Eligibility

As a City of Oakland RHS Plan participant, you are eligible to receive reimbursement for "Qualified Medical Expenses" under your RHS Plan.

Qualified Medical Expenses Under the RHS Plan

• Costs of diagnosis, cure, mitigation, treatment, or prevention of disease, and the costs for treatments affecting any part or function of the body.
• Payments for legal medical services rendered by physicians, surgeons, dentists, and other medical practitioners, which may include the costs of equipment, supplies, and diagnostic devices needed for these purposes.
• Medical care expenses primarily to alleviate or prevent a physical or mental defect or illness. Eligible expenses do not include expenses that are merely beneficial to general health, such as vitamins or a vacation.
• Out-of-pocket expenses - e.g. medical or dental insurance deductibles and copayments, or any other out-of-pocket medical expense that qualifies under IRC Section 213(d) with the exception of direct long term care expenses.
• Premiums you pay for insurance that covers the expenses of medical care, and the amounts you pay for transportation to get medical care, which include amounts paid for qualified long-term care services and limited amounts paid for any qualified long-term care insurance contract.
• Other medical expenses that may not be covered by a health insurance plan (e.g., vision, prescription drug, acupuncture, home health care, nursing home expenses, nursing services, organ transplants, therapy as a medical treatment, durable medical equipment, home improvements made to accommodate the home for a disabled condition, and any other retiree medical expense deductible under IRC Section 213(d).

*Please consult IRS Publication 502, Medical and Dental Expenses, on the IRS website for a thorough discussion of the types of expenses that qualify under your RHS Plan. Also, these guidelines are subject to change with any changes to IRS regulations or to the City's Plan Document.

Reimbursement Process

RHS participants are eligible to receive reimbursement for "Qualified Medical Expenses" under your City of Oakland RHS Plan. MissionSquare Retirement works with Meritain Health, the third-party administrator that handles your RHS claim reimbursement requests. Please read these instructions carefully before submitting a reimbursement request.

Reimbursements can be submitted daily either by online, mail or fax. Supporting documentation must be provided with each request. Supporting documentation for expenses include: Explanation of Benefits, Premium Notices, Receipts, or Itemized Bills. All documentation must include the patient's name, date(s) of service, service provided, insurance payment if applicable, and total patient out-of-pocket amount.

Mail Instructions:

Mail the completed VantageCare RHS Benefits Reimbursement Request Form, along with supporting documentation, to Meritain Health at:

VantageCare RHS Plan, c/o Meritain Health

P.O. Box 30136

Lansing MI 48909-7611

Fax Instructions:

Fax the completed VantageCare RHS Benefits Reimbursement Request Form, along with supporting documentation, to Meritain Health at (888) 665-8495.

Eligibility & Reimbursement Rules

Pre-tax premiums are not eligible for reimbursement. Eligible after-tax insurance premiums include: Health/Medical, Dental, Vision, and Long Term Care.

Recurring reimbursements can be set up monthly or quarterly as requested. A reimbursement form must be sent for any premium amount changes or to end a recurring reimbursement.

Reimbursement Inquiries

If you need information concerning your reimbursement requests, contact Meritain Health at (888) 587-9441.

Balance inquiries: If you have questions about your RHS account balance or want to check the status of your reimbursement requests, you can do so online by logging in.