Flexible Spending Account
Examples of Eligible and Ineligible Expenses under a Healthcare Reimbursement Account
Your Healthcare Reimbursement Flexible Spending Account lets you pay for medical care expenses not covered by your
insurance plan with pre-tax dollars. Eligible items must meet the definition of medical care under 213(d). Under this
definition, “Medical care” means amounts paid for the diagnosis, cure, mitigation, treatment or prevention of disease or for
the purpose of affecting any structure or function of the body. For example, the typical use of the item is to alleviate or
treat personal injuries or sickness. Items that are merely beneficial to general health are not reimbursable. The products
and services listed below are examples of medical expenses eligible for payment under your Healthcare Reimbursement
FSA, to the extent that such services are not covered by your medical and dental insurance plan. This listing is not allinclusive and additional expenses may qualify. The items listed below are subject to change in accordance with IRS
regulations.
Dental Services
9
Crowns/Bridges
9
Dental Implants
9
Dental X-rays
9
Dentures
9
Exams/Teeth Cleaning
9
Extractions
9
Fillings
9
Gum Treatment
9
Occlusal Guard
9
Oral Surgery
9
Orthodontia/Braces
9
TMJ related expenses
Insurance Related Items
9
Copay Amounts
9
Deductibles
9
Pre-existing Condition Expenses
(medical)
9
Private Hospital Room Differential
Lab Exams/Tests
9
Blood Tests
9
Cardiographs
9
Diagnostic
9
Laboratory Fees
9
Metabolism Tests
9
Spinal Fluid Tests
9
Urine/Stool Analyses
9
X-rays
Medications
9
Prescription Drugs
Obstetric Services
9
Childbirth Classes (Lamaze)
9
Midwife Expenses
9
OB/GYN Exams
9
OB/GYN Prepaid Maternity Fees
(reimbursable after date of birth)
9
Post-natal Treatment/Pre-natal
Treatment
Practitioners
9
Allergist
9
Chiropractor
9
Christian Science
9
Dermatologist
9
Homeopath
9
Naturopath
9
Osteopath
9
Physician (licensed medical
professional)
9
Psychiatrist / Psychologist
Other Medical Treatments or
Procedures
9
Abortion (legal)
9
Acupuncture
9
Alcoholism (inpatient treatment)
9
Drug Addiction
9
Hearing Exams
9
Hospital Services
9
Infertility
9
In-vitro Fertilization
9
Lasik/Laser and Vision Correction
Including prescription glasses
9
Norplant Insertion or Removal
9
Patterning Exercises
9
Physical Examination (if not
employment related)
9
Physical /Occupational Therapy
9
Rolfing
9
Smoking Cessation Programs
9
Speech Therapy
9
Sterilization
9
Transplants (including organ
donor)
9
Treatment for Handicapped
9
Vaccinations/Immunizations
9
Well Baby Care
Over the Counter Drugs
9
Allergy medicine
9
Antacids
9
Anti-diarrhea medicine
9
Cold medicine
9
Cough drops, throat lozenges,
sinus medications, nasal sinus
sprays
9
Diabetic Supplies
9
Items that used to be a prescribed
drug and now available over the
counter
9
Laxatives
9
Menstrual cycle products for pain
and cramp relief
9
Motion sickness pills
9
Pain reliever
9
Pedialyte for ill child’s dehydration
9
Sleeping aids to treat occasional
insomnia (note-if taken regularly
will require medical practitioner’s
note)
9
Suppositories and creams for
hemorrhoids
Other Medical Equipment
Supplies, and Services
9
Abdominal/Back Supports
9
Acne Treatment
9
Ambulance Services
9
Arches/Orthopedic Shoes
9
Bactine, Calamine lotion
9
Band-Aids, bandages, gauze pads
9
Blood Pressure Monitoring devices
9
Braille Books and Magazines
9
Carpal Tunnel Wrist supports
9
Cold/hot packs for injuries
9
Contact lens cleaning solution
9
Contraceptives and Prescribed
birth control
9
Counseling
9
Crutches
9
First aid cream
9
First aid kits
9
Guide Dog (for visually/hearing
impaired person)
9
Hearing Aids and Batteries
9
Hospital Bed
9
Incontinence supplies
9
Learning Disability (special
school/teacher)
9
Liquid adhesive for small cuts
9
Medic Alert Bracelet or Necklace
9
Muscle or joint pain products such
as BenGay
9
Nasal Strips
9
Nicotine gum or patches for stopsmoking purposes
9
Ovulation Monitor
9
Oxygen Equipment
9
Pregnancy test kits
9
Prosthesis
9
Reading glasses
9
Rubbing alcohol
9
Special ointment or cream for
sunburn
9
Splints/Casts
9
Syringes
9
Thermometers (ear or mouth)
9
Transportation Expenses (essential
to medical care) **
9
Tuition Fee at Special School for
Disabled Child
9
Visine and other such eye products
9
Wart remover treatments
9
Wheelchair
** Reimbursed at government approved annual rate Æ
Flexible Spending Account
Examples of Eligible and Ineligible Expenses under a Healthcare Reimbursement Account
Items that may be covered when accompanied by a medical practitioner’s note must be used to treat a specific medical
condition of limited duration.
9
9
9
9
9
9
Pills for persons who are lactose
intolerant
Nasal sprays for snoring
Orthopedic shoes and inserts (for
orthopedic shoes, you can only be
reimbursed for the extra cost over
buying non-orthopedic shoes)
Capital Expenses
Equipment, supplies and materials
relating to physical/mental
handicaps.
Marriage Counseling
9
9
9
9
Fiber supplements to treat a specific
medical condition
Cosmetic Surgery-covered only
when treating a congenital
abnormality, a personal injury
resulting from an accident or
trauma or disfiguring disease
Weight loss drugs to treat a specific
disease
Medicated shampoos and soaps,
unless prescribed by a medical
practitioner for a specific scalp/skin
infection
9
9
9
9
9
9
9
9
9
Dietary or herbal medicines to treat
a specific medical condition
Sunscreen
Prenatal vitamins
Support Hose
Wigs (hair loss due to disease)
Massage Therapy
Health Club monthly premium
Prescribed Medical and Exercise
Equipment
Vitamins
Claims substantiation: The participant must submit adequate claim substantiation. The receipt must state the name of
the medicine or drug, the purchase date and the amount paid. The participant must sign the reimbursement form
indicating that the claim was for the individual, their spouse, or eligible dependent. Where a physician’s note is required, it
does not need to state the precise medical condition.
Items that are NOT eligible for reimbursement under a Health Care Spending Account:
9
9
Suntan lotion
9
Toothpaste or toothbrushes (electric
9
9
Cosmetics
or otherwise), even if a dentist
9
9
Ear Piercing
recommends treating a condition
9
9
Maternity Clothes
9
Burial Expenses
9
9
Dental bleaching or any other teeth
9
Illegal operations, treatments and
whitening
medications
Toiletries
Dietary supplements
Items paid or payable by insurance
Premiums for group health coverage
Personal hygiene products
Whose Medical Expenses can I Reimburse?
You can generally include medical expenses you pay for yourself as well as those you pay for someone who was your
spouse, qualifying child or qualifying relative when the product or services were acquired.
A qualifying child is a child who is you son, daughter, stepchild, foster child, brother, sister, stepbrother, stepsister or a
descendent of any of them, who is under 19 years old or under, 24 years old and a full time student or permanently
disabled, and who lived with you for more than half the year and did not provide over half of his or her own support.
A qualifying relative is virtually anyone who lived with you throughout the year and who was not a qualifying child for
another taxpayer and who you provided over half of the support
Special Note:
Due to recent IRS guidance, up front payments for Orthodontia may be Reimbursed even though the services for all
treatments have not as of yet been incurred. With your reimbursement request you must submit the contract which
specifies payment and total amount of the contract and the start date of the treatment.