Katie Beckett - Healthcare Reimbursement Account (HRA) Guide

2024 Update

Payflex has rebranded and is now Inspira. We are trying to make sure all references are updated to reflect this change. If you happen to find a resource not yet updated contact our web guy

2023 Update

The Katie Beckett HealthCare Reimbursement Account (HRA) allows people to spend program dollars on IRS qualified HealthCare expenses. Inspira is the Katie Beckett Program’s HRA administrator. The HRA may be used with the Inspira card to cover out-of-pocket medical expenses or to reimburse claims from an itemized receipt.

Requesting HRA Service

The Katie Beckett Case Manager assists families with requesting the Katie Beckett HRA service. It is a one-time per year allocation and cannot be modified during the plan year. We strongly encourage families to review the types of expenditures listed below while considering how much of their Katie Beckett funds to allocate to the HRA.  DIDD cannot pay for claims submitted prior to the HRA authorization date on the plan. The $10,000 Katie Beckett budget expenditure cap may not exceed $10,000 across the calendar year and unspent funds cannot be rolled over into the next plan year. Once the services are authorized by the DIDD Case Manager on the child’s Katie Beckett support plan, Inspira will mail your HRA debit card to the address on file.

Helpful tips on using the HRA as well as understanding the calendar and ISP year budgeting may be found:

Inspira HRA Debit Card, Online Portal and Mobile App

Families may expect to receive the HRA debit card within 21 days of authorization. If the card has not arrived within 21 days, please contact Inspira at StateofTN@inspirafinancial.com. It will arrive in a plain white envelope in the parent or legal guardian’s name and contain instructions on how to set up the account.  The date the HRA service is authorized on your child’s Individual Support Plan (ISP) is the first date expenses are eligible.  For instance, if the HRA service is authorized on 3/1/22, a doctor’s visit that occurs on or after that date would be eligible for HRA use.  A doctor’s visit that occurs on 2/28/22 would not be eligible.

Only the enrolled child is covered by the HRA.  It is currently a one-time per year allocation and cannot be modified during the calendar year.  Funds left over from one calendar year do NOT carry over into a new year.  Families with 2022 expenditures have until 3/31/23 to submit claims. 

You may log into the Inspira online portal at www.inspirafinancial.com or download the Inspira mobile app to review your HRA balance, submit claims and check claims status. Additional information regarding the Inspira online portal are located at Inspira  Reimbursement Quick Reference Guide. For information on the Inspira mobile app, go here: Inspira Mobile Application Flyer.

Using your HRA Benefit

The HRA can be used two ways:

  • With the provided Inspira card to pay for covered out-of-pocket medical expenses.
  • Reimbursement claims with an itemized receipt. 

Information about eligible expenses can be found in the appendix of this document.  Those include but are not limited to:

  • Copays and deductibles
  • Speech Therapy, Occupational Therapy, Physical Therapy, and Non-Traditional Therapies
  • Medical Equipment and Supplies
  • Orthotics
  • Vision and Dental
  • Respite (reimbursement only)
  • Prescriptions

Using the Inspira Card:

The Inspira card can currently be used at medical offices such as hospitals, doctors’ offices, therapy offices, vision providers, dental offices, and pharmacies. When using the card, it’s important to run it as credit, not debit.  Please be aware that credit/debit card processing fees are not a covered expense. 

Receipts must be submitted to validate all card purchases, and some purchases require a Letter of Medical Necessity (LOMN) from a doctor to be an eligible expense. Inspira currently aims to review and approve supporting documentation within 30 days.

Please be aware that the card cannot be used to purchase future appointments.  For instance, the card cannot be used to purchase a block of 10 future therapy appointments, since there must be validation the visits have occurred.  Doing so, may lead to suspension of your Inspira card. 

Submitting Claims for Reimbursement:

Reimbursement requests are typically processed by Inspira within 7-10 business days but may take longer.  These claims are paid by check or direct deposit.

There is a daily spending limit of $2,650 for both the Inspira card and the number of claims submitted daily.

Submitting Claims

You may submit HRA claims by logging into the Inspira online portal at www.inspirafinancial.com or into the mobile app and selecting “File A Claim” to upload all supporting documentation (including receipts and invoices) for the expense. All claims should be submitted as expense type: “medical with deductible”.   

The claim should include the following information:

  • Provider or merchant name
  • Type of expense (“medical with deductible”)
  • Date of service
  • Child’s name
  • Child’s DOB
  • Child’s last 4 digits of SSN
  • Description of service
  • EOB or other documentation showing reimbursement, or a statement that no other reimbursement is available and therefore no EOB to apply
  • Final amount of patient liability owed (final out of pocket cost after all reimbursement)
  • Letter of Medical Necessity (LOMN) if applicable

Inspira will send an alert should the expense require additional information for upload. Be sure to respond timely to any requests as to not delay the determination. If no documentation is received within 56 days of the first written request, the Inspira  card will be temporarily inactivated until all appropriate supporting documentation of the expense is submitted and approved.

For information on how to file a claim, select  Video: How to File a Claim with Inspira.

For additional information on how to verify Inspira card purchases, click How to Verify Inspira Card Purchases Online.

To find helpful ways to submit claim documentation and prevent card suspension, please review Keep Inspira Card Active Flyer.


Letter of Medical Necessity

Inspira requires a Letter of Medical Necessity (LOMN) Form from the healthcare provider confirming the expenses are needed to treat a specific diagnosis. It must be completed by child’s physician or therapist, including - but not limited to - pediatrician, specialist, medical doctor, physician’s assistant, licensed/registered nurse practitioner, and occupational/physical/speech therapist. In addition, multiple expenses may be itemized on one form. If the form is not available, a statement on letterhead from the medical provider detailing each diagnosis and expense is acceptable. The letterhead should include the following information:

  • Employer Name: State of Tennessee Katie Beckett HRA
  • Member Number: last 4 digits of child’s social security number
  • Duration

To view the LOMN form, please click, Inspira  Letter of Medical Necessity Form

A Letter of Medical Necessity form does not need to be renewed on an annual basis IF a healthcare provider indicates on the form that it is effective for the child’s duration of enrollment in the Katie Beckett Program.


Once approved, reimbursement claims from itemized receipts are typically processed in 7-10 business days and paid by check or direct deposit.


If your HRA account has been frozen due to an overpayment of funds, you can remediate this by:

  • Using another form of payment at the point of sale and submitting the claim to Inspira 
  • Paying it back in full online in your Inspira portal or by calling Inspira at (855) 689-8943
  • Making payments to Inspira via check. The check will need to be made out to Inspira and the address to send the funds to are:

FSA Overpayments
PO BOX 8396
Omaha, NE 68103-8396

You must indicate you are part of the State of TN Katie Beckett HRA and the parent should indicate their full first and last name.


You may email Inspira at StateofTN@inspirafinancial.com or call (855) 689-8943 if you have any questions. Be sure to indicate the child’s legal name and date of birth when contacting Inspira. You may contact your Katie Beckett Case Manager with any questions regarding your support plan and budget authorizations.


DIDD has numerous resources for Katie Beckett families on their Katie Beckett webpage.  Previous recordings and presentations from Inspira (formerly PayFlex) webinars may be found including:

Appendix A

IRS Eligible and Ineligible Items

The following list is the complete list of IRS eligible and ineligible items. There are many items that may not be applicable to a child in the Katie Beckett Program, but out of an abundance of caution, DIDD is keeping the list in its entirety.  Items deemed eligible by the IRS do not require a letter of medical necessity, however some items require the form. You may include multiple expenses on one LOMN form.