Ever pulled out your Health Equity card to pay for a prescription only to hear those four dreaded words: “Your card was declined”?

Nothing quite matches that mix of confusion and embarrassment when your health benefits card gets rejected at checkout. But don’t worry—there are some super common reasons this happens, and most are easy fixes.

Let’s dive into why your Health Equity card might be playing hard to get, and how to solve it faster than you can say “do you take credit instead?”

Why Your Health Equity Card Gets Declined (And How to Fix It)

So your Health Equity card just got declined. Before you panic or start questioning your life choices, let’s break down the most likely culprits:

Common Reasons for Health Equity Card Declines

1. Activation and Timing Issues

Your card isn’t activated yet. This is probably the most facepalm-worthy reason. New cards need to be activated before use—just like your regular credit cards.

You’re being too eager. Many Health Equity cards have a 24-hour waiting period after activation. Try to use it too soon, and you’ll get declined. Patience, grasshopper.

Your card expired. Check the expiration date! Cards typically last 3-5 years, but if yours is past its prime, it’s time for a replacement.

2. Money Problems (The Not-So-Fun Kind)

Insufficient funds in your account. Your card is linked to your FSA, HSA, or HRA account—if there’s not enough money in there, your card will decline faster than a bad Tinder date.

You’ve hit your plan deadline. Many FSA plans have “use it or lose it” policies. If your plan year or grace period ended, those funds might be gone with the wind.

According to a recent EBRI survey, about 30% of all FSA card declines happen because people try to spend more than they have available. Check your balance regularly!

3. What You’re Buying Isn’t Eligible

The IRS has very specific rules about what qualifies as a medical expense. Your Health Equity card is programmed to follow these rules.

Trying to sneak in some vitamin gummies or designer face creams? The system knows, and it will shut you down.

Some common non-eligible items that people try to purchase include:

• Toothpaste and general hygiene products
• Cosmetics (even if they have SPF)
• General wellness products
• Over-the-counter medications without a prescription (though this has changed with recent legislation)

4. Merchant Issues

The store isn’t set up properly. Not all merchants are created equal in the eyes of your Health Equity card. The card only works at:

• Doctor’s offices
• Hospitals
• Pharmacies with IIAS certification
• Vision centers
• Dental offices
• Other approved healthcare providers

That Target or Walmart might sell medicine, but if they’re not properly coded or don’t have the right system (called IIAS), your card might decline.

According to Health Equity’s own data, approximately 25% of declines happen because the merchant doesn’t have the proper certification or coding to accept health benefit cards.

5. Technical Glitches

Sometimes it’s not you, it’s them.

Merchant card reader issues can cause declines that have nothing to do with your card or account.

System outages at Health Equity or in the payment processing network can also cause temporary declines.

How to Fix a Declined Health Equity Card

When your card gets declined, don’t just stand there awkwardly (we’ve all been there). Take action:

1. Pay another way for now. Sorry, but this is the quickest solution at checkout.

2. Check your balance by logging into your Health Equity account or using their mobile app.

3. Call member services at 1-877-924-3967. They can tell you exactly why your card was declined.

4. Verify your purchase is eligible by checking the official IRS Publication 502 or using Health Equity’s eligible expense list.

5. Submit for reimbursement if you had to pay out of pocket for an eligible expense.

Preventing Future Declines

Nobody wants to be the person holding up the pharmacy line while frantically calling customer service. Here’s how to avoid the drama:

• Always check your balance before shopping. The Health Equity app makes this super easy.

• Keep your card activated and updated. If you get a new card, activate it right away (but remember that 24-hour rule).

• Know what’s eligible before you shop. When in doubt, ask!

• Save those receipts! The Journal of Financial Planning recommends keeping all healthcare receipts for at least 3 years, even for approved transactions.

• Shop at IIAS-certified stores when possible. Major pharmacies like CVS, Walgreens, and Rite Aid typically have this certification.

Remember, your Health Equity card is basically an IRS hall monitor in plastic form. It’s designed to keep both you and your employer compliant with tax rules around healthcare spending.

The next time your card gets declined, take a deep breath, pay another way, and then troubleshoot when you’re not holding up a line of impatient shoppers. Your blood pressure (and fellow customers) will thank you.