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File a Claim

Use the claim submission method that works best for you – the choice is yours!

Submit Your Claim in One of These Ways

Online

Filing a claim through your online account is easy to do.


  • Log in to your account. If this is your first time logging into your FSAFEDS account, you’ll need to register first before logging in.
  • Once you have logged into your account, click Submit Receipt or Claim and select your Reimbursement Option.
  • Follow the step-by-step instructions.
  • Upload digital copies of your itemized receipts (and other documentation if needed).

FSAFEDS App

Our app is the easiest and quickest way to submit a claim!


  • Log in to the FSAFEDS app using the same username and password as your online account.
  • Select whether to submit a claim or pay a provider.
  • Follow the prompts to enter claims details.
  • Take photos of your itemized receipts (and other documentation if needed) or upload from your mobile device.
  • Tap Submit Claim to authorize the claim and finish the submission.

Fax or Mail

  • Download the form you need from the File a Claim dropdown menu.
  • Fill in all the information requested on the form and sign it.
  • Fax or mail the form, along with copies of your itemized receipts (and other documentation if needed), to:

Mail

FSAFEDS Program - Claims
P.O. Box 14127
Lexington, KY 40512-4127

Fax

866-643-2245 (toll-free) or
650-577-5340

If mailing your claim, please send in copies of your receipts and keep the original documents in your files.

Most claims are processed within one to two business days after they are received and verified. Payments are sent shortly thereafter. For additional information, check out the Submitting Claims Quick Reference Guide (PDF).

Receipt Requirements

FSAs are regulated by the Internal Revenue Service (IRS). IRS regulations state when filing a claim, your expenses listed must be incurred by you, your spouse, or eligible dependent during the coverage period and the dates noted on the claim. You must also file your claim with the appropriate supporting documentation. That means, save each and every receipt – you’ll most likely need it.

You must have a receipt or an explanation of benefits from your insurance carrier for each health care claim you submit against your account.

For quick processing, make sure all receipts include these five pieces of information:

  • Patient's Name – the name of the person who received the service or for whom the item was purchased. For retail store purchases, this information may be excluded.
  • Provider's Name – the provider that delivered the service or the merchant where the item was purchased.
  • Date of Service – the date when services were provided or the item was purchased.
  • Type of Service – a detailed description of the service provided or item purchased. A pharmacy prescription receipt is sufficient for prescriptions.
  • Cost – the amount paid for the service or product and/or the portion that is not reimbursed through your insurance carrier.

Please note: For some expenses, a Letter of Medical Necessity Form (PDF) from a doctor may be required.

Learn More

There are three ways to submit a Dependent Care FSA claim:

  1. Use the FSAFEDS app to have the dependent care provider certify the service by providing a signature on your mobile device.
  2. Have the dependent care provider certify the service by signing the completed claim form (PDF).
  3. Submit a claim (PDF) with an itemized statement from the dependent care provider. For quick processing, make sure receipts include the following five pieces of information:
  • Patient's Name – the name of the person who received the service
  • Provider's Name – the provider that delivered the service
  • Date of Service – the date when services were provided
  • Type of Service – a detailed description of the service provided
  • Cost – the amount paid for the service

  • DO use your insurance carrier’s Explanation of Benefits (EOB) statement for health care receipts, especially if your insurance paid a portion of the expense.
  • DO make sure your receipt is legible; check that it isn’t too dark or light and that information is not cut off.
  • DO include stamped provider information on handwritten receipts.
  • DON’T send credit card receipts, cancelled checks, or balance forward statements as they typically do not include all five key pieces of information.
  • DON’T use highlighters on your receipts.

Take a photo of each receipt and store them in your FSAFEDS app.

If you participate in paperless reimbursement, your FEHB plan or FEDVIP plan automatically forwards your claims to FSAFEDS each week. It may take up to 10 to 12 business days from the time your FEHB plan submits your claim until your funds are deposited into your account via electronic funds transfer (EFT) – otherwise known as direct deposit.

The payment schedule for retail and mail-order pharmacy vendors is generally longer than what you may experience for medical, dental and vision claims. That means, your pharmacy claims will most likely take longer for reimbursement.

Still Have Questions?

If you still have questions about filing a claim, check out our Claims FAQs. Or if you prefer, simply contact us. We’re here to help.

Important!

You can view all forms from our dropdown menu (they are in PDF format) using Adobe Acrobat Reader, which is free from Adobe. To save a form to your desktop, right click on it and select Save As. You can now name the file and save to your computer. All FSAFEDS forms are 508-compliant and web-accessible. All claims and supporting documentation must be submitted in English.