Acupuncture

Fees paid for acupuncture are eligible medical expenses when submitted with documentation supporting a specific medical condition.

Adoption

You can include medical expenses you paid for your child before adoption if the child qualified as your dependent when the services were rendered or were paid.

Fees for medical expenses or any fees relating to the adoption process incurred prior to the beginning of adoption negotiations are not eligible. Medical expenses associated with an adopted baby's birth incurred by the birth mother are also not eligible.

Air Conditioning, Air Filter, Purifier, Humidifier

The cost of these portable units recommended by a physician as treatment for a specific medical condition is an eligible expense when submitted with documentation supporting a specific medical condition. If the value of the home increases then these amounts are not reimbursable.

Alcoholism

Payments to a treatment center for alcohol or drug addiction are eligible medical expenses. This includes meals and lodging provided by the center during medical treatment.

You may include transportation costs incurred to attend Alcoholics Anonymous (AA) meetings recommended by the attending physician, when submitted with supporting documentation.

Ambulance

Fees for ambulance service are covered.

Anesthesiology

Fees for anesthesiology are covered.

Arch Support

Qualifies as a medical expense only if prescribed by a physician as treatment and when submitted with documentation supporting a specific medical condition.

Artificial Insemination

SEE FERTILITY

Artificial Limb

Expenses for the purchase of an artificial limb qualify as medical expenses.

Asthma Equipment

Nebulizers or peak flow meters prescribed for treatment of asthma are eligible expenses.

Capital Expenses

Amounts paid for special equipment installed in your home for improvement qualify as medical expenses if there is documentation from a physician that the equipment is mainly needed for or as a result of a specific medical condition. If the capital expenditure increases the value of the property, the excess value is not reimbursable.

Improvements made to accommodate a residence for a person's disability do not usually increase the value of the residence, and the full cost is usually reimbursable.

Only reasonable costs to accommodate a personal residence for a disabled condition are considered medical care. Additional costs for personal motives, such as for architectural or aesthetic reasons, are not reimbursable.

Car

Special hand controls and other special equipment installed in a car for use by a disabled person qualify as medical expenses.

The cost of operating a specially equipped car, except as discussed under Transportation, is not covered. (SEE TRANSPORTATION)

Childbirth Classes (Lamaze)

Childbirth classes are not eligible medical expenses. Classes are elective and not medically necessary (personal convenience).

Chiropody

Fees paid to a chiropodist (chiropractic foot doctor) for medical care are eligible expenses if there is documentation of a specific medical condition.

Chiropractors

Fees paid to a chiropractor are eligible if there is documentation of a specific medical condition.

Christian Science Practitioner

Fees paid to a Christian Science practitioner are eligible expenses when treatment is rendered for a specific medical condition.

Circumcision

Infant circumcision is a covered medical expense. This procedure is also covered if performed in the member's home by a rabbi. Adult circumcision is covered ONLY if it is performed for a specific medical reason.

All other circumcisions are considered cosmetic

COBRA Premiums

Premiums paid for COBRA benefits are not a covered expense.

Collagen Injections

Collagen injections are considered to be cosmetic, however, may be covered if medically necessary (e.g., for treatment of severe acne).

Condoms

SEE BIRTH CONTROL.

Contact Lenses, Solutions, Supplies, and Warranties

Expenses, including shipping and handling incurred for the purchase of contact lenses, qualify if the contact lenses are needed for medical reasons. Amounts paid for contact lens solutions and supplies qualify as medical expenses. Fees paid for eye exams are also eligible.

Non prescription lenses are not covered.

Copays/Coinsurance

A copay or coinsurance fee qualifies as a medical expense.

Cosmetic Treatment

Expenses incurred for cosmetic surgery necessary to improve a deformity arising from or directly related to a congenital abnormality, a personal injury or a disfiguring disease qualifies as eligible medical expenses.

Generally, medical expenses paid for unnecessary, i.e., elective, cosmetic treatment are not covered. (This applies to any procedure that is directed at improving the patient's appearance and that does not meaningfully promote the proper functioning of the body or prevent or treat an illness or disease.)

Examples of non-covered cosmetic surgery procedures:

Counseling

Amounts paid for counseling (i.e., behavioral, marriage or pastoral counseling) for a family member with a medical condition qualify as medical expenses. There must be documentation from a physician stating that counseling was prescribed and that it is medically necessary to treat a specific medical or mental illness.

Family counseling or support counseling for other family members to learn how to cope with a family member's illness is not a covered expense.

CPR

CPR classes are not considered "medically necessary"; therefore, the expense is not reimbursable under FSA.

Dancing Lessons

Amounts paid for dancing lessons do not qualify as medical expenses.

Deductibles

Deductibles qualify as medical expenses.

Dental Treatment

Amounts paid for dental treatments qualify as medical expenses. This includes fees paid to dentists for X-rays, fillings, braces, extractions, dentures, caps, crowns, fluoride treatment, implants, etc.

In addition, the installation and monthly rental charges for fluoride treatments to home water qualify as medical expenses when prescribed by a physician or dentist. However, the amount should be limited to the cost allocable to the current plan year.

Dentist

Fees paid to a dentist qualify as health care expenses when services are for the treatment of a specific medical condition.

Dermatology

Fees paid to a dermatologist for medical care qualify as medical expenses.

Diabetic Equipment/Supplies

Medical expenses may include amounts paid for the following equipment and supplies for treatment of diabetes:

Diagnostic Services

Fees paid for diagnostic services, as prescribed by a physician, are eligible medical expenses.

General wellness screenings do not qualify as medical expenses.

Diapers/Diaper Service

Amounts paid for adult diapers or a diaper service qualify as a medical expense if prescribed by a physician to relieve the effects of a specific medical condition. Diaper expenses for handicapped individuals beyond infancy are also covered.

Dietitian

Fees paid to a dietitian are eligible when referred by a physician for treatment of a specific medical condition.

DNA Testing

DNA testing for paternal responsibility is not considered an eligible expense.

Domestic Partners

Medical expenses incurred by domestic partners are usually not eligible for reimbursement from an FSA. Members should consult with their plan sponsors on domestic partner coverage.

Doula

Expenses associated with a birthing assistant/coach for women in labor are not considered eligible medical expenses.

Drug Addiction

SEE ALCOHOLISM.

Drugs

SEE MEDICINES.

Durable Medical Equipment (DME)

The cost associated with the purchase or rental of durable medical equipment that is prescribed by a medical practitioner to alleviate or treat a specific medical condition qualifies as an eligible expense.

Costs can include:

*Reimbursement is only for the amount that exceeds the cost of a similar or regular product. Letter of medical necessity only needed for items that have a dual purpose (e.g. chair, sheets, oral hygiene equipment).

Ear Piercing

Expenses associated with ear or body piercing is not eligible medical expenses.

Educational Classes

Educational classes are not eligible medical expenses (care for a newborn, breast feed, cope with diabetes, etc.).

Electrolysis

SEE COSMETIC TREATMENT.

Eyeglasses/Supplies (e.g., storage case, replacement cost), Warranties

Amounts paid for prescription vision/sports eyewear, supplies (i.e., eyeglasses, goggles, sunglasses) for a medical condition qualify as a medical expense. Fees paid for eye exams are also eligible.

Tinting of prescription eyewear qualifies as an eligible medical expense.

Over-the-counter eyeglasses and sunglasses are not covered.

Exercise Equipment

Exercise equipment may be covered when prescribed by a physician as treatment for a specific medical condition.

Exercise equipment used for improvement of general health is not covered.

Experimental Drugs

Amounts paid for experimental drugs are eligible if obtained legally.

Fertility

Medical expenses associated with the treatment of infertility, including shots, in vitro fertilization and artificial insemination incurred by the member, are reimbursable expense. Semen and embryo storage associated with an active attempt to conceive are also eligible for reimbursement.

Note, donor expenses incurred by the member (egg donation, sperm donation) are eligible during active treatment only, if expenses are not covered by a medical plan.

The cost of an ovulation kit qualifies as an eligible medical expense when prescribed by a physician for infertility.

Fees associated with preserving semen/embryos for future generations are not eligible.

Flu Shot

Flu shots are eligible medical expenses.

Founder's Fee

SEE LIFETIME CARE ADVANCE PAYMENTS.

Funeral Expenses

Amounts paid for funerals do not qualify as medical expenses.

Guide Dog or Animal

The cost of a guide dog or other animal to be used by the visually impaired or hearing impaired qualifies as a medical expense. The cost of a dog or other animal trained to assist persons with other physical disabilities can also be covered. Amounts paid for the care of these specially trained animals are also eligible medical expenses.

Gynecologists

Fees paid to a gynecologist for medical care are eligible medical expenses.

Handicapped Persons

SEE SCHOOLS, SPECIAL.

Health Club

Dues paid to a health club, YMCA, YWCA or spas are allowable when the member submits documentation from the attending physician stating that the membership expenses are for treatment of a specific medical condition. Reimbursement should be only for the individual membership and for the component that is related to a single year. Any dues that carry over to a subsequent year would violate the IRS rule of constructive receipt.

Health club dues, YMCA/YWCA dues or amounts paid for steam baths for your general health or to relieve physical or mental discomfort not related to a particular medical condition are not eligible medical expenses.

Health Screenings

SEE DIAGNOSTIC SERVICES.

Holistic/Homeopathy Practitioner

Fees paid to a holistic or homeopathy doctor are eligible when treatment is provided for a specific medical condition.

Hospital Services

Amounts paid for hospital services that are not covered under a medical plan qualify as medical expenses (e.g., upgrade from semi-private to private room, fees charged for parents to stay with a child, etc.). (SEE LODGING/TRIPS)

Human Guide

Expenses for a human guide - to take a blind child to school for example Ð are reimbursable. Also see GUIDE DOG or ANIMAL.

Hypnosis

Hypnosis is considered a medical expense when it is prescribed by a physician as treatment for a specific medical or mental condition.

Infertility Treatments

SEE FERTILITY.

Insurance Premiums

Amounts paid as premiums to purchase health care coverage are not eligible medical expenses. This includes COBRA, Medicare A&B premiums.

Interplacque Machine

SEE DURABLE MEDICAL EQUIPMENT (DME).

Investigational Surgery

Fees for investigational surgery are eligible when recommended/prescribed by a doctor.

In Vitro Fertilization

SEE FERTILITY.

Laboratory Fees

Amounts paid for laboratory fees that are part of your medical care are eligible medical expenses.

Lamaze Classes

See CHILDBIRTH CLASSES.

LASIK Eye Surgery

Expenses associated with LASIK/PRK or radial keratotomy surgery to correct impaired vision are eligible.

Late Fees Payments

Late fees associated with payment of medical expenses are not eligible.

Lead Paint/Asbestos Removal

Costs of removing lead-based paints/asbestos from surfaces in a home to prevent a child who has (or has had) lead poisoning from eating the paint are eligible expenses. The cost of repainting is not reimbursable.

Learning Disability

See SCHOOLS, SPECIAL.

Legal Fees

Legal fees paid to authorize treatment for a mentally ill patient are eligible medical expenses.

However, if guardianship or estate management fees are included, they are not eligible for reimbursement. Legal fees to obtain a divorce are not eligible.

Lessons

Lessons qualify as medical expense when submitted with supporting documentation from a physician that the lessons are necessary to treat a medical condition.

Lessons that are not prescribed by a physician for treatment of a medical condition are not eligible for reimbursement (e.g., clarinet lessons to correct malocclusion).

License Requirements

See MEDICAL SERVICES.

Lifetime Care Advance Payments

Prepayments of life care fees or founders fees paid monthly or as a lump sum under an agreement with a retirement home are not eligible expenses. These payments are considered to be premiums.

Lodging/Trips

The cost of meals and lodging at a hospital or similar institution qualify as medical expenses if the main reason for being there is to receive medical care. Expenses incurred for transportation to another city are eligible health care expenses if the trip is primarily for and essential to receiving medical services. You may also be able to include up to $50 (refer to IRS Publication 502) per person, per night for lodging.

You cannot include in medical expenses amounts you pay for a trip or vacation taken for a change in environment, improvement of morale or general improvement of health, even if a doctor recommends the trip.

Long Term Disability (LTD)

Any member who is currently on Long Term Disability and is considered an eligible employee as outlined in the plan sponsor's SPD, can submit eligible medical expenses to FSA if enrolled.

However, premium payments for Long Term Disability coverage are not considered eligible medical expenses.

Marijuana

Expenses associated with marijuana when purchased or used under state laws for treatment of a medical condition are not eligible for reimbursement. This drug remains illegal under federal law and does not qualify as a Sec. 213 medical expense.

Marriage Counseling

SEE COUNSELING.

Massage Therapy

Massage therapy is covered if the member submits documentation from a physician confirming that massage therapy is prescribed as treatment of a specific medical condition. The physician should also include the frequency and duration of the therapy.

Massage therapy for general health does not qualify as a medical expense.

Maternity Charges

Amounts paid to physicians for delivery charges quality as eligible expenses.

Maternity Clothes

The cost of maternity clothing is not an eligible expense.

Mattresses

Amounts paid for a mattress or special bedding for a person with documentation supporting a medical condition is a medical expense, but only for the amount that exceeds the cost of similar regular bedding. Proof of the cost of regular bedding is necessary to pay the expense.

Meals

Meals associated with inpatient medical care are eligible expenses.

Medical Plan Information

Payments for services to keep your medical information so that it can be retrieved from a computer data bank are an eligible medical expense. Fees associated with copying medical records are also eligible.

Medical Services

Eligible medical expenses for treatment of specific medical conditions include fees paid to:

Medicines

Eligible medical expenses include amounts paid for prescribed medicines and drugs. A prescribed drug is one that requires a written order by a medical practitioner and is dispensed through a pharmacy for its use by an individual. You may include expenses you pay for delivery charges, postage and handling of mail-order prescribed drugs.

Fees paid for over-the-counter medications and/or supplies for "medical care" are reimbursable. Examples of covered expenses include but are not limited to:

Expenses that are "merely beneficial to an individual's general health" are not reimbursable. Examples of non-covered expenses include but are not limited to:

Note: Certain non-covered over-the-counter expenses may become eligible when prescribed by a physician as treatment for a specific medical condition and submitted with supporting documentation.

Mentally Retarded (Special Home for)

Expenses associated with keeping a mentally retarded person in a special home (not the home of a relative) on the recommendation of a psychiatrist to help the person adjust from life in a mental hospital to community living is an eligible expense.

Mouth Guards

Occlusal guards prescribed by a dentist to prevent a person from grinding his/her teeth at night are eligible expenses.

Neurologist Fees

Fees paid to a neurologist for treatment of a specific condition qualify as medical care and are eligible for reimbursement.

Nursing Home

Medical expenses associated with the cost of medical care provided in a nursing home or home for the aged for an employee, spouse or dependent are eligible for reimbursement (i.e., with a bill from a provider or facility for medical services). This includes the cost of meals and lodging in the home if the main reason for being there is to receive medical care.

Non-medical expenses are not eligible.

Nursing Services

Wages and other amounts paid for nursing services are eligible medical expenses. This includes services connected with caring for the patient's condition, such as dispensing medications changing dressings, bathing and grooming the patient.

Only the amount spent for nursing services is a medical expense. If the attendant also provides personal and household services, these amounts must be divided between the times spent performing household and personal services and the time spent for nursing services. However, certain expenses for household services or for the care of a qualifying individual incurred to allow an employee to work may qualify for the child and dependent care credit. See Publication 503, Child and Dependent Care Expenses.

Nutritional Supplements

Special foods or nutritional supplements are only covered if there is supporting documentation from a physician that they were prescribed as treatment for a specific medical condition.

Optometrist

SEE CONTACT LENSES, EYE GLASSES.

Organ Donor

Donor's expenses that are paid by the FSA enrollee are eligible for reimbursement.

Orthodontia

Out-of-pocket orthodontia expenses are eligible for reimbursement. However, a dental policy is usually to reimburse only the prepaid amount that corresponds to the member's current enrolled plan year. Prepaid expenses are subject to proof of payment, i.e., cancelled check, bill from provider indicating payments or credit card receipt). You will also be required to initially submit a copy of the orthodontia treatment contract.

Orthopedic Shoes

Amounts paid for special shoes are eligible medical expenses, but only for the amount that exceeds the cost of regular footwear.

Over-the-Counter Medications

See: MEDICINES.

Oxygen

Amounts paid for oxygen or oxygen equipment to relieve breathing problems caused by a medical condition is eligible.

Parking

SEE TRANSPORTATION.

Pastoral Counseling

SEE COUNSELING.

Personal Trainers

Fees paid to personal trainers are eligible for reimbursement if recommended by a medical practitioner to treat a specific medical condition.

The use of personal trainers for improvement of general health is not covered.

Personal Use Items

Personal use items used primarily to prevent or alleviate a physical or mental defect or illness are an eligible medical expense when accompanied with documentation supporting a specific medical condition.

For example, the full cost of a wig purchased upon the advice of a physician for the mental health of a patient who has lost all of his/her hair from disease, can be included as medical expenses.

Physical Exam for Caregiver

Expenses for a physical exam for a potential caregiver are not expenses for the care of a qualifying individual, nor do they fit into the definition of a household expense.

Physical Therapy

Physical therapy is covered only if the member submits documentation from a physician confirming that physical therapy is prescribed as treatment for a specific medical condition. The physician should also include the frequency and duration of the therapy.

Prescription Drugs

SEE MEDICINES.

Prosthesis

SEE ARTIFICIAL LIMB.

Psychiatric

Amounts paid for psychiatric care are eligible for reimbursement. This includes fees associated with the care of a qualifying individual in a specially equipped medical center where the dependent receives medical care when prescribed by a physician.

Psychoanalysis

Amounts paid for psychoanalysis qualify as medical expenses.

Psychologist

Fees paid to a psychologist for medical care are eligible medical expenses when submitted with documentation supporting a specific medical condition.

Reasonable & Customary

Amounts that exceed Reasonable & Customary fees qualify as medical expenses.

Schools, Special

Payments to a special school for a mentally impaired or physically disabled person qualify as eligible health care expenses if the main reason for using the school is its resources for relieving the disability. Costs can include:

Smoking Program

Expenses associated with the cost of a stop-smoking program are eligible health care expenses and do not require letter of medical necessity.

Special Foods

SEE NUTRITIONAL SUPPLEMENTS.

Speech Therapy

Expenses associated with speech therapy are eligible when prescribed as treatment for a medical condition (e.g., autism or dyslexia).

Sperm Storage

Fees paid for storage of sperm for treatment of infertility are eligible health care expenses.

Storage fees paid for non-medical reasons are ineligible.

Stem Cell Storage

This expense is reimbursable if used in treatment of a specific medical condition. The cost to collect, freeze and store stem cell would also be eligible as long as a specific medical condition is present. The amount that is not covered under regular medical coverage would be a reimbursable expense.

Sterilization

The cost of obtaining a legal sterilization or to reverse sterilization is an eligible health care expense.

Substance Abuse

SEE ALCOHOLISM.

Surrogate Mother

Flexible Spending Account members who fulfill the role of surrogate mother may submit for reimbursement for qualified medical expenses incurred that is not covered by insurance.

Medical expenses incurred by a third party, i.e., a surrogate mother, are not considered eligible expenses. Fees paid to an agency to search for a surrogate mother are not considered eligible for reimbursement.

Swim Therapy

Expenses associated with swim therapy or a swim club membership when prescribed by a medical practitioner as treatment for a specific medical condition (e.g., rheumatoid arthritis) are eligible health care expenses.

Swim lessons to learn the fundamentals of swimming are not eligible health care expenses.

Taxes incurred for medical services or products qualify as eligible health care expenses (e.g., sales tax and state hospital bill surcharges).

Telephone

Expenses associated with enhancing a telephone to accommodate a deaf person or persons with disabilities are eligible health care expenses.

Telephone Consultation (Physicians' Fees)

Fees charged by physicians for telephone consultations are eligible health care expenses. The phone charge is also an eligible expense.

Television

Expenses associated with the cost of modifying a television to assist a handicapped person are eligible health care expenses.

Cost may include an adapter that attaches to a regular television. It may also include the cost of a specially equipped television. Eligible reimbursement is the cost associated with the specialization over the cost of a similar standard model.

Transplants

SEE ORGAN DONOR.

Transportation

Amounts paid for transportation primarily for, and essential to, medical care qualifies as medical expenses when submitted with documentation supporting a specific medical condition. Included are:

Transportation expenses can be covered for a nurse who provides medical services to the patient who is traveling to get medical care and is unable to travel alone. Transportation expenses to see a mentally ill dependent are covered, if the visits are recommended as a part of the treatment. Commuting expenses for a physically disabled person are not covered.

Note: IRS Publication 502 indicates that transportation expenses to travel to another city will not qualify as an eligible expense when a member elects the destination.

Trips

SEE LODGING/TRIPS.

Tuition

Expenses charged for medical care included in the tuition of a college or private school are eligible health care expenses if the charges are separately stated in the bill provided by the school.

Medical coverage premiums attached to a college tuition or private school bill do not qualify as an eligible expense.

Tutoring

Tutoring fees paid on a doctor's recommendation for a child's tutoring by a specialized teacher qualify as medical expenses with documentation supporting a specific medical condition.

Umbilical Cord Blood

UVR Treatments

UVR treatments are eligible expenses when recommended by a physician for a medical condition (e.g., chronic psoriasis).

Vacation

SEE LODGING/TRIPS.

Vaccinations

Amounts paid for vaccinations or immunizations against disease are eligible health care expenses.

Vasectomy

Medical expenses paid for a legal vasectomy are covered.

Varicose Vein Surgery

Expenses associated with the removal of varicose veins prescribed by a doctor for treatment of a specific medical condition are eligible health care expenses.

Removal for cosmetic purposes is not an eligible expense.

Weight Loss Drugs

Weight loss drugs prescribed by a physician to treat a medical condition (e.g., morbid obesity, hypertension) are eligible for reimbursement.

Weight loss drugs associated with general weight loss are not eligible for reimbursement.

Weight Loss Programs

Medical expenses paid for a weight loss program prescribed by a doctor for treatment of a specific medical condition (e.g., high blood pressure, heart disease) are covered. Reimbursement should be only for the component that is related to a single calendar year. The member should submit documentation from the attending physician prescribing the weight loss program confirming that it was medically necessary for a specific medical condition and not for general health enhancement.

Wellness Scans

SEE DIAGNOSTIC SERVICES.

Whiten Teeth

SEE BLEACHING/BONDING.

X-ray Fees

X-ray fees associated with medical care qualify as eligible health care expenses.