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WageWorks HealthCare Reimbursement Account
Plan Year: January 1, 2006 -
December 31, 2006
Medical Reimbursement Plan Maximum: $5,000
Medical Reimbursement Plan Minimum: None
Waiting Period: 1 Year
The Health Care Reimbursement Account (HCRA) offers a real advantage for your
pocketbook. Many people find this a cost effective way to pay for such items as
medical and dental plan deductibles/co-payments, eyeglasses, contact lenses,
orthodontics and other health-related expenses that may not be covered by
insurance. Even taxpayers who do not itemize can take advantage of this tax
break by using the Health Care Reimbursement Account.
Managing Your Account
WageWorks makes it easy for you to track your money with real-time
account access and frequent account statements.
Online Account Access
Access your account online anytime to check account activity and claims
status. Log onto www.wageworks.com to
view your account. A simple registration process is required the first time you
visit. Or, you may be able to access this site through your employer’s benefits
portal.
Access by Phone
If you do not have Internet access, you can call our automated voice system
to check your account status. Call toll free (877) 924-3967 and follow the
prompts to check account balance, claims status and account activity. WageWorks
Customer Service Representatives are available from 9am to 8pm Eastern Time and
from 6am to 5pm Pacific Time.
Monthly Statements
Every month you will receive a statement that contains your account balance,
payment history and helpful tips for using your accounts. This statement will be
emailed to you if you have entered an email address in your Profile and mailed
to you if you have not.
Using the WageWorks Health Care Card
Why Use The Card?
By purchasing eligible health care items with the card, the cost of your
purchases is automatically deducted from your Health Care Account. No claims to
file. No waiting for reimbursement.
When To Use the Card
Use the card to pay for eligible health care expenses such as co-payments,
prescriptions and glasses.
Where To Use the Card
In addition to doctors’ offices and pharmacies, you can use your card to
purchase
eligible merchandise at discount chain stores, supermarket pharmacies and
wholesale clubs.
How To Use Your Card
1. Activate your card by calling (866) 363-4128.
2. Give your card to the service provider or swipe it yourself. If you are using
a terminal, choose the credit option. Sign for your purchase.
3. Save the itemized receipt (not the credit card-like receipt) that describes
what you paid for. You may be asked to submit this receipt to show you used the
card for eligible health care expenses. Watch your monthly statement for
details.
Call (877) 924-3967 if you have any questions about using your Health Care Card.
Using The WageWorks Web Site
Register
If you have not already registered to use the WageWorks site, you can register
at www.wageworks.com to access your
account, schedule payments, download forms and update your personal information.
1. Go to www.wageworks.com and click on
First Time User? Register Now.
2. Enter the information requested so we can identify you.
3. Confirm or update the contact information in your Profile.
4. Review the User Agreement and confirm your acceptance.
Download Forms
1. Log onto your account at www.wageworks.com,
and choose the Print Forms button.
2. Select Health Care or Dependent Care.
3. Select the form you need.
4. Print or save the form.
Scheduling Payments
Use the WageWorks web site to schedule payments to your health care or
dependent care provider. Here’s how:
Pay My Provider—Health Care
1. Log onto your account at
www.wageworks.com and choose the Health Care tab.
2. Click Request Pay My Provider.
3. Confirm or enter your email address.
4. Enter your provider information.
5. Enter patient information.
6. Enter your payment amount(s).
7. WageWorks will make the requested payment(s) from your account and mail it
directly to your provider.
Pay My Provider—Dependent Care
1. Log onto your account at www.wageworks.com
and choose the Dependent Care tab.
2. Click Request Pay My Provider.
3. Confirm or enter your email address.
4. Enter your provider information.
5. Enter dependent care information.
6. Enter your payment amount(s).
7. WageWorks will make the requested payment(s) from your account and mail it
directly to your provider.
Health Care Account
Your WageWorks Health Care Account saves you money by allowing you to
pay for your eligible health care costs with pre-tax dollars. Your election
amount is deducted from your paycheck automatically by your employer. You have
easy access to your account to pay for eligible health care expenses not covered
by your health plan by using the convenient WageWorks payment options: the
WageWorks Health Care Card, Pay My Provider or Pay Me Back.
Over-the-Counter Drugs and Medicine Are Eligible!
If you buy products like
Advil®, Band-Aids®, Benedryl®, Claritin® or Tums®, you can now use your Health
Care Account to pay for these items thanks to an IRS ruling in September 2003.
Check the list of Health Care Expenses to find out which items are covered.
Reimbursement for Over-the-Counter Drugs and Medicine
When you file a Pay Me Back claim, make sure the description you enter on
your claim form clearly indicates the type of over-the-counter product you
purchased
such as indicated in the list of Health Care Expenses. You
must also submit an itemized receipt that indicates what you paid for, the date
and the amount.
WageWorks Health Care Card
The WageWorks Health Care Card works like a credit card that you can use to
purchase eligible health care services and items at qualified merchants who
accept MasterCard®. Unlike a credit card, the cost of the purchases you make
with the card is automatically deducted from your Health Care Account.
When To Use It
The WageWorks Card is a “limited-use” card, which means you can use it only
at qualified medical offices and merchants to pay for eligible health care
expenses. For full details of items that are and are not covered see the list of
Health Care Expenses. Your card should be used only for eligible health care you
receive while covered under the Health Care Account. You cannot use the card to
pay for services you received before you were covered under this account this
plan year or to pay for eligible health care you will receive any time in the
future. The WageWorks Card is especially convenient for:
• Co-payments at your doctors, dentists and hospitals
• Prescriptions at the pharmacy counter or through a mail-order program
• Prescription eyeglasses, sunglasses or contact lenses
• Surgical and laboratory fees
• Medical supplies
How To Use It
• Give your card to the service provider or swipe it yourself at the point
of purchase.
• If you are using a terminal, choose the credit option.
• Sign for your purchase.
• Keep your itemized receipt–the one that describes what you paid for.
Other Things You Need To Know
• Be sure to keep your receipts and other records each time you use the
card. In most cases WageWorks receives enough information about your purchase
when you pay with the card to confirm that it was for an eligible expense.
Occasionally, we require more information to verify a payment. Your monthly
statement will show you if more information is required.
• You will be required to reimburse your account for any use of the card for
ineligible expenses. If you cannot show the card was used to pay for eligible
health care expenses, then you will be required to reimburse your Health Care
Account for the amount of the purchase. Your monthly statement will notify you
of any payments due. If you fail to reimburse your account when requested, you
may be subject to any of the following: (1) the amount due will be deducted from
your next Pay Me Back reimbursement check, (2) your card privileges may be
revoked and (3) other collection efforts may be taken in accordance with your
employer’s policies.
• Save your receipts with your tax documents just as you should for other uses
of your Health Care Account.
• The card cannot be used to get cash value. Keep the card safe like a credit
card. All purchases will be charged against the account balance.
Pay My Provider
You tell us how much to pay your provider and we will write and mail a check
directly from your account.
When To Use It
Pay My Provider is your most convenient payment option if you have:
• Regularly scheduled payments for eligible expenses such as orthodontic care or
physical therapy
• Balance billing, which is when your provider bills your health plan and then
bills you for the amount your insurance doesn’t cover
• Invoices you receive after the date of service for eligible expenses that
require only basic proof of service.
See Proof of Service definitions for more information.
How To Use It
• Log onto your account at
www.wageworks.com
• Click on Health Care tab
• Click on Request Pay My Provider
• Confirm or enter your email address
• Enter your provider information
• Enter patient information
• Enter your payment amount(s)
• WageWorks will make the requested payment(s) from your account and mail it
directly to your provider
Other Things You Need To Know
• An email address is required to use Pay My Provider so we can send you
time-sensitive payment information.
• WageWorks will send you an email if you use up all the money in your account
before we can make your requested payment(s).
• As with all use of your Health Care Account, save your receipts or other proof
of expense with your tax documents.
Pay Me Back
Sometimes you will want to pay for your health care expenses yourself and
have WageWorks pay you back with money from your Health Care Account.
When To Use It
Some expenses are easier to pay for first and then get reimbursed. For
example:
• You must pay in advance. Pay for the service as required and then file your
claim once you have received the service.
• Your provider does not accept credit cards.
• You purchase over-the-counter drugs and medications.
• The expense is listed as a Maybe in the Health Care Expense list and requires
additional information to get approved.
• You receive a bill from your provider after your insurance pays and your
portion is less than $20, the minimum Pay My Provider payment amount.
How To Use It
• Pay for your eligible health care expense as you usually do and save your
receipt.
• Complete a Health Care Pay Me Back form. There is one form included in this
guide. Additional forms are available for download from
www.wageworks.com, or
you can request one from your benefits representative.
• Fax your form and photocopies of your proof of services to (877)353-9236.
• Or mail your form and photocopies of your proof of service to:
WageWorks.
Other Things You Need To Know
• Remember to send us a photocopy of the proof, not your original. Keep your
originals with your tax documents for the year.
• Check the proof of service definitions and the list of Health
Care Expenses to find which type of proof of service you
need to provide.
Whose Expenses Are Eligible?
You can use your Health Care Account to pay for health care expenses
incurred by any of the following people - even if they are not covered by your
employer’s health coverage:
• You
• Your spouse, if you are legally married and file a joint tax return
• Your child, grandchild or any other child who you claim as a tax dependent
regardless of age
• Your older child, elderly parent, domestic partner or any other person who you
claim as a tax dependent
Proof of Service Definitions
Basic Proof applies to the
most common types of expenses, such as office visits, prescription and pharmacy
items, over-the-counter drugs and medicine, balances not covered by your health
plan, recurring expenses for ongoing treatment. For these types of expenses, you
can provide doctor’s receipts, pharmacy forms, an itemized receipt, a provider’s
bill or an explanation of benefits from your health plan provider.
Basic + Letter Proof is required for expenses that aren’t as
straightforward as those listed above. In addition to a receipt, you must
provide a signed letter from your doctor. The letter must include your
diagnosis, indicate that the expense is for a medically prescribed service, and
state the specific reason for the expense.
Basic + Letter + Cost Proof is for very specific expenses such as Braille
books. In addition to the cost of the special item, you must also provide proof
of the cost of the standard, unmodified item. Only the difference in cost
between the standard item and the modified item is eligible to be paid through
your Health Care Account.
|
Expense
|
Eligible |
Proof of Service* |
Best Way to Pay |
|
Acupuncture
|
Yes |
Basic |
Card or Pay Me Back |
|
Acne treatments (including over-the-counter)
|
Yes |
Basic |
Pay Me Back |
|
Adoption (medical expenses related to)
|
Yes |
Basic |
Pay My Provider |
|
Adoption fees
|
No |
|
|
|
Alcoholism treatment
|
Yes |
Basic |
Pay My Provider |
|
Allergy products (including over-the-counter)
|
Yes |
Basic |
Pay Me Back |
|
Allergy & sinus medicine
|
Yes |
Basic |
Pay Me Back |
|
Allergy treatments (including over-the-counter)
|
Yes |
Basic |
Pay Me Back |
|
Alternative dietary substitutes
|
No |
|
|
|
Alternative drugs and medicines
|
Maybe |
Basic + Letter |
Pay Me Back |
|
Alternative healers
|
Maybe |
Basic + Letter |
Pay Me Back |
|
Ambulance
|
Yes |
Basic |
Any |
|
Antacid (including over-the-counter)
|
Yes |
Basic |
Pay Me Back |
|
Antibiotic ointment (including over-the counter)
|
Yes |
Basic |
Pay Me Back |
|
Aspirin (over-the-counter)
|
Yes
|
Basic |
Pay Me Back |
|
Asthma medicines or treatments
|
Yes |
Basic |
Pay Me Back |
|
Bandages and related items
|
Yes |
Basic |
Pay Me Back |
|
Birth control
|
Yes |
Basic |
Pay Me Back |
|
Body scans and other diagnostic services
|
Yes |
Basic |
Card or Pay Me Back |
|
Braille books and magazines
|
Maybe |
Basic+Letter+Cost |
Pay Me Back |
|
Canker & cold sore treatments
|
Yes |
Basic |
Pay Me Back |
|
Chest rubs (including over-the-counter) |
Yes |
Basic |
Pay Me Back
|
|
Child or newborn care instruction
|
No |
|
|
|
Childbirth classes
|
Yes |
Basic |
Any |
|
Chiropractic treatment
|
Yes |
Basic |
Any |
|
Chiropractor (office visit)
|
Yes |
Basic |
Any |
|
Christian Science practitioners
|
Yes |
Basic |
Pay My Provider |
|
Co-insurance (medical, dental or vision)
|
Yes |
Basic |
Pay My Provider |
|
Cold & flu prevention
|
No |
|
|
|
Cold & flu medicine
|
Yes |
Basic |
Pay Me Back |
|
Cold cream
|
No |
|
|
|
Condoms and spermicides
|
Yes |
Basic |
Pay Me Back |
|
Contact lenses, cleaning solutions, etc.
|
Yes |
Basic |
Pay Me Back |
|
Contraceptives (over-the-counter)
|
Yes |
Basic |
Pay Me Back |
|
Co-payments (medical, dental or vision)
|
Yes |
Basic |
Card or Pay Me Back |
|
Cord blood storage (for future treatment of a birth defect or known medical condition)
|
Maybe
|
Basic + Letter |
Pay Me Back |
|
Cord blood storage
|
No |
|
|
|
Cosmetic surgery
|
No |
|
|
|
Cough drops & sore
throat lozenges
|
Yes |
Basic |
Pay Me Back |
|
Cough syrup (including over-the-counter)
|
Yes |
Basic |
Pay Me Back |
|
Counseling
|
Yes |
Basic |
Pay My Provider |
|
Counseling (healthcare related)
|
Yes |
Basic |
Pay My Provider |
|
Crutches (purchase or rental) |
Yes |
Basic |
Card or Pay Me Back
|
|
Dancing lessons
|
Maybe |
Basic + Letter |
Pay Me Back |
|
Deductibles (medical, dental or vision)
|
Yes |
Basic |
Pay My Provider |
|
Dental products
|
Maybe |
Basic + Letter |
Pay Me Back |
|
Dental treatments
|
Yes |
Basic |
Pay My Provider |
|
Dental veneers
|
Maybe |
Basic + Letter |
Pay Me Back |
|
Diagnostic services
|
Yes |
Basic |
Pay My Provider |
|
Dietary supplements
|
Maybe |
Basic + Letter |
Pay Me Back |
|
Drug addiction treatment
|
Yes |
Basic |
Pay My Provider |
|
Drugs (prescription)
|
Yes |
Basic |
Card |
|
Dyslexia treatment
|
Yes |
Basic |
Pay My Provider |
|
Ear drops & wax removal
|
No |
|
|
|
Electrolysis
|
No |
|
|
|
Exercise equipment
|
Maybe |
Basic + Letter |
Pay Me Back |
|
Eye examinations
|
Yes |
Basic |
Pay My Provider |
|
Eye related equipment/materials
|
Yes |
Basic |
Pay Me Back |
|
Eyeglasses (over-the-counter)
|
Yes |
Basic |
Pay Me Back |
|
Eyeglasses (prescription)
|
Yes |
Basic |
Card or Pay Me Back |
|
Face lifts
|
No |
|
|
|
Fertility monitor (over-the-counter)
|
Yes |
Basic |
Pay Me Back |
|
Fertility treatment
|
Yes |
Basic |
Pay My Provider |
|
Fertility treatment
|
No |
|
|
|
Fitness programs
|
No |
|
|
|
Flu shots
|
Yes |
Basic |
Pay My Provider |
|
Funeral expenses
|
No |
|
|
|
Gastrointestinal
medication
|
Yes |
Basic |
Pay Me Back |
|
Guide dog (dog, training, care)
|
Yes |
Basic |
Pay My Provider |
|
Hair removal
|
No |
|
|
|
Hair transplant
|
No |
|
|
|
Hand lotion
|
No |
|
|
|
Health club dues
|
No |
|
|
|
Hearing aids and batteries
|
Yes |
Basic |
Pay Me Back |
|
Herbal medicines
|
No |
|
|
|
Herbal treatments (non-prescription)
|
No |
|
|
|
Homeopathic medicines
|
No |
|
|
|
Hospital services
|
Yes |
Basic |
Pay My Provider |
|
Household help
|
No |
|
|
|
Illegal operations
|
No |
|
|
|
Illegal substances
|
No |
|
|
|
Immunizations
|
Yes |
Basic |
Pay My Provider |
|
Infertility
treatment
|
Yes |
Basic |
Pay My Provider |
|
Insulin
|
Yes |
Basic |
Card or Pay Me Back |
|
Insulin testing materials and equipment
|
Yes |
Basic |
Pay Me Back |
|
Insurance premiums
|
No |
|
|
|
Insurance
premiums
|
No |
|
|
|
Laboratory fees
|
Yes |
Basic |
Pay My Provider |
|
Lactose
treatment
|
Yes |
Basic |
Pay Me Back |
|
Lamaze classes
|
Yes |
Basic |
Pay My Provider |
|
Laser eye surgery
|
Yes |
Basic |
Card or Pay Me Back |
|
Lasik
|
Yes |
Basic |
Card or Pay Me Back |
|
Laxatives (including over-the-counter)
|
Yes |
Basic |
Pay Me Back |
|
Learning disability treatments
|
Yes |
Basic |
Pay My Provider |
|
Lice treatment (including over-the-counter)
|
Yes |
Basic |
Pay Me Back |
|
Lodging (essential to receive medical care)
|
Maybe |
Basic + Letter |
Pay Me Back |
|
Long-term care services
|
No |
|
|
|
Magnetic therapy
|
No |
|
|
|
Marriage counseling
|
No |
|
|
|
Massage
therapy
|
Maybe |
Basic + Letter |
Pay Me Back |
|
Mastectomy-related special bras
|
Yes |
Basic |
Card or Pay Me Back |
|
Maternity clothes
|
No |
|
|
|
Medical abortion
|
Yes |
Basic |
Card or Pay Me Back |
|
Medical
equipment
|
Yes |
Basic |
Pay My Provider |
|
Medical monitoring and testing devices
|
Yes |
Basic |
Pay Me Back |
|
Medical records charges
|
Yes |
Basic |
Pay My Provider |
|
Medical savings accounts
|
No |
|
|
|
Medical
supplies
|
Maybe |
Basic + Letter |
Pay Me Back |
|
Medicines (over-the-counter)
|
Yes |
Basic |
Pay Me Back |
|
Medicines (prescription)
|
Yes |
Basic |
Card or Pay Me Back |
|
Modified equipment |
Maybe |
Basic+Letter+Cost |
Pay Me Back
|
|
Monitors & test kits
|
Yes |
Basic |
Pay Me Back |
|
Motion & nausea (including over-the-counter)
|
Yes |
Basic |
Pay Me Back |
|
Nasal sprays (including over-the-counter)
|
Yes |
Basic |
Pay Me Back |
|
Nasal strips
|
No |
|
|
|
Non-prescription drugs and medicines
|
Yes |
Basic |
Pay Me Back |
|
Norplant insertion or removal
|
Yes |
Basic |
Pay My Provider |
|
Nursing services (wages and taxes)
|
Yes |
Basic |
Pay My Provider |
|
Nutritional
supplements
|
Maybe |
Basic + Letter |
Pay Me Back |
|
OB/GYN fees
|
Yes |
Basic |
Pay My Provider |
|
Occlusal guards to prevent teeth grinding
|
Yes |
Basic |
Pay My Provider |
|
Office visits (medical, dental or vision)
|
Yes |
Basic |
Card or Pay Me Back |
|
Operations (excluding cosmetic)
|
Yes |
Basic |
Pay My Provider |
|
Optometrist / ophthalmologist fees
|
Yes |
Basic |
Pay My Provider |
|
Oral care (over-the-counter)
|
No |
|
|
|
Organ transplants (recipient and donor)
|
Yes |
Basic |
Pay My Provider |
|
Orthokeratotomy
|
Yes |
Basic |
Pay My Provider |
|
Orthodontia
|
Yes |
Basic |
Pay My Provider |
|
Over-the-counter medication
|
Yes |
Basic |
Pay Me Back |
|
Ovulation monitor (over-the-counter)
|
Yes |
Basic |
Pay Me Back |
|
Oxygen
|
Yes |
Basic |
Card or Pay Me Back |
|
Pain reliever (including over-the-counter)
|
Yes |
Basic |
Pay Me Back |
|
Personal use items (toothbrush, toothpaste, etc.)
|
No |
|
|
|
Physical exams
|
Yes |
Basic |
Pay My Provider |
|
Physical therapy
|
Yes |
Basic |
Pay My Provider |
|
Pregnancy tests (over-the-counter) |
Yes |
Basic |
Pay Me Back
|
|
Premiums (health plan or insurance)
|
No |
|
|
|
Prescription drugs
|
Yes |
Basic |
Card or Pay Me Back |
|
Prosthesis
|
Yes |
Basic |
Pay My Provider |
|
Psychiatric care
|
Yes |
Basic |
Pay My Provider |
|
Psychoanalysis
|
Yes |
Basic |
Pay My Provider |
|
Psychologist fees
|
Yes |
Basic |
Pay My Provider |
|
Radial keratotomy (RK)
|
Yes |
Basic |
Card or Pay Me Back |
|
Reading glasses (over-the-counter)
|
Yes |
Basic |
Pay Me Back |
|
Reconstructive surgery
|
Maybe |
Basic + Letter |
Pay Me Back |
|
Removal of benign mole, cyst or tumor
|
Yes |
Basic |
Pay My Provider |
|
Retin-A (excluding cosmetic uses)
|
Maybe |
Basic + Letter |
Pay Me Back |
|
Rogaine®
|
No |
|
|
|
Smoking cessation (programs / counseling)
|
Yes |
Basic |
Pay My Provider |
|
Smoking cessation drugs (prescription)
|
Yes |
Basic |
Card or Pay Me Back |
|
Smoking
cessation gum or patches
|
Yes |
Basic |
Pay Me Back |
|
Special equipment
|
Maybe |
Basic+Letter+Cost |
Pay Me Back |
|
Special foods
|
Maybe |
Basic+Letter+Cost |
Pay Me Back |
|
Speech therapy
|
Yes |
Basic |
Pay My Provider
|
|
Sterilization
|
Yes |
Basic |
Pay My Provider |
|
Student health fees (for medical services)
|
Yes |
Basic |
Card or Pay Me Back |
|
Sunglasses (over-the-counter)
|
No |
|
|
|
Sunglasses (prescription)
|
Yes |
Basic |
Card or Pay Me Back |
|
Sunscreen
|
No |
|
|
|
Supplies
|
Maybe |
Basic + Letter |
Pay Me Back |
|
Surgery (cosmetic)
|
No |
|
|
|
Surgery (excluding cosmetic)
|
Yes |
Basic |
Pay My Provider |
|
Surgical abortion |
Yes
|
Basic |
Card or Pay Me Back |
|
Swimming
lessons
|
Maybe |
Basic + Letter |
Pay Me Back |
|
Teeth bleaching or whitening
|
No |
|
|
|
Therapy (for treatment of a medical condition)
|
Yes |
Basic |
Pay My Provider |
|
Toothpaste, toothbrush, floss
|
No |
|
|
|
Transgender treatments / surgery
|
No |
|
|
|
Transportation, parking and related travel expenses (essential to receive medical care)
|
Maybe |
Basic + Letter |
Pay Me Back |
|
Tubal ligation
|
Yes |
Basic |
Pay My Provider |
|
UV protection clothing
|
No |
|
|
|
Vaccinations
|
Yes |
Basic |
Pay My Provider |
|
Varicose veins surgery
|
Yes |
Basic |
Pay My Provider |
|
Vasectomy
|
Yes |
Basic |
Pay My Provider |
|
Viagra® (prescription)
|
Yes |
Basic |
Card or Pay Me Back |
|
Vitamins (over-the-counter)
|
No |
|
|
|
Vitamins (prescription)
|
Yes |
Basic |
Card or Pay Me Back |
|
Weight loss counseling
|
Maybe |
Basic + Letter |
Pay Me Back |
|
Weight loss
program
|
No |
|
|
|
Weight loss
program and / or drugs
|
Maybe |
Basic + Letter |
Pay Me Back |
|
Weight loss foods
|
No |
|
|
|
Wheelchair and repairs
|
Yes |
Basic |
Pay My Provider |
|
X-ray fees |
Yes |
Basic |
Pay My Provider
|
See Proof of Service definitions for more information.
WageWorks Dependent Care Reimbursement Account
Plan Year: January 1, 2006 -
December 31, 2006
Dependent Care Reimbursement Plan Maximum: $5,000
Your WageWorks Dependent Care Account saves you money by allowing you to pay for
your eligible dependent care costs with pre-tax dollars. Your election amount
will be deducted automatically from your paycheck by your employer and used to
fund your account. You have easy access to your account to pay for eligible
dependent care expenses using the convenient WageWorks payment options: Pay My
Provider or Pay Me Back. (Debit Card does not apply to the Dependent Care
Account).
Pay My Provider
When To Use It
Pay My Provider is the most convenient payment option. You tell us how much
to pay your provider and we’ll write and mail a check directly from your
account.
How To Use It
• Log onto your account at
www.wageworks.com
• Click on Dependent Care tab
• Click on Request Pay My Provider
• Confirm or enter your email address
• Enter your provider information
• Enter dependent information
• Enter your payment amount(s)
• WageWorks will make the requested payment(s) from your account and mail it
directly to your provider
Other Things You Need To Know
• Payment will be made in the amount requested or your account balance
before the payment date, whichever is lower.
• WageWorks will send you an email if you use up all the money in your account
before we can make your requested payment(s).
• An email address is required to use Pay My Provider so we can send you time
sensitive payment information.
• As with all use of your Dependent Care Account, save your receipts or other
proof of expense with your tax documents.
Pay Me Back
When To Use It
If you like to pay for your dependent care expenses as you normally do and
then get reimbursed for your expenses, then Pay Me Back is the option for you.
How To Use It
• Pay for your dependent care as you usually do.
• Complete a Dependent Care Pay Me Back form. There is one form included in this
guide. Additional forms are available for download from
www.wageworks.com, or
you can request one from your benefits representative.
• Provide proof of service for each expense in the form of a photocopy of your
cancelled check (front and back) or a photocopy of a receipt, statement or bill
from your provider (formal or informal), or your provider’s signature on the
form.
• Fax your form and photocopies of your proof of services to (877)353-9236.
• Or mail your form and photocopies of your proof of service to:
WageWorks.
Other Things You Need To Know
• Remember to send photocopies of your proof of service.
• Save your originals with your tax documents.
What Qualifies
You can use your Dependent Care Account to pay for expenses to care for any
eligible dependents:
• Your child, grandchild or any other child under the age of 13
• Your older child, spouse, elderly parent or any other person who is physically
or mentally incapable of self care
All of the following must be true about this person:
• The person lives in your home at least eight hours on each day you pay for
care
• You (and your spouse, if you are married) pay over half the cost of
maintaining a household for the person
• You claim the person as a tax dependent, or you would be eligible to except:
(a) the person’s income prevents you from doing so or
(b) the person is claimed by his non-custodial parent due to written decree
And, all of the following must be true about the care:
• The care is provided while you work or to enable you to work. If you are
married, the care is provided while your spouse also works or to enable your
spouse to work or go to school full-time (at least 5 months a year) or while
your spouse is incapable of self care.
• The care may be provided by a relative or a non-relative but is not provided
by a tax dependent.
• Your care provider must conform to state and local laws (including being
licensed, if required) and be able to provide you with his/her Social Security
or Tax ID number. You will need this to request a payment or file a claim.
Dependent Care Expenses
|
Child Care Expenses |
Eligible?
|
|
After school programs |
Yes |
|
Babysitting (someone else’s home) |
Yes |
|
Babysitting (your home) |
Yes |
|
Before school programs |
Yes |
|
Child care |
Yes |
|
Dance lessons |
No |
|
Educational services (other than pre-school) |
No |
|
Kindergarten |
No |
|
Language classes |
No |
|
Nursery school |
Yes |
|
Piano lessons |
No |
|
Preschool |
Yes |
|
Private school tuition (for kindergarten and up) |
No |
|
Sick child care |
Yes |
|
Sleep-away camp |
No |
|
Summer day camp |
Yes |
|
Transportation to and from eligible care |
Yes |
|
Tutoring |
No
|
|
Elder Care Expenses |
Eligible?
|
|
Adult day care center |
Yes |
|
Day nursing care |
No |
|
Elder care (in your home) |
Yes |
|
Elder care (outside your home) |
Yes |
|
Medical care |
No |
|
Nursing home care |
No |
|
Senior day care |
Yes |
|
Transportation to and from eligible care
|
Yes |
Frequently Asked Questions
Where can I get more Pay Me Back Forms?
Included with this guide is one Health Care Pay Me Back form and one
Dependent Care Pay Me Back form. If you need additional forms, you can download
them from www.wageworks.com, request one from your company benefits manager or
contact WageWorks Customer Service at (877) 924-3967.
Can I change or cancel my plan once I have enrolled?
You may be eligible to change or cancel your enrollment after experiencing a
qualified change (such as getting married or having a child) only if and as
permitted by your employer’s plan.
How long will it take to receive reimbursement for my claims?
You can expect to receive a reimbursement check for approved Pay Me Back
claims within about one week.
What if my claim is denied?
You will be notified via mail or email within a week if your claim is denied
and if additional information is needed to approve your claim. You can also view
your claim status online at anytime.
How do I request a second Health Care Card?
You will receive a card with your name on it for your own use after you
enroll. You may request a second card for use by one of your dependents (it will
have their name on it). Both cards will automatically draw from funds in your
Health Care Account. To request a second card, log into your account at
www.wageworks.com and click on the Health
Care tab. Select “Request a Second Card” and provide your dependent’s first and
last names and social security number, or send an email to
help@wageworks.com. If you do not have
Internet access, call WageWorks Customer Service at (877) 924-3967 Monday
through Friday, 9am to 8pm Eastern Time and from 6am to 5pm Pacific Time.
What if I lose my Health Care Card?
If you lose your card, or if it’s stolen, report it to WageWorks immediately
by calling toll-free (877) 924-3967.
How do I know my personal information is kept secure and private?
WageWorks is committed to keeping your personal information safe by
enforcing rigorous security and privacy procedures including SSL encryption on
our web site. WageWorks’ web site has been certified by the TRUSTe Privacy
Program, and we are compliant with all current HIPAA regulations. WageWorks’
full Privacy Policy is available online at
www.wageworks.com.
What if I have additional questions?
If you can’t find the answer to your question in this guide, browse the Help
section of our web site at www.wageworks.com,
send us an email at help@wageworks.com
or call us at (877) 924-3967 (877-WageWorks). Our customer service
representatives are here to assist you from 9am to 8pm Eastern Time and from 6am
to 5pm Pacific Time.
The Rules
The following rules are dictated by federal regulations. These apply
when you participate in the Health Care Account or Dependent Care Account,
employer-sponsored plans that allow you to pay for eligible health care or
dependent expenses on a pre-tax basis.
Rules for Both Accounts
1. By enrolling, you authorize your employer to deduct your election amount
from your paycheck on a pre-tax basis.
2. Your account can be used to pay for eligible expenses incurred while you are
enrolled during the plan year. Expenses are considered incurred on the day of
service for health care or on the day your dependent receives care for dependent
care, not when you are billed or pay. Your account cannot be used to pay for
expenses incurred before or after you are covered under this plan or that will
be incurred in the future.
3. You cannot take a deduction or tax credit on your tax return for any health
care or dependent care expenses paid for through your accounts.
4. You are responsible for maintaining documentation (receipts, etc.) to verify
your expenses (the nature of each expense, the amount and the date incurred).
Keep these with your other important tax papers for the calendar year. You may
be requested to provide these per your monthly statement.
5. After the plan year ends, you will have a 90-day run-out period to get
reimbursed through the Pay Me Back feature for eligible expenses incurred while
you were covered under in this plan during the plan year.
6. Be sure to incur eligible expenses totaling your election amount while you
are covered under in this plan during the plan year. Any balance remaining in
your account after the 90-day run-out period cannot be rolled over or paid out
to you and will be forfeited.
7. If you want to participate in the plan during the next plan year, you will
need to
re-enroll during the next open enrollment period. We’re not allowed to keep you
enrolled or automatically re-enroll you.
8. You may be eligible to change or cancel your enrollment after experiencing a
qualified change, only if and as permitted by your employer’s plan.
9. Participation in this plan reduces your taxable income and may affect other
compensation-based benefits such as life, disability and Social Security.
10. Consult a tax advisor if you have any questions regarding your personal
situation.
11. You cannot use your dependent care account balance to pay for health
expenses and vice versa.
Rules for Your Health Care
Account
1. Your Health Care Account can be used to pay for only medically necessary
and eligible health care expenses that are not covered by or reimbursed through
insurance, a health plan or any other source.
2. When you use your WageWorks Card, you are certifying that the expenses paid
for with the card are medically necessary and not covered by or reimbursable
through any other source.
Rules for Your Dependent Care Account
1. Your Dependent Care Account can be used to pay for only work-related and
eligible dependent care expenses that are not covered by any other source.
2. You will need to provide the Social Security or Tax ID number of your
dependent care provider to request payments or get reimbursed from your
Dependent Care Account.
Definitions
Coverage Period
The period of time during which you are enrolled for the Health Care Account
or
Dependent Care Account during the plan year. You can use your Health Care
Account to pay for eligible expenses incurred during your coverage period.
Dependent Care Account
An employer-sponsored plan that allows you to set aside pre-tax income from
your paycheck to pay for eligible dependent care expenses incurred while you are
enrolled during the plan year.
Eligible Expense
A health care or dependent care expense that you can pay for using your
Health Care Account or Dependent Care Account. See the list of Health Care and
Dependent Care Expenses.
Health Care Account
An employer-sponsored plan that allows you to set aside pre-tax income from
your paycheck to pay for eligible health care expenses incurred while you are
enrolled during the plan year.
Medically Necessary
For the diagnosis, cure, mitigation, treatment, or prevention of disease
and/or for transportation primarily for and essential to receiving medical,
dental or vision care.
Participant
A person enrolled for a Health Care Account or Dependent Care Account.
Plan Year
The period of time during which your employer offers the Health Care Account
or
Dependent Care Account. You can use your Health Care Account or Dependent Care
Account to pay for eligible expenses incurred during your coverage period during
the plan year. Check online at www.wageworks.com or with your employer for your
plan year start and end dates.
Proof Of Service For Dependent Care
A provider’s signature on your claim form, a receipt, or other record of a
dependent care expense from a third party that specifies the type of care
provided, the date care was provided, and the cost.
Proof Of Service For Health Care
A written record documenting your health care expense that describes the
service you received or the item you purchased, the date of service and the
amount. A credit card-like receipt that shows only the cost is not sufficient
proof of service.
See Proof of Service definitions for more information.
Provider (Dependent Care)
A person or business who provides dependent care services. Can include
daycare centers, preschools, and senior daycare.
Provider (Health Care)
A person or business providing health-related services or materials. Can
include doctors, optometrists, pharmacists, dentists, orthodontists, and medical
suppliers.
GUIDELINES:
1. Use Pay Me Back for any type of eligible expense.
2. Pay for your expenses any way you like and then get reimbursed for them
directly from your Health Care Account. Do not file a claim for any expenses
paid for with the WageWorks Card or Pay My Provider. (Remember, expenses do not
have to be paid in order to qualify for reimbursement; they just have to be
incurred.)
3. After you have received the service or made your purchase, complete and
submit a Pay Me Back form with the appropriate required proof.
4. You can view the status of your claim online within 24 hours after we receive
it.
5. Reimbursement checks are mailed twice a week for APPROVED claims. You can
expect your check to be mailed to you within 5 days after we receive it
(provided you have an available balance in your account).
6. Your Health Care Account balance will be automatically adjusted to reflect
all payments made using Pay Me Back, Pay My Provider and your WageWorks Card.
PROOF OF SERVICE:
You will need to provide proof of service for each expense listed on the Pay
Me Back form. Your proof should be appropriate for the type of expense:
• Pharmacy receipt for prescriptions and other pharmacy purchases
• Doctor’s office receipt for office visit
• Explanation of Benefits (EOB) from your insurance or health plan, for covered
medical and dental expenses
• Bill or invoice from doctor or dentist for expenses not covered by your
insurance or health plan
• Payment contract, monthly payment coupon or statement from your orthodontist
• Receipt from your optometrist or other medical service provider
Note: Some expenses may require
you to submit a letter or written statement from your doctor stating (1) the
diagnosis and (2) the need for the expense and, if applicable, the difference in
cost between (3) standard, unmodified item and
(4) special or modified item. For a list of these expenses, go to
www.wageworks.com or see your WageWorks
Health Care and Dependent Care Guide.
ELIGIBLE DEPENDENTS:
You can use your Health Care Account to pay for health care expenses
incurred by any of the following people (even if they are not covered by your
employer’s health coverage):
• You
• Your spouse (if you are legally married and file a joint tax return)
• Your child, grandchild or any other child who you claim as a tax dependent
(regardless of age)
• Your older child, elderly parent, domestic partner or any other person who you
claim as a tax dependent
• Your older child, elderly parent, domestic partner or any other person who you
would be eligible to claim as a tax dependent except the person’s income
prevents you from doing so
GUIDELINES:
1. Pay for your expenses as usual and then get reimbursed (with pre-tax
dollars) directly from your Dependent Care Account.
2. You will need to complete and submit a Pay Me Back form with the appropriate
required proof.
3. You can view the status of your claim online within 24 hours after we receive
it.
4. Reimbursement checks are mailed twice a week for APPROVED claims. You can
expect your check to be mailed to you within 5 days after we receive it
(provided you have an available balance in your account).
5. Your account is funded strictly through your payroll deductions. Your
available balance at any time is the total of all amounts deducted from your
paycheck (as reported to us by your employer) less any payments made to date.
6. There is no limit to the amount of claims you can file against your account
at any time. However, payments will be limited to your available balance.
7. Once you have used your available balance, no additional benefits will be
paid until your available balance again exceeds $0 (as your payroll deductions
are reported by your employer).
8. All unpaid claims will be held to await available funds from your payroll
deductions. Each time a payroll deduction is reported by your employer, any
unpaid claims will be paid up to the amount of your new available balance.
9. Your Dependent Care Account balance is automatically adjusted to reflect all
payments made using Pay Me Back and Pay My Provider.
10. If you are using the Pay My Provider feature, you are not eligible to get
reimbursed through Pay Me Back until all of your Pay My Provider payments have
been made or cancelled.
PROOF OF SERVICE:
You will need to provide proof of service for each expense listed on your
Pay Me Back form. Submit one of the following for each expense:
• Signature of your provider on this form
• Photocopy of your cancelled check (front and back)
• Photocopy of a receipt
• Statement or bill from your provider (formal or informal)
ELIGIBLE DEPENDENTS:
You can use your Dependent Care Account to pay for expenses to care for any
eligible dependents:
• Your child, grandchild or any other child under the age of 13
• Your older child, spouse, elderly parent or any other person who is physically
or mentally incapable of self care
All of the following must be true about this person:
• The person lives in your home at least eight hours on each day you pay for his
care
• You (and your spouse, if you are married) pay over half the cost of
maintaining a household for the person
• You claim the person as a tax dependent, or you would be eligible to except:
(a) the person’s income prevents you from doing so or (b) the person is claimed
by his non-custodial parent due to written decree
And all of the following must be true about the care:
• The care is provided while you are working or enables you to work (and, if you
are married, while your spouse is working or going to school full-time at least
5 months a year or incapable of self care)
• The care may be provided by a relative or a non-relative but is not provided
by a tax dependent
• Your care provider must conform to state and local laws (including being
licensed, if required) and be able to provide you with his/her Social Security
or Tax ID number
Please remember as required by
law, any money in your Health Care or Dependent Care Account not used by the end
of the plan year, will be forfeited. Therefore, it is in your best interest to
be conservative when estimating your contribution, but keep in mind that your
tax savings may more than make up for any extra dollars you leave in your
account at the end of the year. If you are in doubt about an expense, please
contact WageWorks for assistance.
Also, in line with Internal Revenue Service guidelines, you can change your
election if you have a qualifying status change during the plan
year. This includes change in legal marital status, change in number of tax
dependents, termination or commencement of employment, dependent satisfies or
ceases to satisfy dependent eligibility requirements, or a judgment, decree or
order. However, the adjustment in your election must be relevant to the change
in status and the requested election change has to be in line and consistent
with the event. All requests must be submitted to WageWorks Corporation for
approval.
There is a run off period with
the reimbursement accounts. You will have 90 days following the end of
the plan year to file for services rendered during the plan year.