My Accounts

HSA

Health Savings

$2,847.50

Available

FSA

Flexible Spending

$840.00

Expires Dec 31

HRA

Employer HRA

$500.00

Available

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Claims Submit a Reimbursement Request

Submit a Reimbursement Request

Request reimbursement from your HSA, FSA, or HRA for eligible healthcare expenses.

Expense Details

Step 1 of 4 — Tell us about the healthcare expense

Member ID *

Found on your Vizor.cx member card

Account to Claim From *

Date of Service *

Must fall within your current plan year

Expense Category *

Provider / Merchant *

Claim Amount ($) *

Patient *

Expense status *

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