Eligible Medical Expenses
This article applies to you if you have a Via Benefits reimbursement account (sometimes known as a Health Reimbursement Arrangement).*
Generally, the IRS Tax Code 213(d) determines eligible reimbursable expenses. (For more information, see the IRS publication 502.) However, your former employer might not include all 213(d) expenses as eligible for reimbursement from your reimbursement account. Each employer establishes its own guidelines regarding eligible expenses for which it allows reimbursement. This information is available:
In your summary plan description (SPD)
By viewing eligible expenses in your account
By contacting Via Benefits
In the Reimbursement Guide Via Benefits sends you within two weeks of your plan's effective date
If you think something may be reimbursable based on this information, submit a reimbursement request. Your request will be paid or denied according to your reimbursement account's rules. If it’s denied, you'll be sent an Explanation of Payment (EOP) or an Explanation of Unpaid Expenses (EOUE). The statement provides instructions on what to provide, such as a Letter of Medical Necessity, so your request may be reprocessed. It may also tell you no further action is necessary. If tax advice is required, please seek the services of a tax professional.
Eligible Expenses
Premiums
Your funding program may allow for reimbursement for your eligible premium expenses to the degree that funds are available. As long as it's an eligible premium, you can apply the funds provided in your reimbursement account toward post-tax premium expenses incurred while you're eligible for your funding program. Generally, you pay your insurance premiums to the insurance carrier every month before requesting 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 for reimbursement for your eligible out-of-pocket health care expenses to the degree that funds are available. Out-of-pocket expenses include copayments, deductibles, and coinsurance payments. This list provides a sample of eligible expenses for reimbursement based on 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 includes some common health care expenses that may not be eligible for reimbursement under your specific funding program. For more information on eligible expenses covered by your particular plan, refer to your SPD, view eligible expenses using your account via the website, or contact Via Benefits.
Premiums for life insurance, critical illness,
income protection, or disability insurancePremiums 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+
+Unless a documented medical necessity
*Via Benefits reimbursement accounts are administered by Extend Health, LLC.