The Health Care Card, administered through HealthEquity, pays for many eligible health care expenses at the point of sale using funds from an employee's reimbursement account. That means less hassle and less paperwork.

Please note: You can only use the Health Care Card in the plan year of the incurred expense.

The Health Care Card works much the same way as a debit card. It automatically deducts pre-tax money from your Health Care Reimbursement Account for eligible purchases, including dental and doctor's fees, prescriptions (including home delivery), and some medical supplies. The amount of money you determine to contribute to your reimbursement account for the plan year serves as the "spending limit" for the card.

In addition to health care providers (doctor's office, dentist's office, etc.), the Health Care Card can be used at certified pharmacies and retailers such as Wal-Mart, Walgreens, Target, CVS, Kerr Drug, Harris Teeter and Kroger for eligible over-the-counter expenses such as bandages, contact lens cleaning supplies and reading glasses. You do not need to submit your receipts for eligible health care expenses to HealthEquity when using a certified pharmacy or retailer. However, it is recommended that you keep all receipts for IRS purposes. The Health Care Card is also easy to use for Express Scripts mail order prescriptions.

Please note: The health care card can be used for paying eligible health care services/expenses during the current plan year. It cannot be used to pay past bills from prior plan years.

While enrolled in the Health Care Reimbursement Account, you may continue to submit paper claims, use the Health Care Card, or upload claims online. HealthEquity now offers a mobile application that allows participants to review their account balances and submit photos of their receipts from their smart phones or other mobile devices. Discover more at wageworks.com.

When Should I Receive My Health Care Card?

If you are newly enrolled in a Health Care Reimbursement Account, you should receive your HealthEquity Health Care Card within 7-10 business days following your enrollment. Please contact HealthEquity at 1-877-924-3967 if you enrolled during Open Enrollment and have not received your card by January 1st.

New cards are issued with an expiration date three years from the issue date. Expired cards are replaced automatically. If you enrolled as a new hire or due to a qualifying life event, you should receive your card within two weeks of your enrollment in a Health Care Reimbursement Account.

Certified Pharmacies

A list of certified retailers where the HealthEquity card will be accepted is available here. All Duke Pharmacies accept the Health Care Card.

How to Use Your Card

To use your card at any eligible health care provider or pharmacy that accepts Visa® debit cards:

Activate Your Card

  • Activate your card by calling 1-866-363-4128 and follow the instructions provided at the prompts.
    • Be sure to use the last four digits of your Duke Unique ID if your Social Security Number is requested.
       
  • Prior to using the card, please refer to the list of eligible health care items.

At the Point of Service

  • Swipe your card when asked for a form of payment for an eligible health care expense.  
  • Choose credit (even though this is not a credit card).  
  • Sign the receipt or screen; no PIN is required.  
  • Save the receipt that describes exactly what you paid for with your card. Even if your purchase is approved at the checkout counter, HealthEquity may contact you to verify your purchase. Additionally, the IRS recommends that you save your receipts for tax purposes. 

If Your Card is Declined

  • Use another form of payment. (The provider or pharmacy will not have details about the reason the card was declined. Do not ask them to call HealthEquity.)
  • Contact HealthEquity Customer Service yourself at 1-877-924-3967 to find out the reason for declination.

Using Your Card: What You Can Expect

At the Point-of-Sale

Your card transaction will be approved for payment at the point-of-sale if all of the following are true:

  1. The card is activated (call 1-866-363-4218 to activate)
  2. Your account balance (your annual election minus any previously approved transactions) is sufficient to cover the transaction amount.
  3. The merchant is on the approved list because they are likely to sell or provide eligible health care products or services.

If the transaction is approved, the money is transferred from your Health Care Reimbursement Account to the merchant via the card payment network.

If the card transaction is not approved for payment, then it is declined at the point of sale; no money is transferred from your account. You will need to use an alternate form of payment. If you believe the expense is an eligible expense, you can use a "Pay Me Back" form to claim reimbursement.

Within 20 Days of Transaction Date

The card transaction is automatically approved as an eligible health care expense if any of the following is true:

  1. The transaction amount matches a health plan deductible or co-pay amount. (Please note that co-insurance does not apply).
  2. The merchant is IIAS-certified.
  3. The transaction amount and merchant match a previously approved transaction you made during this plan year.
  4. Information from another source (claims data from prescription drug plan, claims data from health plan or merchant data) verifies this transaction was for eligible health care products or services.

If the card transaction is not automatically approved, it is displayed in your account as "Pending".

20+ Days From Transaction Date

Any amount of the card transaction that is not approved as an eligible health care expense by any of the approved methods above is displayed in the "Action Needed" section of your online account and/or Statement of Activity.

Your account will describe the options you have to resolve this issue.

90 Days From Transaction Date

If you have a Card transaction that requires verification, you will be notified by email and with a message upon log in to your account. 

Frequently Asked Questions

When and Where You Can Use the Card

When can I use the card?

You can use your HealthEquity health care card beginning January 1 if you enrolled in a Health Care Reimbursement Account during Open Enrollment. Otherwise, you may begin using your card effective with your enrollment in a Health Care Reimbursement Account and receipt of the card. You can use the card until December 31 to pay for eligible expenses you or your eligible dependents incur during the plan year. Your card is a three-year card and expires on the date printed on the card. If you re-enroll in a Health Care Reimbursement Account for another plan year, you will be able to use this same card until it expires at the end of the third year. Therefore, please do not discard the card even after depleting all funds in your account.

Where can I use the card?

You can use your HealthEquity health care card at doctor and dentist offices, vision centers, pharmacies, and other eligible health care-related merchants who accept Visa® debit cards. Below is a chart of typical merchant types: Card payments at all other merchant categories (including restaurants, entertainment, and travel) are prohibited and automatically declined through the card network when authorization is attempted. Please note: The UNC School of Dentistry does not operate under a dental merchant category code. Therefore, the health care card cannot be used at this facility.

Ambulance Services
Chiropractor
Counseling Services
Dental, Medical Lab
Dentist, Orthodontist
Drug Proprietors
Health, Med Services
Hearing Aid Sales
Hospital
Nursing, Personal Care
Optician
Optometrist
Orthopaedic Goods
Osteopathic Physician
Pharmacy
Physicians
Podiatrist
Wholesale Medical Equipment

Remember, the easiest way to purchase prescription drugs and other eligible health care items is to use your health care card at a merchant with an inventory control system referred to as "IIAS." Local merchants in our area that are currently IIAS certified are listed here. For online pharmacy purchases, www.drugstore.com uses the IIAS system. 

Can I use my health care card with the pharmacy mail order program?

Yes. You can use your health care card with the pharmacy mail order program. Just provide the account number from your card to your pharmacy vendor (e.g. Express Scripts).

Can the health care card be used outside of the United States?

The health care card can be used internationally as long as the provider operates under an eligible merchant category code. Depending on the provider and the transaction, the expense may have to be verified with receipts or other documentation. If you make a purchase in a currency other than the currency in which your card was issued, the amount deducted from your funds will be converted by Visa USA Inc. into an amount in the currency of your card. In this case, the issuer reserves the right to increase the currency conversion rate by an additional 3% and will retain this amount as compensation for its services.

At the Point of Sale

Will I have to separate my items at checkout?

At IIAS-certified merchants the card will only be accepted for payment of eligible health care items. At these stores, when both health care and non-health care items are not separated and the health care card is presented for payment, only those eligible health care items will be paid for on that card. Another form of payment will then be requested for the remaining non-health care related items. However, if the card is used at a non-IIAS certified merchant you are encouraged to separate your items if you wish to only pay for the health care related items using the HealthEquity health care card. Otherwise, you may have to pay back your HealthEquity health care card account for all non-health care related items.

How will I know if a merchant is IIAS-compliant?

An updated list of all IIAS-certified merchants will be maintained here

What is the spending limit on my card?

The value on the card at the beginning of the plan year is equal to your health care reimbursement account annual election. As claims are submitted, the value of the card decreases by the amount of the transaction. If enough eligible health care claims have been incurred, the balance will eventually reach zero.

Am I able to use my card to pay for multiple prescriptions during one transaction?

You are able to use your health care card for multiple prescriptions. However, when multiple prescriptions are purchased at the same time, they are not viewed separately by the card payment network, and the lump sum of the prescriptions is what the card payment network processes. Since the total prescription cost will not be a multiple of a co-pay, which is one of the requirements for the transaction to be substantiated at the point of sale, you may be required to submit receipts to verify your expenses.

What happens if I have an expense that is larger than my account balance? Can I still use my card for the amount of the available balance and then use another form of payment to pay for the difference?

If your expense is larger than your account balance, you can use up to the account balance and pay for any remaining difference using another form of payment. If you attempt to pay for any expense that is more than your account balance, the transaction will be declined.

What if the card is declined?

If your HealthEquity health care card is declined at the point of sale, please use another form of payment to pay for your eligible health care service or expense. You will be able to submit a paper claim using a Pay Me Back claim form.

Receipts and Requests for Reimbursement

Why should I keep my receipts?

In order to keep this program in compliance with IRS regulations, it is important to make sure the card is used only for eligible expenses. HealthEquity is responsible for reviewing all card transactions and verifying that the card is used only for eligible health care products and services. In order to make your card transactions go smoothly, keep your receipt even if your purchase is approved at the checkout counter. Receipts are most often requested for purchases at pharmacies that sell both eligible items like reading glasses, and ineligible items like magazines, greeting cards, and snacks. Additionally, receipts are often requested for dental and vision care expenses, pharmacy expenses that are amounts other than the standard pharmacy co-pay, or when health care provider expenses are amounts other than the standard health care provider co-pay. We suggest that you separate your purchases and pay for eligible health care items with your HealthEquity health care card, and use another form of payment for everything else.

Why do I need to provide a receipt for some transactions and not for others?

You will be required to keep/provide your receipt(s) depending on where you purchase your eligible health care items. There are certain retailers who are IIAS-compliant, which means that particular vendor has a computer system which automatically can determine if your purchases are eligible health care items. Many retailers are IIAS-certified, so you will not have to submit receipts when using your health care card at these stores.

How do I know if I need to provide a receipt or other documentation to HealthEquity?

A Card Use Verification form will be included in all monthly statements each time you have a card transaction with an amount that has not been verified. This form makes it easy to submit receipts or other documentation to verify the eligibility of these expenses and resolve the card transactions. You can also check your online account for the latest information.

What do I do if I lose my receipt?

Your monthly account statement will let you know and explain your options. These options may range from submitting a substitute receipt to paying back your account for the amount of the transaction.

If I cannot provide a receipt to substantiate an expense, how do I pay back my health care card account?

For any expenses that have not been substantiated within 75 days of the transaction, that amount will be deducted from your next requested reimbursement check or you may repay your account per the instructions on your statement.

How can I ensure most of my health care and pharmacy transactions are substantiated at the point of sale without having to provide receipts?

One of the first recommendations after you receive your health care card is to log in to your account, and click "Improve My Card Experience" on the left-hand side of the Health Care overview page. By entering your health and prescription plan member IDs for you and your eligible dependents, you give HealthEquity the information needed to automatically verify more of your health care card transactions. Your plan member ID can be found on your health and/or dental insurance plan card(s). (Be sure to enter your new member IDs if you change providers.)

What happens if I use my health care card to purchase multiple prescriptions? Will I have to submit receipts to verify each of them?

If the total amount of the transaction is not a multiple of one of your pharmacy co-pays, you will be required to substantiate the expenses by submitting receipts for each of the prescriptions.

Other Questions about the Card

What should I do if I do not receive my health care card by January 1?

You should first check that you are properly enrolled in a health care reimbursement account. If you are, then contact HealthEquity Customer Service at 877-924-3967.

I enrolled in a health care reimbursement account as a new hire. When will I receive my health care card?

As a new hire you will receive your health care card within two weeks of your enrollment in a health care reimbursement account.

What do I do if I lose my card or if my card is stolen?

If you believe your card has been lost or stolen, or that someone has transferred or may transfer money from your card account without your permission, call HealthEquity immediately at 877-924-3967. This is the best way to minimize any possible losses.

How do I get additional cards for my spouse and/or dependents?

You can order additional cards for your spouse or eligible dependents. Log in to your account, then click the Health Care tab, and select Request Additional Card. You can then enter the first name, last name, and required security information for each additional cardholder. Additional cards will be issued in the name(s) of your spouse or eligible dependent(s). Card activation is based on the four digits you provided to HealthEquity when the additional card was requested. These four digits are required during the activation process. 

Will I get a new card if I re-enroll in a Health Care Reimbursement Account next year?

Your card is a three-year card and expires on the date printed on the card. If you re-enroll in a Health Care Reimbursement Account before the expiration date on the card, you will be able to use this same card. Therefore, please do not discard the card even after depleting all funds in your account.

Is there a charge for a replacement card?

No.

Can my card be suspended?

Yes, in certain situations, usually to prevent unauthorized use or misuse of the card, including:

  • The card has been reported lost or stolen
  • Suspicious activity is observed
  • At any time, upon Duke's request

What happens if I change my name? Will I automatically be mailed a new card?

Make sure you notify Duke of your name change, and then verify that the information has been updated in Duke's payroll system. Once this has been done, you will need to call HealthEquity to request a new card with your updated name.

My spouse and I are both Duke employees. Can we both get health care cards?

Yes. Each eligible Duke employee is able to enroll in a health care reimbursement account and contribute the maximum of $3,200 per year.

My spouse and I are both Duke employees. Can we enroll in one health care reimbursement account and get two cards that link to that account, so that we could both pay for qualifying health care expenses from one account?

Yes. Either you or your spouse can enroll in a Health Care Reimbursement Account and request additional health care cards for use by eligible dependents, including your spouse. All additional requested cards will be linked to the same Health Care Reimbursement Account.

Do I have to use the HealthEquity health care card to have a Health Care Reimbursement Account?

No. You can still submit paper claims by downloading and completing a "Health Care Pay Me Back" claim form. Your expenses will be reimbursed via the method you selected (direct deposit or check) when you created your online HealthEquity account. You may submit paper claims, use the health care card, or do a combination of both to access the available funds in your Health Care Reimbursement Account.

I have a dependent care reimbursement account. Can I use my HealthEquity health care card to pay for my dependent care expenses?

No, you cannot use your health care card to pay for dependent care expenses.

Duke Basic Enrollees

I am enrolled in the Duke Basic health plan. Will I receive a health care card?

Yes. All Duke Basic members will receive a health care card. The amount available in your health care reimbursement account is contingent on the level of coverage you have with Duke Basic. In addition to the amount you may have chosen to contribute to your own Health Care Reimbursement Account, Duke provides $200 for individual, $300 for employee/child, $400 for employee/children, $400 for employee/spouse, or $500 for family coverage.

I am enrolled in the Duke Basic health plan, but I will also have a separate Health Care Reimbursement Account. Will I receive two health care cards?

No. The funds from the Duke Basic reimbursement account will be combined with the funds from your Health Care Reimbursement Account, so that the total from the two accounts will be available to you during the plan year.