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Do I need to submit anything else with a claim?

Yes, an itemized bill, receipt, or Explanation of Benefits (EOB) from the provider must be included, showing the following:

  • Patient name
  • Provider name
  • Type of service
  • Date(s) services were provided, and
  • Amount you were charged, or your cost after insurance settlement.

Account statements must include all of the above bulleted items, for each expense, if they are to be used instead of a receipt. Over-the-counter (OTC) drugs and medicines can be paid for or reimbursed through a Health Care FSA without a doctor's prescription. Certain eligible expenses also require a Letter of Medical Necessity, signed by your doctor, in order to receive reimbursement.