Answers on eligibility
Want to know if your expense is eligible? Use our app to scan a barcode, in-store or anywhere else.
Now it’s easier than ever to manage your PayFlex account on the go. With the PayFlex Mobile app, you can access your account anytime, anywhere. It gives you the info you need, when you need it.
Want to know if your expense is eligible? Use our app to scan a barcode, in-store or anywhere else.
Not sure how much you have to spend? Check the app and view your balance in just a couple of taps.
Need to file a claim? Use the app. Enter your claim details, take a picture of your itemized receipt, statement or Explanation of Benefits and submit. It’s that easy.
Spending money in your account is easy with the PayFlex Card. Use it for eligible health care expenses, such as doctor and dentist visits, prescriptions, hospital stays, hearing and vision care.
Be sure to review your plan to find out exactly what’s eligible. And enjoy all the PayFlex Card has to offer.
You can use the card to pay for eligible expenses. Payment happens right away if you have funds in your health savings account (HSA), flexible spending account (FSA) or health reimbursement arrangement (HRA).
Using your card means you don’t have to pay out of pocket. That’s money you can spend on other things you might need.
You won’t have to submit a claim for your PayFlex Card expenses or wait for reimbursement. However, you should keep all your itemized receipts, statements and Explanations of Benefits (EOBs). We may ask you to submit documents later to verify your expense is eligible.
Simply choose your eligible expense item and swipe your card to pay from your PayFlex account. If your health plan is covering part of the expense, wait to use the card until you know how much you owe.
The PayFlex Card is your account debit card. It helps make it easier for you to spend the money in your PayFlex account. You can use this card to pay for certain eligible expenses.
Eligible expenses may include doctor and dentist visits, hospital stays, prescriptions, and hearing and/or vision care. Or your plan may only allow prescription expenses. Be sure to review your plan to determine what’s eligible.
Some employers may also offer the PayFlex Card with a dependent care FSA. In order for your card to work, the merchants and providers must accept Mastercard®.
There are four key benefits to the PayFlex Card.
You can use your PayFlex Card to pay for eligible health care products and services. If you have a health care FSA, you can use your card for eligible expenses that you incur during the plan year. If you have an HSA, you can use the card for eligible expenses that you incur after your HSA is opened.
You can only use the card at merchants and providers that accept Mastercard® and health care cards. This generally includes doctor and dental offices, hospitals, pharmacies, and hearing and vision care centers. You can also use your card at some discount and grocery stores. If your health plan is covering part of the expense, you may want to wait to use the card until you know how much you owe. When you’re ready to pay for an eligible expense, simply provide your card for payment.
You should always keep all your itemized receipts and Explanations of Benefits (EOBs). There may be times when we ask you to show that a card purchase is eligible.
Your card is good for five years as long as you’re a PayFlex member. You don’t need a new card when you move from one PayFlex plan to another. Your election amount is simply deposited into your account and available on your card.
No. You don’t need to use your card for all eligible expenses. You can always use another form of payment for your expenses and submit a claim to pay yourself back. You can do this online, through the PayFlex Mobile® app, or complete a paper claim form and fax or mail it to us.
You can use your card at qualified merchants where Mastercard® is accepted, and where merchants can process health care cards. This may include doctor and dental offices, hospitals, pharmacies, and hearing and vision care centers. You may also use your card at some discount and grocery stores.
If you receive a new card, call the number listed on the activation label. Then enter your card number followed by the # sign. You’ll then enter the last four digits of your Social Security number (SSN). If your SSN is not accepted, you may need to enter the last four digits of your Employee ID number. Once you finish these steps, your card will be activated.
If the merchant or provider allows you to select “debit” or “credit,” either option will work. This means you may choose “credit” and sign the receipt. If you select “debit,” you’ll need to enter a Personal Identification Number (PIN). To create or change your PIN, call 1-888-999-0121.
Call Card Services at 1-888-999-0121. You’ll be asked to enter your card number, the three-digit security code (located on the back of your card) and your five-digit zip code. Then you must enter a new four-digit PIN. To do this, enter four digits of your choice. To confirm your PIN, re-enter your four digits. Once you create your PIN, you can use it right away.
Please make sure to remember your PIN, as you won’t receive a confirmation of it.
No. The card won’t work at an ATM. And you can’t get cash back with your card. You can only use the card to pay for eligible expenses.
There’s more than one reason why you may not be able to use your card.
If you’re unable to use your card, you can use another form of payment. If your expense is eligible, you can submit a claim to pay yourself back. You can do this online, through the PayFlex Mobile® app, or complete a paper claim form and fax or mail it to us.
You may be able to use your PayFlex Card® to pay for OTC items, supplies, drugs and medicines, if they’re considered eligible under your plan.
If you don’t have enough funds in your account, you PayFlex Card will be denied. You could check your balance and ask the merchant to charge your card just for the amount that you have available. Then you would pay the balance with another form of payment. If funds become available in your account, you can pay yourself back by submitting a claim.
Generally, we send a request for documentation when we’re unable to verify if one or more of your card purchases is eligible. This can happen when the amount you paid doesn’t match your copay amount or you paid an “estimated” or “pending” amount. It can also happen when we receive a description of the expense from the merchant or provider that doesn’t clearly tell us what you paid for. All you need to do is send us documentation that shows the following:
We’ll let you know in the letter the date that we need you to respond. If you don’t respond by this date, we’ll have to suspend your card. While your card is suspended, you can’t use it for that account. However, you can still pay for eligible expenses out of pocket and submit a claim to pay yourself back.
You have three options:
If your expense went through your medical or dental plan, you’ll need to send an Explanation of Benefits (EOB) from your plan. This is the best form of documentation.
If your expense didn’t go through your medical or dental plan, you can send an itemized receipt or statement for the expense. It must show:
Generally, we won’t ask you to send information for your prescriptions. But if we do, send your prescription drug receipt that includes the pharmacy name, patient name, prescription name, date the prescription was filled, and the amount you paid.
Note: We can’t accept a cancelled check, credit card receipt, or billing statement that shows “previous balance,” “balance forward,” “estimated,” “filed,” or “pending insurance.”
You’ll want to provide the documentation or payment as soon as possible. We’ll let you know in the letter, the date you need to respond. If you don’t respond by that date, we’ll have to suspend your card. While your card is suspended, you can’t use it for that account. However, once we confirm that the amount you paid was for an eligible expense or receive your re-payment to cover the expense, we’ll re-activate your card.
Call us as soon as possible to report a lost or stolen card. We’ll then cancel your card and send you a new one.
If you’re worried about identity theft after cancelling your card, you can use Mastercard’s Identity Theft Resolution Services at no cost. They can assist you with the process of restoring your identity. Identity Theft Resolution Services include:
To learn more about the Identity Theft Resolution Services, call the Mastercard Assistance Center at 1-800-MC-ASSIST (1-800-622-7747).
Note: This information is general in nature for informational purposes only. Please refer to your employer’s plan for specific information about your plan.
No. There’s no fee to download the app. Anyone with a PayFlex account can use it for free*.
*Standard text messaging and other rates from your wireless carrier still apply.
You’ll use the same username and password you use for the PayFlex member website. If you haven’t set up your online account with PayFlex, you can get started today.
Click on Trouble logging in? on the log in page of the app.
If you have a PayFlex FSA or HRA, you can use the app to submit a claim to pay yourself back for an eligible expense you paid out of pocket. After you log in to the app, select Manage to get started. To send documents with your claim, simply take a picture and upload it through the app.
If you have a PayFlex HSA, you can transfer funds through the app. After you log in to the app, select Manage to get started. You can deposit funds into your HSA or request funds from your HSA.
Yes. Here are a few of the ways we make your security our priority:
Give us a call. If your issue is account related, you can get help via your online account.
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