Benefits Plans - Flexible Spending Accounts: Health Care -
Filing Claims for Reimbursement

Filing a Claim

After you incur an eligible expense, you have the option of submitting a claim online or completing a paper claim form and mailing or faxing it along with your itemized documentation.

Submitting a claim online

To submit a claim online you first need to register.

  1. Go to the PayFlex/HealthHub website for U-M faculty and staff at:
  2. Click Register on the homepage.
  3. Enter your 8-digit UMID as your Member ID (not your Social Security Number) and then enter your zip code.
  4. Complete the online registration form.

To reimburse yourself:

  1. Login to by entering your username and password, then click Submit.
  2. Click on File a Claim and select Pay Me.
  3. Enter your claim information: type of expense, date of expense and the amount of expense. To add additional claims, select Add Claim.
  4. Once you have entered in all of your claims, click Submit.
  5. Confirm all expense details, then click Submit. If you need to make changes, click Previous.
  6. Select Fax or Upload for your document choice. In order to upload your receipts, they will need to be scanned into a PDF format.
    • If you selected “Fax,” click on Web Claim Coversheet, then print and sign the form. Fax your claim and itemized receipts to (866) 932-2567.
    • If you selected “Upload,” use the Browse button to upload an electronic document from your computer. To add additional documents, click on Add Additional Documents.
  7. After uploading your documents, you must check the Signature box at the bottom of the page to electronically sign your claim. If submitting dependent care claims, please make sure the provider’s signature is legible.
  8. Click Submit. If you enrolled in eNotify, you will receive an email from PayFlex notifying you when your claim has been processed.

To reimburse a provider:

  1. Login to by entering your username and password, then click Submit.
  2. Click on File a Claim and select Pay Them.
  3. Enter a new provider or select a payee from your current list and click Next.
  4. Enter your contact number, statement date, invoice number, patient name and any comments you may have.
  5. Fill in your claim information and click Next.
  6. Verify your claim information is correct and click Next.
  7. Choose to fax or upload your documentation and click Select.
  8. You will receive a confirmation email from

Submitting a Paper Claim via Mail or Fax

  1. Login to your HealthHub account and select My HealthHub Resources to download a claim form from Administrative Forms.
  2. Complete the fillable Form by entering your claim information.
    • Print and sign the form.
    • Mail the completed form and itemized receipts to:

    PayFlex Systems USA
    P.O. Box 3039
    Omaha, NE 68103-3039

    (Or) FAX the completed form along with the itemized
    receipts to (402) 231-4310

You can submit claims for 2014 until May 31, 2015 and submit 2015 claims until May 31, 2016.

PayFlex Card Claims Validation
If you pay your eligible health care expenses with your PayFlex Card, request itemized receipts for your expenses and save them. PayFlex/HealthHub will require the itemized receipts to substantiate your claim. If a receipt is not provided, you may be requested to pay back the amount you were reimbursed.


For more information, call PayFlex/HealthHub at 877-343-1346 or visit the website at

Electronic Fund Transfer (EFT)

Next: Dependent Care Flexible Spending Accounts

The University of Michigan in its sole discretion may modify, amend, or terminate the benefits provided with respect to any individual receiving benefits, including active employees, retirees, and their dependents. Although the university has elected to provide these benefits this year, no individual has a vested right to any of the benefits provided. Nothing in these materials gives any individual the right to continued benefits beyond the time the university modifies, amends, or terminates the benefit. Anyone seeking or accepting any of the benefits provided will be deemed to have accepted the terms of the benefits programs and the university's right to modify, amend or terminate them.