What Happens When You Need Care

Use Your Health Care FSA

If you are enrolled in the Health Care FSA (flexible spending account) you can use your account funds to pay for eligible expenses.

  • Point of Payment: Present your Your Spending Account™ credit card
  • Bill Payment: Write your Your Spending Account™ credit card number in the bill’s credit card section
  • File a Claim: You can receive reimbursement for funds paid by filing a claim electronically, by fax or by mail


Where you receive medical care and who provides the care affect the coverage you receive and your cost for coverage. Using an in-network provider will usually provide the most coverage at the lowest cost.


What You're Responsible for If You Stay In Network

  • Your provider (doctor's office, hospital, laboratory, etc.) files the claim. You may receive a bill after the claim has been processed if you have any patient responsibility. If your service was routine preventive care, you pay nothing.
  • You pay your deductible and coinsurance/copay.
  • Your costs for services are less because the network providers generally discount services between 40%-50% of the total costs.
  • Check your Explanation of Benefits (EOB) to make sure it's accurate, and keep it for future planning.

What You're Responsible for If You Go Out of Network

  • You may need to file a medical claim. It's likely that your provider (doctor's office, hospital, laboratory, etc.) will bill you for the entire cost of the service. Some out-of-network providers may require you to pay for the charges up front.
  • You pay more of the costs, higher deductibles, coinsurance, and out-of-pocket maximum, plus there are no network discounts.
  • There is a Reasonable & Customary (R&C) limit set by your medical claims administrator. It's based on the amount that 90% of doctors and other providers in the area charge for a given service. You pay all costs over R&C each time you use an out-of-network doctor or service. You'll receive a separate bill for these costs.


What You're Responsible for While You're Traveling

  • If you become ill or injured while traveling, contact your medical claims administrator (find telephone number on back of medical ID card) to find if there is a network doctor or hospital in the area. If so, charges will be covered at the in-network level. If not, you'll be charged at the out-of-network level.
  • If you have an emergency while traveling, go to the nearest emergency room. If it's a true emergency, the charges will be paid at the in-network level. If it's not a true emergency, the charges will be paid at the out-of-network level. Some examples of true emergencies are: fractures, lacerations, motor vehicle accidents, hemorrhage, shock, or other conditions associated with deterioration of vital life functions.