The Flex Card is cashless, but not paperless. IRS regulations require that all FSA transactions are substantiated (approved) as eligible expenses. Fortunately, many transactions (such as swipes for doctor visit co-pays or for prescription drugs or other eligible items at a pharmacy) will be automatically approved and will not require documentation. However, you will occasionally need to submit documentation to approve a card swipe and meet IRS requirements. The major benefit of the Flex Card is that it provides immediate payment so that you do not have to pay for eligible expenses out of your own pocket and then wait to be reimbursed.