We had the 40K + $100 deal (end of June), but we were wondering the same thing. Last month my wife had some chest pains that turned out to be acid reflux, but they sent her to the ER because of the location of the pains. Well, $3,500 later before meeting her out of pocket max, last week we used this card to pay the bill, paid off the balance and reimbursed ourselves from our HSA, and our statement closes on August 8 11. I'll report in when the miles post. (Good news is, even though it was an expensive way to find out, after a cardiologist reviewed the test results her heart seems to be in very good shape.)