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HSA Application

Filing a Claim

When you want to either make a payment to a provider or reimburse yourself using funds in your health and benefit account(s) (Flexible Spending Account(FSA); Limited Purpose Flexible Spending Account (LPFSA); Dependent Care Flexible Spending Account (DCFSA); Health Reimbursement Arrangement (HRA); Lifestyle Spending Account (LSA)), you will need to file a claim. You can file a claim on the member website, on the MyHealth app, by mail or fax.

Member website

From the Home screen select “Send Payment” or "Reimburse Myself" and follow the on-screen instructions to complete the submission process

MyHealth app

Select "File a Claim" > "Add a New Payee" or "Pick a Payee"
From the Home screen select “Send Payment” or "Reimburse Myself" and follow the on-screen instructions to complete the submission process
Upload your receipt > "Submit"
Note: When you use a receipt from the Receipt Organizer it will display with a green "Used" indicator at the top right.

Mail or fax

Download the Reimbursement Request Form from the member website: "Tools & Support" > "Account Support & Forms"
Fill out the form.
Fax or mail it to Bank of America.

Deadlines for filing claims

For details on filing deadlines, find your plan in the "Accounts" section on the homepage. Hover mouse over the information icon to the right of the plan name and a pop-up will appear showing you the key dates for your account.

Note: You cannot use your Health and Benefit Visa debit card for any prior year claims. They will need to be processed via the member website or mobile app. Learn more.

Tip: You can choose to receive text alerts on your claim status. On the member website: "Message Center" > "Update Notification Preferences"

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Bank of America, N.A. makes available The HSA for Life® Health Savings Account as a custodian only. The HSA for Life is intended to qualify as a Health Savings Account (HSA) as set forth in Internal Revenue Code section 223. However, the account beneficiary establishing the HSA is solely responsible for ensuring satisfaction of eligibility requirements set forth in IRC sec 223. If an individual/employee establishes a HSA and s/he is not otherwise eligible, s/he will be subject to adverse tax consequences. In addition, an employer making contributions to the HSA of an ineligible individual may also be subject to tax consequences. We recommend that applicants and employers contact qualified tax or legal counsel before establishing a HSA.

Bank of America does not sponsor or maintain the Flexible Spending Accounts (FSA) / Health Reimbursement Accounts (HRA) that you establish. The programs are sponsored and maintained solely by the employer offering the plan, or by an individual establishing an independent plan. Bank of America acts solely as claims administrator performing administrative tasks pursuant to an agreement with, and at the direction of, the sponsoring employer or individual under an independent plan. The sponsoring employer or individual under an independent plan is solely responsible for ensuring such arrangements comply with all applicable laws.

The planning tools and information calculators are illustrative only, and accuracy is not guaranteed. They are intended to provide a comparative tool for various consumer health care options and potential costs and savings of those options. Bank of America and its affiliates are not tax or legal advisors. The calculators are not intended to offer any tax, legal or financial advice and do not assure the availability of or your eligibility for any specific product offered by Bank of America or its affiliates. Please consult with qualified professionals to discuss your situation. This site may contain links to third-party content, which may be articles, videos, or calculators, regarding health plans only as a convenience. Some articles, videos and calculators may have been written and produced by third parties not affiliated with Bank of America or any of its affiliates.

Neither Bank of America nor any of its affiliates or employees provide legal, tax or accounting advice. You should consult your legal and/or tax advisors before making any financial decisions. This material should be regarded as general information on health care considerations and is not intended to provide specific health care advice.

If you have questions regarding your particular health care situation, please contact your health care, legal or tax advisor.

Please consult with your own attorney or tax advisor to understand the tax and legal consequences of establishing and maintaining a HSA, FSA, Dependent Care FSA, and/or HRA plan.

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Bank of America, N.A., Member FDIC. Mutual Fund investment offerings for the Bank of America HSA are made available by Merrill Lynch, Pierce, Fenner & Smith Incorporated (“MLPF&S”), a registered broker-dealer, registered investment adviser, Member SIPC, and a wholly owned subsidiary of Bank of America Corporation (“BofA Corp.”). Investments in mutual funds are held in an omnibus account at MLPF&S in the name of Bank of America, N.A., for the benefit of all HSA account owners. Recommendations as to HSA investment menu options are provided to Bank of America, N.A. by the Chief Investment Office (“CIO”), Global Wealth & Investment Management (“GWIM”), a division of BofA Corp. The CIO, which provides investment strategies, due diligence, portfolio construction guidance and wealth management solutions for GWIM clients, is part of the Investment Solutions Group (ISG) of GWIM.

Investment products:

Are Not FDIC Insured

Are Not Bank Guaranteed

May Lose Value

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