Medical Expense Reimbursement
This article applies to you if you have a Via Benefits reimbursement account (sometimes known as a Health Reimbursement Arrangement).*
You can be reimbursed for an out-of-pocket medical expense as long as it's an eligible expense (such as an office visit or prescription copay, dental treatment, hearing aids, etc. Your Reimbursement Guide provides more details on reimbursable expenses.
You can request reimbursement by submitting a reimbursement request on the Via Benefits Accounts mobile app, on the website, or by submitting a Reimbursement Request Form.
Documentation Requirements
For out-of-pocket expenses, such as prescriptions and doctor's office copays, we need third-party documentation that includes all of the following:
Provider Name
Patient Name
Date of Service (when the service occurred or the product was purchased)
Type or Description of Service
Amount incurred or charged (not amount paid)
We recommend you get one of the following documents to provide the information above:
An Explanation of Benefits (EOB) from your insurance carrier
An itemized statement from your provider. This statement can’t say “insurance pending” or “estimate.”
An itemized receipt or ledger from your pharmacy
Expenses Incurred in a Foreign Country
Expenses you incur in a foreign country may be eligible for reimbursement, as long as the care is medically necessary. If the supporting documentation is in a foreign language, the five required elements (provider name, participant name, date of service, type or description of service or product, and document showing the participant’s financial responsibility) must be translated in to English. The amount of the expense must be converted from the foreign currency to U.S. dollars. You can do the translation and currency conversion yourself. It doesn't need to be a formal translation.
Medication ordered from another country, such as Canada, and consumed within the U.S. isn't an eligible expense.
Transportation Expenses
Transportation or travel expenses might be reimbursable, depending on your former employer’s reimbursement guidelines. Your Reimbursement Guide provides more details on reimbursable expenses.
Eligible Transportation Expenses
Transportation expenses are eligible for reimbursement when they're essential to medical care.
Your expenses can include subway, bus, taxi, train, or plane fares, rideshare services (e.g., Uber, Lyft), ambulance services, parking or toll fees, mileage, and transportation expenses for individuals who must go with the person receiving treatment, like a parent, nurse, or caregiver.
Documentation Requirements
All of your transportation expenses must have a corresponding expense for medical care, such as an Explanation of Benefits (EOB) or an itemized statement from your provider.
Also, your transportation expenses (except for mileage and parking meters) must have receipts or statements that include the expense amount, dates, provider, and address to and from.
Mileage Logs
Your proof of mileage must be kept in a mileage log or similar document.
A mileage log should include:
Origin or starting address (usually your home address)
Provider's address (where medical care was incurred)
Total distance traveled between locations, in miles
Expense dates
Expense recipient (who the expense was for)
Requested amount (mileage rate x miles traveled)
Refer to IRS issues standard mileage rates for 2022 for more details.
Type of service (e.g., office visit, emergency room, chemotherapy)
Accepted mileage documents include a printout from an online map service, such as Google Maps, a handwritten document, or an Excel or Word printout.
*Via Benefits reimbursement accounts are administered by Extend Health, LLC.
