Guidelines for Using Your HRA

Guidelines for Using Your HRA

Your HRA is a reimbursement account offered by your employer as part of your benefits package. Your employer sets up and funds the account to reimburse you for your eligible out-of-pocket health care expenses.

Each plan year (or other designated period of coverage) your employer contributes a specified amount to your HRA — you cannot make an additional contribution. You are not taxed on the value of your HRA or the reimbursements you receive from the account.

Participation in a health reimbursement arrangement is your choice. If you decide to use the account, you must satisfy any HRA eligibility requirements set up by your employer. Your employer will provide a Summary Plan Description (SPD) that gives the complete rules and regulations for your HRA plan.

Please review the following information so you are aware of the rules that apply to your HRA. Use the links below to navigate to a specific section.

IRS Regulations

Health reimbursement arrangements are regulated by IRS rules. These rules require WageWorks to review your HRA reimbursement requests. You must keep all receipts and other supporting documentation that verify your HRA eligible expenses.

Eligible HRA Expenses

Only eligible expenses can be reimbursed under the HRA. These expenses are defined by Internal Revenue Code § 213(d) and your employer's plan. You can use your HRA funds throughout the coverage period to pay for eligible HRA expenses.

Important: Since your employer chooses which health care expenses are covered by their plan, your eligible expenses may not be the same as those listed on our HRA Eligible Expenses page. Check your employer's Summary Plan Description (SPD) for eligible expenses under your HRA plan.

Generally, eligible expenses include items that are meant to diagnose, cure, mitigate, treat, or prevent illness or disease. This also includes transportation for medical care. Expenses such as cosmetic surgery, personal grooming products, vitamins, and items for general well-being are not eligible expenses.

As you may know, health care reform impacted HRAs, including the eligibility of over-the-counter (OTC) medicines and drugs. OTC medicines are only eligible expenses if prescribed by a doctor (or another individual who can legally issue a prescription) in the state where you purchase the OTC medicines.

Depending on your employer's plan, HRA expenses may be incurred by you, your spouse, or your eligible dependents during an eligible period of coverage and while you are an active participant in the HRA plan. Medical care expenses are incurred when you (or your spouse or dependents) are provided with medical care that gives rise to the expenses — not when you are formally billed, charged for, or pay for the medical care.

Only qualified "out-of-pocket" expenses are eligible for reimbursement. Expenses previously reimbursed by your HRA or covered by any other plan or program, such as an FSA, are not eligible for reimbursement. There's no "double-dipping" allowed. If you are enrolled in both an HRA and an FSA, refer to your Summary Plan Description for rules outlining which account pays first.

Expenses reimbursed under your HRA may not be used to claim any federal income tax deduction or credit.

Reimbursement Requests

The maximum reimbursement amount that you can receive is equal to your account balance at the time your reimbursement request is processed. Any portion of a reimbursement request that is over the maximum reimbursement amount will pend until your account balance can cover the expense.

Example: Your HRA plan year begins in January and your employer contributes $100 each month. In February, you have $200 in your account, but you incur an expense for $300. If you submit a reimbursement request that same month, you will be reimbursed for $200 of the expense, and you will receive the additional $100 when your employer puts the $100 March contribution into your account.

A Request for Reimbursement Form is used to submit a reimbursement claim. The expenses listed must be incurred by you, your spouse, or eligible dependent during the coverage period and the dates noted on your supporting documentation.

After you complete the Request for Reimbursement Form, submit it to WageWorks along with appropriate supporting documentation.

Supporting Documentation

  • For office visits and other services — Your health plan's Explanation of Benefits (EOB) statement or an itemized receipt or bill from the provider that includes the patient's name, a description of the service, the original date of service and your portion of the charge.
  • For prescription drugs — A pharmacy statement or receipt from your pharmacy including the patient's name, the Rx number, the name of the drug, the date the prescription was filled, and the amount.
  • For over-the-counter medicines — A written or electronic OTC prescription along with an itemized cash register receipt that includes the merchant name, name of the OTC medicine or drug, purchase date, and amount, OR a printed pharmacy statement or receipt from a pharmacy that includes the patient's name, the Rx number, the date the prescription was filled, and the amount.
  • For over-the-counter health care-related products — An itemized cash register receipt with the merchant name, the name of the item/product, date, and amount.
  • For insurance or Medicare premiums — For insurance premiums — a copy of the insurance premium billing notice AND proof of payment (copy of front and back of the check, credit card confirmation, etc.) for qualified insurance policies. Itemized bills must include the insurance carrier name, participant name, the amount charged, and coverage dates.

Credit card receipts, canceled checks, and balance forward statements do not meet the requirements for acceptable documentation.

For some expenses, a Medical Determination Form from a doctor may be required. See our Eligible HRA Expenses page.

Find a Request for Reimbursement Form and a Medical Determination Form by logging in to your online account.

Submitting Reimbursement Requests

Submit your reimbursement requests these ways:

  1. MyWageWorks® app — The easiest way to submit a reimbursement request is by using your smartphone or tablet to upload a photo of your supporting documentation. Visit our Mobile Services page for details on how to get this app!
  2. Online — Log in to your online account, download and complete a reimbursement form, and then upload your supporting documentation. You will need access to a scanner to do this.
  3. Fax — Submit your completed reimbursement form and supporting documentation using the fax number listed on the form.
  4. Mail — Send in your completed reimbursement form and copies of your supporting documentation using the address noted on your form.

Maximum Amounts and Capped Funds

Your employer decides the maximum annual contribution to your HRA and may apply an account cap, or limit, to the funds that can accumulate in your account. If you have an account cap, no additional contributions will accrue until the account is used or the account balance falls below the capped amount. Refer to your Summary Plan Description (SPD) for additional details.

Important: Keep track of your real-time account balance and your HRA claims and payment activity through your online account.

Unused and Rollover HRA Funds

Generally, HRA funds are not forfeited at the end of the plan year and may be rolled over to the following year. However, this feature is not available for all HRA plans. Your employer decides if this option applies to your plan.

If your HRA plan includes fund rollovers, your employer may only allow a specified amount to carry over. If your plan does not allow fund rollovers, the HRA balance cannot be cashed out, rolled over into another plan, or accessed for any purpose other than reimbursement of eligible health care expenses. Find specific details in your Summary Plan Description.

If you terminate your employment during the plan year or you otherwise cease to be eligible under the plan, your active participation in the HRA plan will end automatically. Expenses incurred after your termination date are not eligible for reimbursement.

However, some HRA plans include a "spend-down" provision that allows HRA participants to submit eligible HRA expenses, incurred during a specific time frame, after termination. This assumes participants continue to meet all other requirements. The spend-down feature is not available for all plans, so refer to your Summary Plan Description for specific details related to your plan.

Important: You may be entitled to elect COBRA continuation coverage under the HRA and receive reimbursement for eligible HRA expenses incurred after your termination. You must be eligible and make the required COBRA premium payment. Find further details in your Summary Plan Description.

Important: The information on the WageWorks website provides basic information regarding participation in your employer's HRA plan. Our site does not contain all of the rules that are specific to governing your employer's plan. For complete rules and plan information, review your plan's Summary Plan Description. Ask your HR or benefits representative for details.