How Your HRA Card Works

Short answer

An HRA card is a debit card issued by your employer's plan administrator that draws money directly from your health reimbursement arrangement account to pay for qualified medical expenses at the point of sale.

Your HRA balance is set by your employer's plan design. Your plan controls whether unused money rolls over, expires, or follows another rule. When you use the card, the purchase amount is deducted from your balance.

What the card is and who issues it

Your employer's plan administrator issues your HRA card as a way to spend your health reimbursement arrangement. It works like any debit card: you swipe it at checkout, and the amount is charged against your HRA balance. Your card is connected to your specific HRA account and employer plan, so no one else can use it.

Think of it as a shortcut to get money out of your account on the spot. Instead of paying out of pocket and submitting a receipt later, the card lets you prove you have the funds right then. The administrator runs the card system, not Burst or your provider.

Balance, activation, lost card

Here's how to manage the practical side of your HRA card.

How to check your balance

Your HRA administrator sends you a card and provides a way to check your balance, either through a website, mobile app, or phone number on the back of the card. Log in to your administrator's portal to see exactly how much you have available.

Activating and using your card

When you receive your card, call the number on the back or visit your administrator's website to activate it. Some cards are active when they arrive. Once activated, you're ready to swipe. Just like a credit card, you may need to sign for a purchase or enter a PIN, depending on the amount and the merchant.

What happens if your card is lost or stolen

Call your administrator immediately and ask them to deactivate the card and issue a replacement. Your HRA balance is protected. Losing the card doesn't mean losing your money. The administrator issues a new one.

Where it works and where it does not

Your HRA card works anywhere that accepts debit cards for medical expenses. Pharmacies usually accept it for prescriptions and over-the-counter medicine, which are considered medical care. Doctor's offices, hospitals, dental clinics, vision centers, medical supply stores, and some health retailers will too. But not every merchant category code is set up to accept HSA or HRA cards.

Common places the card may decline, even for eligible items: gyms and fitness studios, supplement retailers, some online health stores, and grocery stores (even in the pharmacy section). The reason isn't that the expense is ineligible, but that the merchant's type doesn't match the payment system's rules. Supermarkets and wellness retailers often sell eligible items, but their category code flags the whole purchase as general retail.

When the card declines, you have another path

If your card gets rejected, you can pay with any other card or payment method, then request a letter of medical necessity and file for reimbursement. Burst files the reimbursement claim with your administrator, and the administrator pays you from your HRA. This works for gyms, supplements, fitness gear, and hundreds of other eligible items the card won't cover at swipe.

What to do instead: pay any way you like, then get reimbursed

The card is convenient, but it's not the only way to spend your HRA. You can also pay out of pocket with any card or cash, then file a claim to get your money back from your administrator.

Here's the flow: You buy an eligible item. You request a letter from a licensed clinician, if the purchase needs one. Burst files the reimbursement claim with your HRA administrator. The administrator reviews the claim and sends you the reimbursement by deposit or check.

This path works for every eligible expense, whether the card declined it or you just prefer to manage the reimbursement yourself. The letter and claim method gives you access to items the card system can't process.

Why it declines even for eligible items

The usual reason an HRA card declines is that the merchant's business category doesn't match what the payment system recognizes as medical. It's not about whether the purchase qualifies under your plan. It's about how the retailer is classified in the payment network.

For example, a gym membership or fitness class can be reimbursed with a letter from a clinician tying it to a diagnosed condition. But the gym is categorized as 'fitness and recreation,' not 'medical,' so the card is rejected at the terminal. The store never gets a chance to check if your item qualifies. The system sees the merchant category first.

The same thing happens with supplements, vitamins, fitness gear from big retailers, and wellness products sold online. Even if your plan covers them with a letter, the card declines. Eligible doesn't mean the card will work. The reimbursement path exists for exactly this situation.

Getting it reimbursed with Burst

If what you're buying needs a letter of medical necessity, Burst writes it and files the claim. $35 once, about two minutes to request, reviewed by a licensed clinician, typically in your inbox within 24 hours. Burst files the reimbursement claim with your FSA, HSA or HRA administrator, and the administrator pays you out of your account by deposit or check. No letter, no charge. Claim denied, money back. The letter has to be dated on or before the purchase it covers, so request it before you buy.

Get reimbursed for my medical expense

Frequently asked questions

Can I use my HRA card to pay for a gym membership with a letter?

No, the card will likely decline because gyms aren't classified as medical merchants. But you can pay for the membership with another card, request a letter from a clinician, and file for reimbursement. Burst will handle the claim.

What happens to my HRA balance at the end of the year?

It depends on your employer's plan. Your plan document controls whether your balance carries over, gets forfeited, or follows another rule. Ask your administrator what your plan specifies for unused funds.

Is my HRA card tied to the account that pays for my medical insurance?

Your HRA is a separate account your employer funds. Whether it coordinates with your health plan's deductible, or can pay premiums, depends on how your employer designed it. Your plan document spells that out.

Can I get cash from my HRA card at an ATM?

Probably not. Most HRA cards are locked to medical expenses only and won't dispense cash. Check your administrator's rules or the back of your card.

What if the card doesn't cover the full purchase price?

You'll need to pay the difference with another card or payment method. The card will only deduct what's available in your HRA balance.

Do I need a doctor's letter to use my card at the pharmacy?

No. Over-the-counter medicine, menstrual care products, and prescription drugs are all covered under Publication 969's qualified medical expenses. Your card will usually work at checkout without any letter or prior approval.

Keep reading: How an HSA card works, How an FSA card works, HSA vs HRA: the difference, HRA eligible expenses, and all guides on this topic.

Sources

• IRS Publication 969, Health Savings Accounts and Other Tax-Favored Health Plans (qualified medical expenses, distributions from health accounts)

• Rev. Proc. 2025-19 (excepted-benefit HRA maximum contribution limits)

• IRS Publication 502, Medical and Dental Expenses (eligible medical expenses for HRA reimbursement)