If your plan has a combined deductible for medical and prescription expenses and you have not yet met your deductible, you will be asked to pay CareFirst's discounted price for your prescription drug. Provided that you have an adequate balance in your HRA, you can use your debit card to cover the entire cost of your prescription. When the pharmacist files the claim, the amount of the prescription will also be applied to your annual deductible, thus reducing your remaining liability.

Because you have already met your deductible, you are only responsible for the appropriate copay for your prescription, which is based on the type of drug that you are receiving. Provided that you have an adequate balance in your HRA, you can use your debit card to pay your copay.

The use of your debit card is limited to healthcare-related merchants, including doctors, dentists, vision care offices, and hospitals who accept MasterCard. Your card will also be accepted by certain types of merchants that are not considered healthcare-related, like supermarkets, grocery stores, discount stores, drug stores and mail order vendors.

However, these merchants must use an Inventory Information Approval System (IIAS). This allows them to identify qualified healthcare-related items. Most of these merchants have already implemented such a system. A few will be implementing their IIAS system by December 31, 2008. Purchases that do not meet IRS requirements, or purchases from a vendor that does not have an IIAS, will result in your card being rejected.

If you card is rejected, you can still file a claim with BlueFund Administrators and be reimbursed by check or direct deposit.

Most merchants' inventory information approval systems are able to distinguish between prescription drugs and other healthcare items, such as over-the-counter medications. This is important because most HRA plans only allow HRA funds to be used to cover prescription drugs. When a merchant's system cannot distinguish between prescription drugs and other healthcare items, the debit card transaction will likely be denied. The expense can then be submitted to your BlueFund Administrator for reimbursement by check or direct deposit.

At this time, two frequently used merchants - Walmart and Sam's Club - fall into this category: Your debit card may be rejected at these merchants. This may change in the future. You may still buy your prescriptions from these merchants but you will have to file a claim with your BlueFund Administrator to be reimbursed.

If you exceed your annual deductible with the purchase of a prescription drug, your pharmacist will make the necessary adjustments to your out-of-pocket cost, and you will be charged only the remainder of your deductible, as well as the applicable copay. Your debit card will be swiped for this amount. Provided that you have an adequate balance in your HRA, this transaction will be covered.

Your debit card transaction will be declined if there are not enough funds remaining in your HRA to cover the entire transaction. However, you can ask that the card be swiped for $100, and then pay the remaining balance out-of-pocket.

Yes. Just like your credit card, your HRA debit card is capable of receiving credits in the same way. Money credited to your debit card will be returned to your HRA.

Yes, you can still use your debit card but the debit card will only cover the eligible items. That is the benefit of an IIAS. The merchant's IIAS is capable of sorting your items. You can pay for your eligible items with your debit card, and the remaining balance (for the ineligible items) can be paid out of pocket.

The Inventory Information Approval System (IIAS) used by Walmart (and some other merchants) cannot, at this time, distinguish between prescriptions and other items considered eligible by the IRS. The HRA plan implemented by your employer likely covers medical expenses and prescription drugs only. The IRS requires HRA administrators to "substantiate" or approve transactions. Because there is no way to know if you purchased a prescription only, the debit card transaction cannot be approved. You will need to submit a claim to the Blue Administrator with a copy of your receipt, or use a different merchant.

Depending on your relationship with the doctor, you will be met with one of the following scenarios.

1. You will not be asked to pay any money at the time of your visit. Your doctor will submit a claim for the entire cost of the visit directly to CareFirst. If you have met your annual deductible, CareFirst will pay the claim, minus your copay. If you have not yet met your deductible, CareFirst will apply the allowed cost of the service toward your annual deductible, and you will be responsible for payment to your doctor. The doctor will then invoice you directly for the allowed cost of the service. Provided that you have adequate funds in your HRA, you can pay the doctor with your debit card by simply providing your HRA debit card information.
   
   
2. You will be asked to pay the amount of your office visit copay. You should pay this amount using your HRA debit card. Your doctor will then submit a claim for the remainder of the cost of the visit directly to CareFirst. If you have met your annual deductible, CareFirst will pay the entire claim. If you have not yet met your deductible, CareFirst will apply the allowed cost of the service toward your annual deductible, and you will be responsible for paying the doctor the difference between what you already paid at the office and the allowed cost of the service. The doctor will then invoice you directly for remainder of the allowed cost of the service. Provided that you have adequate funds in your HRA, you can pay the doctor with your debit card by simply providing your HRA debit card information.
   
   
3. Before your visit, some doctors check with CareFirst to determine whether you have met your deductible. If you have not yet met your annual deductible, the doctor may require you to pay the entire allowed cost of your visit in advance. Provided that you have adequate funds in your HRA, you should pay the doctor using your HRA debit card. The doctor will then file the necessary paperwork to ensure that you receive credit toward your deductible.

Yes, your debit card is available for eligible healthcare related transactions, regardless of the provider network. However, your HRA dollars will go further when you receive care from doctors within the CareFirst provider network.