionable debit card expenses, the card will be frozen. The debit card will be reactivated as soon as the necessary documentation has been received to substantiate the expense.
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