Choate House on the Pace Pleasantville campus

Filing A Claim

If you choose not to use the PayFlex debit card, you can still receive reimbursement for eligible health care or dependent care expenses by:

  • submit a claim online by logging into your account and uploading the supporting documentation.
  • submitting a claim using the PayFlex Mobile app. You can download it for free* from your mobile app store. You’ll use the same username and password that you use to log into your Payflexyour account.
  • submitting a paper reimbursement claim form (PDF) and mailing or faxing it to PayFlex with your documentation.

*Standard text messaging and other rates from your wireless carrier still apply.

If the expense was first processed through your medical, dental, or vision plan, you’ll need to provide the Explanation of Benefits (EOB) from the plan.

If your expense was not processed through your medical, dental, or vision plan, you can send an itemized receipt or statement for the expense. The documentation must show the:

  • date of service or purchase
  • amount that you are required to pay
  • description of the item or service
  • name of the merchant or provider

If the claim is for an over-the-counter (OTC) drug or medicine, you must also include a written prescription from your doctor.

For prescriptions, send your detailed receipt. It must include the pharmacy name, patient name, prescription name, date the prescription was filled, and the amount that you paid.

For dependent care expenses, the dependent care provider must sign the claim form or provide an itemized receipt. The receipt must include the date(s) of service.