Want to know more about the PayFlex system? This newsletter explains how the PayFlex system works, and the steps you need to take to access your accounts and use your funds. 1
Step 1: Log in to PayFlex To access your PayFlex account, log into www.aetnanavigator.com. Then, go to Your Accounts and Funds and click Access My Account to access your Flexible Spending Account (FSA) or Health Reimbursement Account (HRA). You ll now be in the PayFlex member website. Once you ve logged in to the PayFlex member website, you can: View your account information Check account balances Submit claims and upload receipts View claim and debit card transaction history Enroll in direct deposit Creating a PayFlex PIN When you use your PayFlex card, some merchants may ask you to select debit in which case you will need to enter a personal identification number (PIN) to complete the transaction. Your card does not automatically come with a PIN, but you can create one at any time by following the steps below: If you already have a PayFlex card that s not expired, call Card Services at 1-888-999-0121. If you receive a new PayFlex card in the mail (not activated), call the number on the card to activate it and get your PIN. If you forget your PIN or want to change it, call Card Services at 1-888-999-0121. Please note: If your spouse or dependent also has a PayFlex card, they will use the same PIN you use. How to manage your accounts from your phone First, register your account online on the PayFlex member website by clicking PayFlex Mobile. Or, register directly on PayFlexDirect.com. Once you have a username and password, you ll use the same information to log into the PayFlex Mobile TM app. This app gives you an easy way to manage your accounts: Snap a picture of your receipts View PayFlex card purchases and submit documentation View alerts and notifications View a list of common eligible expense items 2
Step 2: Use your funds to pay expenses There are two different ways to pay for eligible expenses. Remember, whether you submit a claim or use the PayFlex card, funds will be used from your FSA for Health Care first. Only after all of your FSA funds are used will you be able to access your HRA funds for eligible medical expenses. Option 1 Pay out-of-pocket and pay yourself back Option 2 Use your PayFlex card Pay an eligible expense with cash, check, or personal credit card Then, pay yourself back from your account in one of three ways: Submit the claim online Use the PayFlex Mobile app Fill out a paper claim form and fax or mail it to PayFlex Present your card and select debit or credit, depending on the merchant s preference at the point of service After you swipe your card, the system will automatically confirm if you have funds to pay the expense If you choose to pay an eligible expense out-of-pocket, you will need to submit a claim to pay yourself back. Since PayFlex is a separate system from the claims paying system at Aetna, claims on the Aetna site are not automatically uploaded to PayFlex. To submit a claim online (or mail/fax to PayFlex), download or print a claim form from your account website. You ll need to send an Explanation of Benefits (EOB) or a detailed receipt with your claim when you send it in. There are a few ways to file a claim online on the PayFlex website: Select File a Spending Account Claim from the left-side navigation of My Dashboard, or Select File a Claim within the FSA or HRA account box. Then, follow this three-step process: Enter in the Expense Type, Expense Begin Date, and Amount for each claim item. To enter additional expenses, click Add Another Expense. When you are done, click Next. Review your information. If the information is correct, click Next to continue. To edit a claim, click the Previous button. Select a method to submit your documentation to PayFlex. You can either fax or upload documents. For more details, download the Reimbursement Account Quick Reference Guide from the Educational Materials in the Resource Center. This guide includes step-by-step instructions for all the features on the PayFlex website. What s the PayFlex card and how do I use it? When you opened your account, you should have received a PayFlex debit card. The debit card provides a way to pay eligible expenses directly from one of your accounts, rather than having to pay out-of-pocket and submit claims for reimbursement later. If you have not received a debit card, please call 1-888-678-8242 or visit www.aetnanavigator.com. For medical services such as an office visit, you should wait until your claim has been processed and your EOB is available so you know how much you owe. Then, you can use the card to pay your provider directly. 3
Step 3: Show documentation The IRS requires documentation to confirm your expenses are eligible for reimbursement. So there may be times you will need to provide additional documentation to verify that an expense is eligible. Even though the PayFlex debit card is able to recognize a doctor s office, for example, the service provided may not be an eligible expense. PayFlex will notify you when you need to substantiate a claim. It s important to respond in a timely manner or your card may be deactivated. This is done for your safety to ensure you are the one using your card. You can sign up for email or text message alerts on the PayFlex website. There are a few different ways you can document your purchases with the PayFlex debit card. You can: 1. Download an EOB from Aetna s (or another provider s) website and upload it to PayFlex online. 2. Take a picture of your EOB or receipts with your smart phone and upload it through the PayFlex Mobile TM app. 3. Mail or fax your paper EOB or receipts. Acceptable documentation for health care expenses: EOB This is the best form of documentation. If the claim goes through your health care plan, you ll receive an EOB from your plan administrator. Detailed receipt or itemized statement If the claim didn t go through your plan, for example, a claim for an over-the-counter (OTC) drug expense, you can send a receipt or itemized statement that shows the following: Date of purchase or date the service was incurred Your financial responsibility (amount paid) Description of purchase or type of service Provider or merchant name Patient or dependent name (if applicable) Note: If you re submitting a claim for an OTC drug or medicine, you must also include a written prescription from your doctor. Prescription drug receipt If you re sending in a prescription drug receipt, it must contain the pharmacy name, patient name, drug name (if listed), date the prescription was filled, and the amount you paid. A cancelled check, credit card receipt, or balance due statement is not an acceptable form of documentation. 4
An example of PayFlex in action: using your PayFlex card to pay expenses with FSA funds Here s how you can access your accounts. During annual enrollment... In 2015... Sarah enrolled in individual coverage in the Active Health Option. Sarah has a sore throat and visits her doctor. Sarah s doctor prescribes medication, which she fills at her local pharmacy. Sarah receives an alert from PayFlex requesting documentation for the claim from her doctor s visit. Sarah elected to contribute $500 to the FSA for Health Care for 2015. Rather than paying at the time of her visit, she waits to receive an EOB from Aetna so she knows her payment responsibility. She then provides her PayFlex card information on her bill to pay the amount due. The system confirms she has funds available to cover the transaction and automatically deducts the amount. Since she has both an FSA and an HRA, the funds will come from her FSA first. Sarah uses her PayFlex card to pay for the prescription. Sarah downloads her EOB from the Aetna site, and uploads it to the PayFlex site. She could also have downloaded the PayFlex Mobile TM app, where she would have received the alert. Then, she could have taken a picture of her itemized bill, detailed receipt, or EOB, and submitted it through the app. Sarah saves her EOB and receipt in case she receives a request for documentation. Several resources are available for you to learn more about your accounts: Microsite: http://nylbenefits.com Aetna: www.aetnanavigator.com or (877) 440-4708 PayFlex member website: www.aetnanavigator.com and go to Your Accounts and Funds and click Access My Account Plus, be sure to read the newsletter about the FSA and HRA, also on the microsite. 5 February 2015