There are many expenses associated with healthcare that are eligible for HSA reimbursement. An HSA covers expenses that benefit you, your spouse and your other dependents.
In general, your HSA covers things such as:
HSA eligible expenses on IRS Website
Setting up a health savings account is simple. When you need a form to set up transactions or change your personal information, Avidia Health is here to help. Find electronic and printable forms below.
| Forms | Downloads |
|---|---|
| Account Maintenance | Mailed Form |
| Authorized Signer Form | Mailed Form |
| Beneficiary Form | Mailed Form |
| Check Order Form | Mailed Form |
| Contribution (Individual) Form | Mailed Form |
| Contribution Correction Form | Mailed Form |
| Distribution Reversal Form | Mailed Form |
| Account Closure Form | Mailed Form |
| Internal Transfer | Mailed Form |
| Rollover Form | Mailed Form |
| Custodial Transfer Form | Mailed Form |
If you need additional assistance, contact us directly and we’ll be glad to send you the forms: 855.248.6311 or HSADeposits@avidiabank.com.
Please complete the form below and an Avidia representative will contact your shortly.
Thank you for your interest in opening up an Avidia Health HSA account. An Account Representative will be contacting you shortly.
