Fidelity HSA & FSA Bill Pay FAQ

How you pay for health care expenses is a personal decision, and you have multiple options available. Here are some tips to help you get the most out of your Fidelity Health Savings Account (HSA) and Flexible Spending Accounts (FSA) experience.

Health Savings Accounts are the most tax-advantaged way to save for health care expenses in retirement. You can choose to reimburse yourself from your HSA immediately, or at a future date. If you want to maintain your HSA balance for long-term health care savings and investing, consider paying your provider directly using your personal bank account or credit card rather than tapping into your HSA funds.

You can link your personal bank account information within the Fidelity Bill Pay tool and use it to pay claims from rather than using your HSA funds.

Important note: Unlike HSA funds, Flexible Spending Account (FSA) funds need to be used in the calendar year and only a limited amount can be rolled over to the next year. See the Flexible Spending Accounts page for more details on how FSAs work.

Use your Fidelity NetBenefits AccessCard to draw from both your HSA and FSA (if applicable). To request additional cards for dependents, log into your NetBenefits account.

If you have both an HSA and Limited Purpose FSA, funds will pull first from your Limited Purpose FSA (if an eligible expense) until that account balance is depleted. Only then will it draw from your HSA available balance. Learn more about the NetBenefits AccessCard.

To initiate a manual reimbursement claim, download the Fidelity Health app on your mobile phone or go to NetBenefits and select the account you wish to draw from (FSA or HSA).

When requesting reimbursement from your FSA, be sure to have your receipt ready. IRS rules require that all FSA claims be substantiated. While this requirement does not apply to HSAs, it’s a good idea to save itemized receipts and documentation for all health care services.

If you are enrolled in the Health Savings Plan (HSP) and want to pay your medical bills directly from your FSA and/or HSA, there are a couple of steps you need to take to get set up. First, log into NetBenefits and provide your  consent  to access your Premera health claims in your Fidelity account. Once you’ve provided consent, your Premera medical claims will be imported for paying out of your Fidelity FSA.

Next, enroll your HSA in Fidelity Bill Pay. Because HSAs are personal financial accounts, Fidelity asks that you positively consent to using your HSA to pay expenses. This step isn’t required to pay expenses from your FSA. This step is embedded in the bill pay flow the first time you pay an expense.

Important note: Before making any payments from your HSA or FSA, be sure to confirm directly with your providers the outstanding amounts due and payee information. Sometimes medical claims get reprocessed or adjusted, so the amount showing due in the Fidelity Bill Pay tool may not be the most up to date. You can log into your Premera account to see the status of claims and view Explanation of Benefits (EOB).

FAQs

Why do I have to provide consent to access my health care claims from Premera?

Why aren’t my healthcare claims or my dependent’s claims showing up in the Fidelity site/app?

There are several reasons why a specific claim may not be sent from Premera to Fidelity.

You’re no longer enrolled in the Health Savings Plan (HSP). In compliance with privacy standards and practices, Premera will only send claim information to your Fidelity HSA if you’re enrolled in the HSP.
The claim has a $0 member responsibility.
The claim is for a prescription.
The claim is for a dependent's sensitive claims. In order for Fidelity to receive information for dependent sensitive claims*, your dependent must provide their authorization to Premera. Your dependent can add an authorization by following these steps:
Log in to Premera.com
Click My Account in the upper right corner
Choose Account Settings
Within the sharing and privacy section, click Add Individual
Authorize the employee/subscriber by clicking the personal funding account settings

Once Premera has received your dependent's authorization, it may take up to a week for the sensitive claims to be included on the next weekly claim file to Fidelity. This functionality is currently in place for HSA only. Premera is working to update their system to include this logic in their FSA substantiation file as well.

*In compliance with several state laws, information regarding sensitive conditions is provided only to the member receiving care, if they’re aged 13 or older. Sensitive conditions include gender-affirming care, reproductive health, and mental health, among others. If you’ve any questions regarding your dependent's sensitive claims, contact Premera at (800) 676-1411.

What happens to my HSA if I am no longer enrolled in the Health Savings Plan?

If you’re not enrolled in the Health Savings Plan (HSP), you’re not eligible to contribute to an HSA. However, since HSAs are individual bank accounts, any funds you had in your HSA are yours to keep and you can leave any remaining funds in your HSA for long term savings, investing, or to pay for qualified medical expenses now or in retirement.

Why don’t all provider addresses pre-populate when I pay an expense?

Provider address will pre-populate for most of your in-network, Washington state claims. Out-of-network claims and claims outside Washington state are often processed by your local Blue Cross Blue Shield; the billing addresses for these claims aren’t available to Premera so can’t be imported to your Fidelity account. Providers often have multiple addresses: one for submitting claims to Premera and another to receive payments. For this reason, provider addresses are not currently pre-populated in the Fidelity payment process.

Important note: Remember, it is always your responsibility to ensure payments are sent correctly, so the best practice is to wait until you receive a bill from your provider either in the mail or via their online portal (if available) to ensure you’re using the correct payee address information. This information isn’t available on your Premera Explanation of Benefits (EOB).

Can I pay an expense from my personal (non-Fidelity) bank account on the Fidelity website/app?

How do I transfer my HSA funds from my former employer to my Fidelity HSA?

Why is there multi-factor authentication (MFA) to add a new HSA payee?

Why does Fidelity ask for substantiation of my FSA purchases made on the NetBenefits AccessCard?

Unlike HSAs which do not require substantiation, IRS rules require that FSA claims are substantiated by the administrator. When you swipe your card for an FSA-eligible purchase, Fidelity’s system recognizes and auto-substantiates purchases made from an IIAS merchant. If your purchase wasn’t made from an IIAS merchant, Fidelity will check the Premera FSA substantiation file for the purchase amount to see if the purchase can be auto-substantiated in this way. If a claim isn’t received from Premera after 60 days, Fidelity will send you a notification asking for documentation in order to substantiate the purchase. Fidelity will send two more reminders every 30 days until documentation is received. The third request will be the final notice. If documentation isn’t received within 10 days of the final reminder, Fidelity will be required to suspend your NetBenefits AccessCard until the purchase is substantiated or the amount is re-paid to the plan.

If you have any questions regarding this process, please review the Fidelity NetBenefits AccessCard FAQ or contact Fidelity at 888-810-6738.

Why doesn’t my claim status update automatically after I pay a claim using the bill pay tool?

Why doesn’t my available balance change when I pay a claim using the bill pay tool?

When you pay a claim using the bill pay tool, you’re requesting that Fidelity issue a check to your provider. In the same way your available balance doesn’t change in your personal checking account on the day you write a check, your available cash amount in your Fidelity HSA won’t change until the check has been cleared. You can view transaction activity detail in your NetBenefits account as well as your HSA at Fidelity.com.

How can I utilize the Fidelity NetBenefits chat feature for assistance?

When you log into NetBenefits, select the chat feature in the lower right corner. Fidelity's Virtual Assistant is a chatbot designed to help you with your workplace account questions, including both your 401(k) and your HSA. Simply type in your question or choose from one of the popular topics and commonly asked questions. Please don't include any personal details or account information. 

How do I view a check payment that has been made to my provider?

Log into Fidelity.com and select “Bill Pay” from the “Accounts & Trade” menu. Once on the Bill Pay Payment Center, choose “Payment Activity” and select your Health Savings Account from the “Selected Account” drop-down menu. You can then filter payments in several ways: 1) Deliver by, 2) Search payee, 3) Status, and 4) Payee category. Choose a filter option and any payments pending or processed will be displayed. You’ll be able to view the check details like status, confirmation number, check number, and date of payment.