Submit or Cancel 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. Read Recurring Premium Reimbursement for more information.
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.
Documentation
When you have health care expenses, be sure to keep your supporting documents (for example, itemized receipts or Explanation of Benefits) to submit along with your reimbursement requests. Specific documentation requirements are included on the back of the Reimbursement Request Form and when you submit requests on the website or on the mobile app.
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 Out-of-Pocket Reimbursement (for copays, coinsurance) or Premium Reimbursement (for insurance premiums). Note: Your former employer or benefits provider may provide premium reimbursement only.
4. Enter the following information:
Category (e,g., Medical, Dental)
Occurrence (One-Time Premium or Recurring 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 2022 through December 2022)
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
Provider/Carrier (e.g., Dr. Smith, CVS, Aetna)
Name of insured
Supporting Documents
1. Select Camera to take a picture of your document and upload it directly from your mobile device
2. Select Photos to choose an image from your phone’s photo library
3. Select Done when you've chosen the desired photo
4. 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
One-Time Reimbursement
Recurring Reimbursement
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.
To submit a reimbursement request on the website, complete the following steps:
1. Sign into your account, and select View accounts under Funds & Reimbursements.
2. Select Reimbursement Center on the Funds and Reimbursements page.
3. On the Dashboard, select Premium Reimbursement or Out-of-Pocket Reimbursement.
Note: Your former employer may provide premium reimbursement only.
4. Review the Let’s Get Started box for detailed instructions on submitting your reimbursement request, and select Continue. Select Don't show again to avoid seeing the box in the future.
5. Enter the following information in the order it's requested:
Note: Subsequent questions are grayed out until the previous answer is provided.
Category (for example, Medical, Pharmacy).
Occurrence (One-Time Premium or Recurring Premium) for premium reimbursements only.
Type (for example, Treatment, Equipment) for out-of-pocket reimbursements only.
Date of Service Enter date(s) using the calendar. Your date of service must be after the date your reimbursement account began.
Note: Premiums don't require a specific date of service because they're based on a full month.
Amount of your request (monthly amount for recurring premiums).
Provider/Carrier Name (for example, 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.
Individual Serviced (select a dependent from drop-down list).
Example of Recurring Premium Reimbursement Request Categories
6. Select Upload File to provide supporting documents.
7. Select Upload Another File to upload additional documents.
8. Select Add Another Expense, or select Review & Submit to proceed.
9. Select Submit.
Canceling or Changing Future Recurring Premium Reimbursement Requests on the Website
If your premium amount changes, or you'd like to stop your Recurring Premium Reimbursement request, you can cancel future Recurring Premium Reimbursement requests on the website. If you received a notice of premium change from your insurance carrier and need to update your premium amount, you'll need to cancel your current request and submit a new request for the updated premium amount. Please don't take these actions until the month before your rate change occurs. Payments can only be canceled for future recurring premium payments and can't be canceled once they've been processed.
To cancel your future Recurring Premium Reimbursement requests, complete these steps:
1. Sign into your Via Benefits account.
2. Select View accounts under Funds & Reimbursements.
3. Select Reimbursement Center on the Funds and Reimbursements page.
4. Select HRA, and then select the Activity tab.
Please note: The HRA tab is customized for your former employer or benefits provider and may have a different name (for example, ARA, HRA).
5. Locate the recurring premium that needs to be canceled under Your Account Activity.
6. Select Processing Scheduled to view the Activity Details section.
Note: The premium's status may display as "Partially Paid" or "Processing Payment."
7. Select Cancel Payment(s) under Payment Breakdown.
8. Select Yes, Cancel Payment(s) to continue. A message appears confirming the cancellation. Select Nevermind if you no longer want to cancel.
The Activity Details section displays scheduled payments that were canceled. If you're unable to complete this process on the website, please call us for assistance.
Submitting a Reimbursement Using a Paper Form
You can submit a paper Reimbursement Request Form; however, we don't recommend it. 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 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 activated 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 From 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
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:
On the website or mobile app: up to five business days
Preferred submission method. 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: seven to 10 business days
Processing times may be longer than expected from January through March.
*Via Benefits reimbursement accounts are administered by Extend Health, LLC.
