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What is SF City Option?

San Francisco City Option (SF City Option) is a healthcare benefit for workers like you in the City of San Francisco and SFO. Employers deposit money into SF City Option, and you can use these funds for health and wellness reimbursement. But first you must finish setting up your San Francisco Medical Reimbursement Account (SF MRA) that your current or former employer started.

What’s New?

Starting March 1, 2023, the City and County of San Francisco will have a policy to close accounts that have not been used for three years. If you don’t finish the enrollment process by April 2026, your account will be permanently closed.

Take Action Now!

Set up your SF Medical Reimbursement account (SF MRA) to access funds for health and wellness expenses for you and your family.

What Happens After I Set Up My Account?

You will receive a SF MRA Welcome Letter, email, and call within 1-3 weeks of submitting your enrollment form.

Register with HealthEquity/Wageworks to view your account balance.
New UserReturn User

Submit claims for health and wellness expense reimbursements.

Discover wide range of health and wellness eligible expense

  • Premiums
  • Vision services
  • Lab tests
  • Activity trackers
  • Doctor’s visits
  • Dental care
  • Baby formula
  • And more

San Francisco City Option is a healthcare benefit for employees in the City of San Francisco and San Francisco International Airport (SFO). Employers who use this healthcare benefit to comply with the Health Care Security Ordinance, deposit money into SF City Option for their covered employees. To access the funds, finish setting up your SF Medical Reimbursement Account that your current or former employer started by going to sfmra.org/enroll.

Beginning March 1, 2023, the City and County of San Francisco will have a policy to close accounts that haven’t been used for three years. If you don’t enroll by April 2026, your account will be permanently closed.

The San Francisco Health Commission approved a policy in January 2022 to permanently close employee accounts that have not been used for a 3-year consecutive period. Any funds in those account will also be permanently reverted to the City and County of San Francisco. This policy is consistent with existing state law (Government Code 50050).

The new policy is effective March 1, 2023. That means the SF City Option program will begin tracking accounts that have had no activity for a three-year consecutive period beginning March 1, 2023, and beyond. The earliest any accounts could potentially be permanently closed is April 2026.

Many people may not remember their employers setting up this account or didn’t receive a welcome kit in the mail. The law says San Francisco and SFO employers must provide a healthcare benefit, so some employers deposit money into SF City Option for workers like you. The account and the money are real, and you can use it for a variety of health and wellness expenses. To access the funds, finish setting up your SF Medical Reimbursement Account that your current or former employer started by going to sfmra.org/enroll.

Beginning March 1, 2023, the City and County of San Francisco will have a policy to close accounts that haven’t been used for three years. If you don’t enroll by April 2026, your account will be permanently closed.

You must first finish setting up your account by going to sfmra.org/enroll. Your enrollment will be complete within four weeks, and you will receive information by mail, email, and call about submitting claims and getting reimbursed for eligible health and wellness expenses. If you do not hear from us after four weeks of setting up your account, email info@sfcityoption.org.

Beginning March 1, 2023, the City and County of San Francisco will have a policy to close accounts that haven’t been used for three years. If you don’t enroll by April 2026, your account will be permanently closed.

First, you must finish setting up your account that your current or former employer started as soon as possible. The City of San Francisco will be closing inactive accounts. You can finish setting up your SF Medical Reimbursement Account at sfmra.org/enroll. Once your enrollment is complete, keep your account active by submitting claims for eligible health and wellness expense reimbursements. Active accounts remain open and roll over year after year until the account balance is $0.00.

Beginning March 1, 2023, the City and County of San Francisco will have a policy to close accounts that haven’t been used for three years. If you don’t enroll by April 2026, your account will be permanently closed.

You can email info@sfcityoption.org to get help setting up your account and learn how much money you have for eligible health and wellness expense reimbursements. In order to access these funds, you must finish setting up your account as soon as possible. You risk losing the funds as the City of San Francisco will be closing inactive accounts.

You are still able to use the funds. But you must take action and finish setting up your SF Medical Reimbursement Account at sfmra.org/enroll as soon as possible, or you risk losing the funds. The City of San Francisco will be closing inactive accounts.

No, your account will not be closed. Once you finish setting up your account, you must submit at least one claim every 3 years to prevent your account from being closed.

The City of San Francisco/SFO has laws that require employers to provide a healthcare benefit. Your current or past employer made the decision to comply with the law by paying into an SF City Option account on your behalf. SF City Option is there to help people pay for eligible health and wellness expenses even if you don’t have health insurance.

There are a wide variety of expenses that are eligible for reimbursement for not only you but your family members. These include health insurance premiums, doctor visits, prescriptions, dental expenses, glasses and contact lenses, lab tests, Covid-19 tests, feminine hygiene products, and much more! Some of the eligible expenses might surprise you! For a complete list of what is eligible and what isn’t, click here.

Once you finish setting up your SF Medical Reimbursement Account at sfmra.org/enroll, you will receive information by mail or email on how to submit claims for eligible health and wellness expense reimbursement. Claims can be made online, by app, by mail, or by fax. If you do not hear from us after four weeks of setting up your account, call HealthEquity/WageWorks 1(866) 697-6078.

It takes from 3-5 business days depending on how you submitted the claim. Claims made online or by app are processed much faster than those made by mail or fax.

You can submit expenses dating back to when your current or former employer started making deposits into your account. To find out your effective date, email info@sfcityoption.org.

No. You cannot cash out or transfer these funds to an HSA or any other health account.

No. You must first finish setting up your account as soon as possible, and then you can use the funds for eligible health and wellness reimbursements. The City of San Francisco will be closing inactive accounts, so regularly submit claims to keep your account active.

Yes. You do not have to have papers to access the funds, and this does not affect your immigration status. We are not connected to ICE or law enforcement in any way.

No. You can be reimbursed by check, which you can have cashed at a check cashing location.

You can email info@sfcityoption.org to get more information about your account, your benefits, or the enrollment process.