A FSA Debit Card is a type of debit card issued in the United States. It can access tax-favored spending accounts such as flexible spending accounts (FSA) and health reimbursement accounts (HRA), and sometimes health savings accounts (HSA) as well. All such cards to date bear the Visa, MasterCard, or Discover brand and operate through their main networks; thus all FSA debit card transactions are of the offline variety (also known as "signature debit" or, inaccurately but commonly, "credit"). This can create confusion at merchants such as Wal-Mart that attempt to "steer" debit cards to online debit (aka "PIN debit" or just plain "debit"); FSA debit cards will not work that way. Background Though these cards can be issued with HRAs and HSAs as well as FSAs, the FSA is the oldest and most common of these accounts; therefore, for simplicity these cards are often referred to as "FSA" debit cards. Though a few FSA debit cards are also issued for dependent care and transportation expenses, most are issued for medical expenses. (The rest of this article deals only with FSA debit cards used with medical FSAs, HRAs or HSAs.) Traditionally, to meet Internal Revenue Service (IRS) substantiation requirements, FSAs were accessed only through claims for reimbursement after incurring (and usually paying) an out-of-pocket expense, often after deductions were already made from the employee's paycheck to fund the FSA. This, along with the so-called "use it or lose it" rule (i.e., all funds not spent are forfeited), has long been seen as one of the problems minimizing utilization of FSAs. The FSA debit card was developed to avoid this problem by allowing users to access their FSA directly without reimbursement, and also (where possible) to provide methods for automating the IRS substantiation requirements which often require substantial paperwork and manpower. Substantiating an FSA debit card transaction without paperwork is known as "auto-adjudication". HRAs, which were introduced later, not by employee funds; however, they are subject to the same IRS requirements as FSAs, and thus are generally accessed only by paper claims or debit cards just like FSAs. Unlike FSAs and HRAs, HSAs do not require substantiation prior to withdrawal; users need only retain their receipts with their tax papers. However, since most HSA providers came from FSA and HRA backgrounds, most offer substantiation services for HSAs that are similar to those for FSAs and HRAs. Though many HSA providers offer