FSA - List of Eligible & Ineligible Expenses

A Medical Flexible Spending Arrangement (FSA) can cover a wide variety of expenses. We’ve assembled a brief list of common expenses that are eligible for reimbursement; not all eligible items are on this list. Some expenses may be eligible if you meet certain criteria. Please review the FSA Enrollment Guide.

If you or your spouse have a Health Savings Account (HSA), you are not eligible to enroll in the FSA. Remember, it is your responsibility to find out if a service or product is eligible before you sign up for the benefit.

    Acne treatment

    Acne treatment

    Over-the-counter acne medications are reimbursable if prescribed you must submit the Rx or this LMN for reimbursement. The cost of normal skin care is not reimbursable. Medical services used to treat acne require an LMN indicating that the procedure is not cosmetic and treats a medical condition.

    Activity tracker

    Activity tracker

    Acupuncture

    Acupuncture

    Adaptive equipment (e.g. raised toilet seat)

    Adaptive equipment (e.g. raised toilet seat)

    Air fare

    Air fare

    Amounts paid for transportation primarily for, and essential to, medical care are reimbursable. Proof of medical visit corresponding with the travel is required. Companion travel expenses are not eligible unless necessary due to the patient’s medical condition. Transportation expenses must not include a personal element. For example airfare for a two week trip to Hawaii which includes a dentist appointment would not be reimbursable.

    Airborne

    Airborne

    Allergy medication

    Allergy medication

    Ambulance fees

    Ambulance fees

    Analgesics

    Analgesics

    Anesthesia

    Anesthesia

    Anesthesia administered for cosmetic procedures or otherwise ineligible expenses are not reimbursable.

    Antacids

    Antacids

    Anti diarrheal

    Anti diarrheal

    Anti-gas medication

    Anti-gas medication

    Anti-itch cream/gel

    Anti-itch cream/gel

    Antibiotic ointment

    Antibiotic ointment

    Antifungal foot cream

    Antifungal foot cream

    Antiseptic

    Antiseptic

    Asthma relief

    Asthma relief

    Automobile

    Automobile

    Medical expenses for special hand controls and other equipment installed in a vehicle are reimbursable if used primarily for care. The cost of operating the vehicle is not eligible. LMN or additional documentation may be required.

    Bandage tape

    Bandage tape

    Bandages

    Bandages

    Birth classes or lamaze

    Birth classes or lamaze

    The class must address specific medical issues; labor, delivery and breathing techniques. The cost of the ‘mother-to-be’ is eligible; however, the costs of ‘father-to-be’ and/or a coach are not eligible.

    Blood pressure monitor

    Blood pressure monitor

    Boutique Practice Fees

    Boutique Practice Fees

    Monthly or annual fees a provider may charge for improved access and/or 24/7 availability

    Braces (knee, ankle, wrist)

    Braces (knee, ankle, wrist)

    Braille books and magazines

    Braille books and magazines

    The cost difference between a regular book or magazine and the braille books/magazines is reimbursable.

    Breast augmentation

    Breast augmentation

    Medical costs related to the removal of breast implants that are defective, causing a medical condition, or restorative procedures for cancer patients are reimbursable. Cosmetic procedures such as implants or injections are not reimbursable.

    Breast pumps & supplies

    Breast pumps & supplies

    Breast reduction

    Breast reduction

    Expenses related to a breast reduction are reimbursable only if the procedure is medically necessary and not cosmetic in nature. LMN required.

    Bug spray

    Bug spray

    Burn cream

    Burn cream

    Capital expenses

    Capital expenses

    Expenses for special equipment or improvements to a home are reimbursable if the primary purpose is medical care. LMN required as well as an appraisal before and after the expense is incurred. Cost of appraisal is not reimbursable and online appraisals are not sufficient (Zillow) as the actual capital expense must be considered in the appraisal.

    Improvements or special equipment installed in the home may qualify for reimbursement if their main purpose is medical care. A LMN is required. The amount reimbursable is reduced by any increase in the value of the property. If the value of the property is not increased by the improvement, the entire cost of the improvement may be reimbursable. If the improvement or modification does not increase the value of the residence then the full cost may be reimbursable. These improvements include, but are not limited to:
    ◾Constructing entrance or exit ramps
    ◾Widening doorways at entrances or exits
    ◾Widening or otherwise modifying hallways and interior doorways
    ◾Installing railing, support bars or other modifications to bathrooms
    ◾Lowering or making other modifications to kitchen cabinets and equipment
    ◾Moving or otherwise modifying electrical outlets and fixtures
    ◾Installing porch lifts and other forms of lifts (but generally not elevators)
    ◾Modifying fire alarms, smoke detectors and other warning systems; modifying stairways
    ◾Adding handrails or grab bars
    ◾Modifying hardware on doors
    ◾Modifying areas in front entrance and exit doorways
    ◾Re-grading the ground to provide access to the residence

    Only reasonable costs are considered medical care. Additional costs for personal motives, such as for architectural or aesthetic reasons, are not reimbursable.

    Capital Expense Worksheet

    The following worksheet may be used to determine the amount of a reimbursable capital expense.
    1.The cost of the improvement $__________ .
    2.The increase in the value of the home as a result of the improvement $__________ .
    If line 2 is equal to or greater than line 1, the cost of the improvement is not reimbursable. If line 2 is less than line 1, go on to line 3.
    3.Subtract line 2 from line 1. This amount may be claimed as a medical expense.

    Although a capital expense may be reimbursable under Section 213, it is not certain to what extent such an expense may be reimbursable under a health FSA. Rules prohibit as a benefit “deferred compensation.” For this purpose, deferred compensation means the use of contributions “from one year to purchase a benefit that will be provided in a subsequent year.” Since a capital expenditure by its nature has value over more than one year, reimbursement of such an expense might be considered deferred compensation. The IRS has not provided specific guidance on this point.

    Accordingly, the expense may be reimbursed in one of the three following ways: (1) not reimburse the expenditure at all (most conservative); (2) prorate the reimbursement over the useable life of the asset (a middle-ground approach); and (3) reimburse the entire expenditure in the year in which it is acquired (most aggressive).

    Operation and Maintenance

    If a capital expense qualifies as a reimbursable medical expense, then expenses related to operation and maintenance also qualify as medical expenses, as long as the medical reason for the capital expense still exists. This is so even if none or only part of the original capital expense qualified as a medical care expense.

    Improvements to Property Rented By a Person with Disabilities

    Improvements to rental property to treat a medical condition are reimbursable if the amount was not reimbursed by the landlord or any other source.

    Chair

    Chair

    The cost difference between a special chair and a normal chair is reimbursable. The chair must be primarily for medical care. Expense requires documentation indicating the cost of three comparable items in order to determine the cost difference. LMN required.

    Chiropractic services

    Chiropractic services

    Chloraseptic sprays

    Chloraseptic sprays

    Christian Science practitioner

    Christian Science practitioner

    Expenses for a Christian Science Practitioner are reimbursable if used to treat a medical condition.

    Co-insurance

    Co-insurance

    COBRA Premiums

    COBRA Premiums

    Cold sore treatment

    Cold sore treatment

    Cold/cough medication

    Cold/cough medication

    College Insurance

    College Insurance

    Contact lens solution

    Contact lens solution

    Contacts

    Contacts

    Contraceptives

    Contraceptives

    Copays

    Copays

    CPAP machine

    CPAP machine

    CPR Classes

    CPR Classes

    Crutches

    Crutches

    Deductibles

    Deductibles

    Expenses applied against a medical or dental insurance deductible are eligible. This is not to be confused with a premium, premiums are not eligible.

    Dental services and products

    Dental services and products

    Expenses for dental services and products are reimbursable. This includes expenses for X-rays, fillings, braces, extractions, dentures, etc. Teeth whitening and other cosmetic services are not reimbursable. Hygiene products including toothpaste, floss, mouthwash, and toothbrush/Sonicare products are not reimbursable.

    Diabetes testing supplies

    Diabetes testing supplies

    Diabetic supplies

    Diabetic supplies

    Diaper rash ointment

    Diaper rash ointment

    Doctor visits

    Doctor visits

    Doula services

    Doula services

    Must be licensed and some postpartum doula expense are excluded

    Drug addiction treatment

    Drug addiction treatment

    Ear wax removal kits

    Ear wax removal kits

    Elastic hosiery

    Elastic hosiery

    Hosiery used to alleviate a medical condition is reimbursable.

    Electrolysis

    Electrolysis

    Ergonomic items

    Ergonomic items

    Ergonomic items are eligible with a Letter of Medical Necessity (LMN).

    Eye drops

    Eye drops

    Eye exams

    Eye exams

    Face Lift

    Face Lift

    Fertility treatment

    Fertility treatment

    Medical expenses related to the treatment of infertility, including in vitro fertilization, are reimbursable. Only storage fees for the current plan year are reimbursable. Storage fees for a future plan year are not reimbursable.

    Finance Charges

    Finance Charges

    First aid kits

    First aid kits

    Flu shots

    Flu shots

    Founder's fee/lifetime care

    Founder's fee/lifetime care

    Part of a life-care fee or “founder’s fee” paid either monthly or as a lump sum under an agreement with a retirement home if it is allocable to medical care. The agreement must require a specified fee payment as a condition for the home’s promise to provide lifetime care that includes medical care. Advance payments to a private institution for the lifetime care, treatment and training of an employee’s physically or mentally impaired dependent upon the employee’s death or inability to provide care are reimbursable. The payments must be a condition for the institution’s future acceptance of the dependent and must not be refundable.

    Funeral Expenses

    Funeral Expenses

    Hair growth products

    Hair growth products

    Hair transplant

    Hair transplant

    Health Club Dues

    Health Club Dues

    Hearing aid supplies

    Hearing aid supplies

    Hearing aids

    Hearing aids

    Hemorrhoid medication

    Hemorrhoid medication

    Home medical equipment

    Home medical equipment

    Hormone therapy

    Hormone therapy

    Hospital

    Hospital

    Expenses incurred at a hospital in-patient or out-patient for laboratory, surgical, and diagnostic services are reimbursable.

    Household help

    Household help

    Human guide

    Human guide

    Expenses for a human guide are reimbursable. For example, the expense of guiding a blind child to school is reimbursable.

    Humidifier

    Humidifier

    Hydrogen peroxide

    Hydrogen peroxide

    Hygiene Products

    Hygiene Products

    Hypnosis

    Hypnosis

    Imported OTC & prescription medicines

    Imported OTC & prescription medicines

    In vitro fertilization

    In vitro fertilization

    Medical expenses related to the treatment of infertility, including in vitro fertilization, are reimbursable. Storage fees for the current plan year only are reimbursable. Storage fees for a future plan year are not reimbursable.

    Individual Counseling

    Individual Counseling

    Insurance Premiums

    Insurance Premiums

    Ipecac syrup

    Ipecac syrup

    Lab work

    Lab work

    Lactation consultants

    Lactation consultants

    Lactose intolerance pills

    Lactose intolerance pills

    Laser eye surgery

    Laser eye surgery

    Late Fees

    Late Fees

    Laxative

    Laxative

    Legal fees

    Legal fees

    Legal fees required to receive medical care are reimbursable. Legal assistance must a necessary expense in order to receive the care (e.g. the care could not have been provided without legal assistance). However, any part of a legal fee that is a management fee; for example, a guardianship or estate management fee is not reimbursable. Additional documentation may be required.

    Lice treatment products

    Lice treatment products

    Liposuction

    Liposuction

    Lodging and meals

    Lodging and meals

    Lodging and meal expenses at a hospital or similar institution are reimbursable if the employee’s primary reason for being there is to receive medical care. The cost of lodging not provided in a hospital or similar institution while an employee is away from home is reimbursable if four requirements are met: (1) the lodging is primarily for and essential to medical care; (2) medical care is provided by a doctor in a licensed hospital or other medical care facility; (3) the lodging is not lavish or extravagant under the circumstances; and (4) there is no significant element of personal pleasure, recreation, or vacation in the travel away from home.

    If the lodging is not provided at a hospital or similar institution then the reimbursable amount cannot exceed $50 for each night for each person. Lodging expenses includes companion expenses if that person must travel with the patient. For example, $100 per night may qualify as a medical expense for lodging if a parent is traveling with a sick child.

    Meals expenses incurred away from home while undergoing medical treatment are not expenses for medical care and are not reimbursable even if the trip is made on the advice of a doctor. This is specific to meal expenses outside of a hospital. See above paragraph for meal expenses at a hospital.

    Marijuana

    Marijuana

    Marriage Counseling

    Marriage Counseling

    Massage

    Massage

    Massage chair

    Massage chair

    Mattress

    Mattress

    Medical abortion

    Medical abortion

    Medical alert bracelet & current year membership fees

    Medical alert bracelet & current year membership fees

    Medical records

    Medical records

    The fees associated with transferring medical records to a new practitioner are reimbursable.

    Menstrual care products

    Menstrual care products

    Missed Appointment Fees

    Missed Appointment Fees

    Motion sickness pills/bracelet

    Motion sickness pills/bracelet

    Naturopathic Expenses

    Naturopathic Expenses

    Naturopathic doctor visits are reimbursable. Naturopathic medicines (dietary supplements etc.) will require a LMN to be reimbursable.

    Non-cosmetic surgery

    Non-cosmetic surgery

    Nursing home

    Nursing home

    The cost of medical care in a nursing home or similar facility for the employee, employee’s spouse, or tax dependent is reimbursable. This includes the cost of meals and lodging in the facility if the primary reason for being there is to receive medical care. Qualified long-term care services cannot be reimbursed on a tax-excludable basis through a flexible spending arrangement on or after January 1, 1997. For this purpose, qualified long-term care expenses are defined in Code Section 7702B(c) as: necessary diagnostic, preventive, therapeutic, curing, treating, mitigating, and rehabilitative services, and maintenance or personal care services, which: (A) are required by chronically ill individual, and (B) are provided pursuant to a plan of care prescribed by a licensed health care practitioner. Thus, under the above definition, expenses that are otherwise reimbursable medical expenses may be long-term care expenses. Code Section 7702B(c)(2) defines a “chronically ill individual” to be a person who (among other things) is “certified” by a licensed health care practitioner as being unable to perform at least two activities of daily living for a period of at least 90 days due to a loss of functional capacity.

    Occupational therapy

    Occupational therapy

    Optometrist

    Optometrist

    Optometric services and expenses for eyeglasses and contact lenses required to treat a medical condition are reimbursable. Premiums for contact lens replacement insurance are not reimbursable.

    Organ transplants

    Organ transplants

    Payments for surgical, hospital, laboratory and transportation expenses for a prospective or actual donor of a kidney or other organ are reimbursable.

    Orthodontia

    Orthodontia

    Unlike other FSA expenses which are deemed incurred when the services are rendered, some orthodontia expenses are deemed incurred when paid—these orthodontia expenses are called pre-payments. For example, if a participant pays a lump sum up front, that payment can be reimbursed in full (provided the lump sum is paid during the same plan year from which reimbursement is requested and while the participant was covered under the plan). You must provide proof of payment in order for prepayments to be reimbursed. Ongoing payments for services (not prepayments) can be reimbursed as those monthly service are rendered (provided the service is provided in the same plan year from which reimbursement is requested and while the participant was covered under the plan). Proof of payment is not required under this second option. Payments made toward orthodontia in a previous plan year or before your eligibility period are not reimbursable.

    Orthotics

    Orthotics

    Oxygen

    Oxygen

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

    Pain relievers

    Pain relievers

    Parasitic treatment

    Parasitic treatment

    Phone

    Phone

    The cost of purchasing and repairing a special telephone that permits a hearing-impaired person to communicate is reimbursable.

    Physical exams

    Physical exams

    Physical Therapy

    Physical Therapy

    Amounts paid for physical therapy to treat a medical condition are reimbursable. Payments made to an individual for special exercises administered to a mentally disabled child are also reimbursable.

    Pregnancy test

    Pregnancy test

    Prenatal vitamins

    Prenatal vitamins

    Prescription drugs

    Prescription drugs

    Prescription glasses

    Prescription glasses

    Psychiatric Care

    Psychiatric Care

    Expenses for psychiatric care, including the cost of a facility where the dependent receives medical care, are reimbursable.

    Psychotherapy

    Psychotherapy

    Reading glasses

    Reading glasses

    Rubbing alcohol

    Rubbing alcohol

    Saline nasal spray

    Saline nasal spray

    Service animal

    Service animal

    The cost of a guide dog or other animal used by the visually impaired or hearing impaired person is reimbursable. Food and veterinarian cost associated with a dog or other animal are also reimbursable. An LMN is required.

    Sexual counseling

    Sexual counseling

    Expenses for counseling by a licensed medical practitioner to treat a medical condition are reimbursable.

    Smoking cessation program

    Smoking cessation program

    Expenses for participation in a smoking cessation program are reimbursable with an LMN.

    Sonicare Products

    Sonicare Products

    Special foods

    Special foods

    The difference in cost between the special food the commonly available “comparable” version of the same product are reimbursable. You must provide the cost of three comparable items for us to determine the cost difference. The special foods must be prescribed and consumed primarily to alleviate or treat an illness or disease, and not for nutritional purposes. Diet food or food related to a weight loss program are not “special foods” and are not reimbursable. An example of a special food is gluten free food consumed by person with a gluten protein allergy. LMN required.

    Special home for mentally impaired

    Special home for mentally impaired

    The cost of keeping a mentally disabled person in a special home (not the home of a relative) is reimbursable if recommended by a licensed medical practitioner to treat a medical condition.

    Special schools

    Special schools

    Expenses paid to a special school for a mentally impaired or physically disabled person if the primary purpose for using the school is to treat a medical condition. This includes the cost of a school that:

    ◾Teaches Braille to a visually impaired child
    ◾Teaches lip-reading to a hearing-impaired child
    ◾Provides remedial language training to correct a condition caused by a birth defect
    ◾Schools for autistic children

    Meals, lodging, and ordinary education supplied by a special school is reimbursable only if the main reason for using the school is its resources for treating the mental or physical disability. The cost of sending a child without a specific medical condition to a special school to benefit from the course of study or disciplinary methods is not reimbursable. LMN required.

    Speech therapy

    Speech therapy

    Sterilization

    Sterilization

    Expenses related to legal sterilization, including vasectomy and reverse vasectomy, are reimbursable.

    Stool softener

    Stool softener

    Sunscreen SPF 15 or greater

    Sunscreen SPF 15 or greater

    Proof of SPF required

    Tattoo Removal

    Tattoo Removal

    Teeth Whitening

    Teeth Whitening

    Thermometer

    Thermometer

    Throat lozenges

    Throat lozenges

    Toiletries

    Toiletries

    Transporation/mileage (to receive medical care)

    Transporation/mileage (to receive medical care)

    Expenses paid for transportation primarily for and essential to the rendering of medical care are reimbursable. This includes bus, taxi, train or plane fare, ambulance service, parking fees, tolls and expenses of a parent who must accompany a child who needs medical care. The mileage rate is indexed each year for inflation. The cost of tolls and parking may also be reimbursable. Proof of office visit corresponding with the mileage required.

    Urinary tract infection treatments

    Urinary tract infection treatments

    Vaccinations

    Vaccinations

    Veneers

    Veneers

    Veneers are eligible as long as they are not cosmetic in nature. A Letter of Medical Necessity is required

    Vitamins & supplements

    Vitamins & supplements

    Vitamins & supplements are eligible with a Letter of Medical Necessity (LMN). The vitamin or supplement needs to be treating a specific diagnosis. Vitamins & supplements used for general health are not eligible.

    Walker

    Walker

    Warranties

    Warranties

    Wart treatment

    Wart treatment

    Weight loss programs

    Weight loss programs

    The weight loss program must treat a medical condition diagnosed by a health care provider (e.g., obesity, diabetes, high blood pressure). Only program fees are eligible. Food or beverage products purchased for weight control or reduction are not eligible (even if a part of the weight loss program). A Letter of Medical Necessity (LMN) is required.

    Wheelchair & repair

    Wheelchair & repair

    X-rays

    X-rays

    Yeast infection treatment

    Yeast infection treatment

  • No Expenses Found