OptumHealthBank.com - Withdrawals & Payments

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Track your expenses with our Expense Tracking Worksheet (PDF)

Download our Funds Availability disclosure (PDF)

Download forms:

Withdrawal/Distribution form (PDF)

Withdrawal Correction form (PDF)

Transfer of Funds – ACH Withdrawal form (PDF)

Additional Debit Card Form (PDF)

Debit Card Dispute form (PDF)

NEED TO KNOW

You can make payments with online bill pay.

Withdrawals & Payments

Paying for health care costs is easy with your OptumHealth Bank HSA.

Qualified Expenses
The IRS defines which expenses you can pay for with your HSA. Find out what expenses are covered.

Ways to Pay
There are several ways to pay for health care costs from your HSA, including using your OptumHealth Bank^SM Health Savings Account Debit MasterCard^®.

Health savings accounts (HSAs) are individual accounts offered by OptumHealth Bank^SM, Member FDIC, and are subject to eligibility and restrictions, including but not limited to restrictions on distributions for qualified medical expenses set forth in section 213(d) of the Internal Revenue Code. This communication is not intended as legal or tax advice. Please contact a competent legal or tax professional for personal advice on eligibility, tax treatment, and restrictions. Federal and state laws and regulations are subject to change.

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