Submitting a Reimbursement Request
This article applies to you if you have a Via Benefits reimbursement account (sometimes known as a Health Reimbursement Arrangement)*.
Once you receive your Via Benefits Reimbursement Guide, you can prepare for when your reimbursement account becomes effective. Create an account on the Via Benefits Accounts mobile app or our website. Set your notification preferences for receiving email or paper notifications about your reimbursement account. You can also submit a reimbursement request if you provided payment information for an initial payment with your application. The request won’t be processed until the first of month; however, you can submit the request. You aren't allowed to file for out-of-pocket expenses until your account goes into effect.
You need to submit reimbursement requests to receive funds from your reimbursement account for your eligible expenses. (You will not receive a debit card.) Use the Via Benefits Accounts mobile app, the website, or a Reimbursement Request Form to submit reimbursement requests. Submitting your requests on the mobile app or on the website is the fastest and most secure way to have your reimbursements processed. You also save time and postage. We recommend you submit premium expenses as a recurring request, if your employer allows, rather than filing a request each month.
If you're Medicare eligible, you may have the option of using Automatic Premium Reimbursement rather than submitting a reimbursement request. Express Reimbursement is available if Automatic Premium Reimbursement isn't available to you or you don't have it turned on.
There may be limitations on who can receive reimbursements from your account. If your spouse has a separate reimbursement account, a separate account must be created so your spouse can submit reimbursement requests. If you'd like to know whether you and your spouse have separate accounts, please call us.
You can cancel future recurring requests on the website or by calling us. Read Modifying Future Recurring Premium Reimbursement.
Reimbursement Time Frames
How long it takes to receive your reimbursement depends on how you submit the reimbursement request and your preferred payment method (direct deposit or check).
Reimbursement request processing times:
Automatic Premium Reimbursement and Express Reimbursement: monthly
Preferred submission method
Website or mobile app: up to five business days
Your request immediately displays in your account
Reimbursement Request Form: up to 15 business days (includes mailing time)
Reimbursement delivery times:
Direct deposit: two to three business days
Check: 7 to 10 business days
Processing times may be longer than expected from January through March.
Documentation
When you have health care expenses, be sure to keep your supporting documents to submit along with your reimbursement requests. Specific documentation requirements are included when you submit requests on the mobile app or website and on the back of the Reimbursement Request Form. You can also read about Documentation Requirements for Reimbursement.
Reimbursement Request Life Cycle
Your reimbursement requests follow this process when you submit them to Via Benefits:
Submitting a Reimbursement Request on the Mobile App
To submit a reimbursement request on the Via Benefits Accounts mobile app, complete these steps:
1. Sign into the mobile app.
2. Select Get Reimbursed.
3. Select Premium Reimbursement (for insurance premiums) or Out-of-Pocket Reimbursement (for copays, coinsurance).
Note: Your former employer or benefits provider may provide premium reimbursement only.
4. Enter the following information:
Category (e,g., Medicare Part A/B, Medical, Dental)
Occurrence (Recurring Premium or One-Time Premium) for premium reimbursements only
Type (e.g., Treatment, Equipment) for out-of-pocket reimbursements.
Date(s) of Service
Provide the coverage dates for recurring and one-time premium requests (e.g., January 2023 through December 2023).
Note: Premiums don't require a specific date of service because they're based on a full month.
Provide the dates for out-of-pocket requests. This can be a single date or a date span.
Note: Out-of-pocket expenses that cross calendar years must be submitted as two separate expenses.
Amount of your request (for premiums, enter the total premium amount paid to your insurance carrier for the selected date of service).
Provider/Carrier (e.g., Aetna, Dr. Smith, CVS).
Name of insured/Individual Serviced.
1. Select Camera to take a picture of your document and upload it directly from your mobile device or select Photos to choose an image from your phone’s photo library.
2. Select Done when you've chosen the desired photo.
3. Select Add to upload more photos.
5. Select Review after you upload your documents.
6. Select Submit after you verify the information on your request, or select Edit to make changes.
Examples
Recurring Premium Reimbursement
One-Time Reimbursement (Premium)
One-Time Reimbursement (Out-of-Pocket)
Submitting a Reimbursement Request on the Website
Note: Some information may be cut off if you set your browser to 125% zoom or higher. We recommend using 100% zoom and expanding your browser.
Automatic Premium Reimbursement and Express Reimbursement are the preferred methods to submit premium reimbursements as they don't require supporting documentation. Reimbursements should only be entered manually if you don't have Automatic Premium Reimbursement or Express Reimbursement turned on.
To submit a reimbursement request on the website, complete the following steps:
1. Sign into Via Benefits, and select View Accounts in the Funds and Reimbursements section.
2. Select Visit the Reimbursement Center for the desired account on the Request Reimbursement and Manage Funds tab.
3. On the Dashboard, select Premium Reimbursement or Out-of-Pocket Reimbursement.
Note: Your former employer may provide premium reimbursement only. You will only see the options that are offered to you by your previous employer.
4. Review the Let’s Get Started box for detailed instructions on submitting your reimbursement request, and select Continue.
5. Enter the following information in the order it's requested:
Note: Subsequent questions are grayed out until the previous answer is provided.
Category (e.g., Medicare Part A/B, Medical, Pharmacy).
Occurrence (Recurring Premium or One-Time Premium) for premium reimbursements only.
Type (e.g., Treatment, Equipment) for out-of-pocket reimbursements only.
Date of Service Enter dates using the calendar. Your date of service must be after the date your reimbursement account began.
Provide the coverage dates for recurring and one-time premium requests (e.g., January 2023 to December 2023).
Note: Premiums don't require a specific date of service because they're based on a full month.Provide the dates for out-of-pocket requests. This can be a single date or a date span.
Note: Out-of-pocket expenses that cross calendar years must be submitted as two separate expenses.
Amount of your request (for premiums, enter the total premium amount paid to your insurance carrier for the selected date of service).
Provider/Carrier Name (e.g., Aetna, CVS).
Note: The providers and carriers you entered in the past appear in the drop-down list. However, you can enter any other provider or carrier in the blank box.
Name of Insured/Individual Serviced (select a dependent from drop-down list).
6. Select Upload File to provide supporting documents.
7. Select Upload Another File to upload additional documents.
8. Select Submit on the Review & Submit page to proceed.
9. Select Submit Another Expense on the Finished page if desired.
Submitting a Reimbursement Using a Paper Form
You can submit a paper Reimbursement Request Form; however, it’s not the preferred method of submission. It’s less secure, and may take up to 10 days longer than submitting your request on the website or on the mobile app.
To request reimbursement by mail, follow these steps:
1. Call us at 1-866-322-2824 (TTY: 711) and use our automated voice system to request a form if you don’t have one.
2. Complete the Reimbursement Request Form to request reimbursement for copays and premium expenses.
3. Mail the completed form and the required documents to the address provided on the form.
Once we receive your reimbursement form, allow five business days for it to be processed.
Note: If you’ve turned on Automatic Premium Reimbursement (Medicare Only), don’t submit a reimbursement request for the same premiums.
Forms are personalized with your information and have a barcode specific to the account holder. Forms can be used to submit requests for eligible dependents associated with the account holder. Submitting requests for ineligible dependents or using a form barcoded for another account holder may result in a delayed or denied reimbursement.
If you and your spouse have separate accounts:
Don’t share your personalized reimbursement forms with your spouse; you and your spouse must submit separate, personalized forms.
Don’t alter a personalized form. Instead, call us and use the automated voice system to request a new form.
The Catastrophic Coverage Reimbursement Request Form and Special Payment Benefit Form are only available by calling Via Benefits. These reimbursement benefits are available to you if offered by your former employer or benefits provider.
Form Explanation
*Via Benefits reimbursement accounts are administered by Extend Health, LLC.