Eligible Medical Expenses
This article applies to you if you have a Via Benefits reimbursement account (sometimes known as a Health Reimbursement Arrangement).*
Generally, IRS Tax Code 213(d) determines which expenses are eligible for reimbursement. (For more information, refer to IRS publication 502.) However, your former employer may choose not to include all 213(d) expenses as eligible for reimbursement from your reimbursement account. Each employer sets its own rules regarding which expenses qualify.
You can find details about your specific eligible expenses by:
Viewing your summary plan description (SPD)
Viewing your reimbursement account
Go to your reimbursement account.
Select the HRA tab (The name may vary depending on your former employer).
Select View Eligible Expenses.
Contacting Via Benefits
Referring to the Reimbursement Guide Via Benefits sends you within two weeks of your plan's effective date
If you believe an expense may be reimbursable based on the available information, submit a reimbursement request. For instructions, read Submitting a Reimbursement Request. Your request will be processed and either paid, not approved, or denied, according to the rules of your reimbursement account. If the request is not approved, you can send us additional documentation to have your request reprocessed. If it’s denied, no further action is necessary.
If you need tax advice, please consult a qualified tax professional.
Eligible Expenses
Premiums
Your funding program may allow reimbursement of eligible premium expenses, up to the amount available in your reimbursement account. As long as the premium is an eligible premium, you can apply your available funds toward post-tax premium expenses incurred while you're eligible for your funding program.
In most cases, you will pay your insurance premiums directly to the insurance carrier each month and then submit a request for reimbursement.
Medical
Medicare Supplement (Medigap)
Medicare Advantage
Individual and Family Plans (Marketplace plans)
Short-Term Medical
Hearing
Medicare Parts A and B
Prescription Drug
Dental
Vision
Long-Term Care
Out-of-Pocket Expenses
Your funding program may allow reimbursement for eligible out-of-pocket healthcare expenses, up to the amount available in your reimbursement account. Out-of-pocket expenses include copayments, deductibles, and coinsurance. This list provides examples of that are generally eligible for reimbursement under IRS Code Section 213(d).
Medical
Doctor
Chiropractor
Hospital bills
Diagnostic testing
Lab work
X-rays
Physical, occupational or speech therapy
Oxygen and oxygen equipment
Medical equipment and repair
Wheelchair
Walker
Crutches
CPAP equipment and supplies
Vaccinations and immunizations
Transportation expenses for medical care
Ambulance
Personal vehicle mileage
Transportation service
Bus, train, taxi, ride share services, parking
Over-the-counter
Diabetic supplies and testing equipment
First aid supplies
Adult incontinence supplies
Pharmacy
Over-the-counter medicines
Dental
Examination, cleaning, and X-rays
Treatment
Oral surgery
Dentures and implants
Vision
Eye examinations
Eye glasses and contacts
Hearing
Hearing aids
Hearing aid batteries and repairs
Non-Reimbursable Expense Examples
This list highlights some common healthcare expenses that may not be eligible for reimbursement under your specific funding program. For detailed information about which expenses are covered by your plan, refer to your summary plan description (SPD), review eligible expenses in your account via the website, or contact Via Benefits for assistance.
Premiums for life insurance, critical illness, income protection, or disability insurance
Premiums for cost sharing insurance (health care sharing ministries, Medi-Share)
Premiums paid on a pre-tax basis before taxable wages are calculated, such as those paid for employer-provided group health insurance
Cosmetic procedures
Medical marijuana or CBD products
Weight loss programs, food and beverages
Assisted living or long-term care expenses
Cost of medical care provided by the facility may be reimbursable
Household help
Gym memberships**
Dietary supplements/Vitamins**
**Unless a documented medical necessity
*Via Benefits reimbursement accounts are administered by Extend Health, LLC.