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Health FSA eligible expenses

The listing below shows commonly requested expenses you can get reimbursed for with your Health Flexible Spending Account. Each item, service, or charge in this table is classified as an eligible expense, potentially eligible expense, or not an eligible expense.

View Eligible Dependent Care FSA Expenses

Expense

Special Rules

Acupuncture

If treating a medical condition.

Adoption – medical expenses incurred before adoption is finalized

If the child is your tax dependent when the service is provided.

Alcoholism treatment

For inpatient treatment

Ambulance

Artificial limbs and teeth

Asthma treatments

Bandages (OTC)

Blood pressure monitoring devices

Blood sugar test kit and test strips (OTC)

Diagnostic items

Body scan

See Diagnostic items/services

Breast pumps and lactation supplies, excluding breastfeeding bras (OTC)

Breast reconstruction surgery following mastectomy

Eligible if surgery was done following a mastectomy for cancer.

Carpal tunnel wrist supports

Chelation therapy

Eligible expense if used to treat a medical condition such as lead poisoning.

Chiropractors

Circumcision

Cold/hot packs (OTC)

Condoms (OTC)

Co-insurance amounts, co-payments and deductibles

Eligible if the underlying service/item qualifies.

Contact lenses, materials, and equipment

If contacts are needed for medical purposes. Supplies needed for using lenses will qualify if the lenses are needed for medical purposes.

Cosmetic procedures or surgery

Not generally eligible except for amounts paid for surgery necessary to improve a deformity arising from a congenital abnormality, personal injury from an accident or trauma, or a disfiguring disease.

Crutches

Deductibles

Dental services

Eligible for expenses incurred for the prevention and alleviation of dental disease. Teeth whitening is not eligible.

Dentures and denture adhesives (OTC)

Diabetic supplies (OTC)

Diagnostic items

Diagnostic item/services

Drug addiction treatment

Drug overdose treatment

Egg donor fees

Eye examinations, eyeglasses and related equipment and materials/cleaners

Flu shots

Gauze pads (OTC)

Glucose monitoring equipment (OTC)

Diagnostic items

Guide dog or other animal aide

Eligible if expense is to assist a physically disabled person; expense of buying, training, and maintaining a guide dog includes the expenses of food and innoculations. Veterinary fees for such animals also qualify as medical care.

Hearing aids (OTC)

Includes the cost of batteries

Hemorrhoid treatment (OTC)

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Hospital services

Immunizations

Incontinence supplies (OTC)

Adult diapers used to relieve incontinence generally will qualify. See Diapers.

Insulin

Includes equipment necessary to inject the insulin, such as syringes or insulin pumps.

Laboratory fees

If part of medical care or diagnosis.

Laser eye surgery/Lasik/Radial Keratotomy

Liquid bandage (OTC)

Mastectomy-related bras

Medical monitoring and testing devices (OTC)

These items include blood-pressure monitors, syringes, glucose kit, etc.

Medical records charges

For the expense associated with transferring medical records to a new medical practitioner.

Medicines and drugs

See Drugs and medicines

Norplant insertion or removal

Obstetrical expenses

Occlusal guards to prevent teeth grinding

Optometrist

Organ donor

Including surgical, hospital and laboratory services as well as transportation expense for donor.

Orthodontia expenses

Orthodontia expenses and supplies are eligible. However, when an orthodontic treatment plan is paid up-front at the time of the first visit or the plan will apportion the reimbursements as services are provided during the treatment plan.

Ovulation monitor

Physical exams

Physical therapy

Pregnancy test kit

Prenatal expenses

Prenatal expenses paid up front may be reimbursed in the year during which the lump sum amount was contracted, despite the fact that all expenses have not yet been incurred.

Prosthesis

Psychiatric care

Eligible if treating a medical condition. Must submit a medical practitioner's recommendation stating the expense is to treat a specific medical condition, an EOB, or a practitioner's receipt listing the diagnosis code.

Radial keratotomy

Screening tests

Must be used for medical diagnosis.

Seeing-eye dog

See Guide dog.

Sinus medication (OTC)

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Smoking cessation (stop-smoking) programs

Sterilization procedures

Supplies to treat medical condition (OTC)

Eligible if the medical supply is used to diagnose or treat a specific medical condition and is not a personal comfort item.

Taxes on medical services and products

Eligible expense to the extent imposed on reimbursable medical care or products.

Telephone equipment for hearing impaired-person

Expense of buying and repairing special telephone equipment for hearing-impaired person.

Television equipment for hearing-impaired person

Eligible expense for the equipment that displays the audio part of television programs as subtitles for hearing-impaired individuals. Eligible reimbursement is limited to the cost that exceeds cost of regular item.

Thermometers (OTC)

Transplants

Eligible expenses include surgical, hospital and laboratory services and transportation expenses for donors.

Transportation expenses for person to receive medical care

Eligible expense if travel is primarily for, and essential to, medical care. Includes car and rental car expenses; parking and tolls. The 2010 standard medical travel mileage rate 16.5¢ per mile. For January through June 2011, the standard medical travel mileage rate is 19¢ per mile. For July through December 2011, the standard medical travel mileage rate is 23.5¢ per mile. Effective January 1, 2012, the standard medical travel mileage rate is 23 ¢ per mile.

Transportation expenses for someone other than the person receiving medical care

Transportation costs of an individual (such as a family member) traveling with the individual receiving medical care will qualify as eligible expenses if the presence of the family member on the trip was indispensable to enable the individual to obtain care, such as a parent traveling with a child or a nurse or other person who gives injections, medication, or other treatment required by a patient who is traveling to get medical care and is unable to travel alone. In addition, an individual who travels to visit a mentally ill dependent, if such visits are recommended as part of treatment.

Vasectomy/vasectomy reversal

Viagra

Eligible expense if prescribed by a physician to treat a medical condition. See Drugs and medicine.

Walkers

Wheelchair

X-ray fee

Eligible if received for medical reasons.

Expense

Special Rules

Acne treatment (OTC)

If to treat acne, it is eligible if incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines. However, the cost of regular skin care does not qualify.

Acne treatment - prescription

If the expense can be used for both cosmetic and medical (such as Retin-A, which can be used to treat both acne and wrinkles), a physicians recommendation with the medical condition is required.

Allergy medicine (OTC)

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Alternative healers

Nontraditional healing treatments provided by professionals may be eligible if provided to treat a specific medical condition. The treatments must be legal. And the expenses do not qualify if the remedy is a food or substitute for food that the person would normally consume in order to meet nutritional requirements. Drugs and medicines recommended by alternative healers to treat a specific medical condition can qualify as medical care. Drugs and medicines incurred after December 31, 2010 must be prescribed. See Drugs and medicines.

Analgesics (OTC)

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Antacid (OTC)

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Antihistamine (OTC)

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Anti-itch creams (OTC)

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Antibiotic sprays or ointments (for first aid) (OTC)

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Aspirin (OTC)

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Behavioral modification programs

See Schools and education

Birth control pills

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Birthing classes/childbirth classes/Lamaze

Expenses for a coach, doula or significant other are not eligible. See Lamaze classes.

Calamine lotion (OTC)

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Childbirth classes

Expenses for a coach, doula or significant other are not eligible. See Lamaze classes.

Chondroitin (OTC)

Eligible if used primarily for medical care. Will not qualify if used to maintain general health. A medical practitioner's recommendation is required stating the item is to treat a specific medical condition.

Christian Science practitioners

Eligible if expense is for medical care.

COBRA premiums

Health FSA – Not eligible
HRA – Not eligible
HSA – Eligible expense

Cold medicine (OTC)

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Contraceptives (OTC)

See birth control pills; condoms; Spermicidal foam.

Cosmetic procedures or surgery

Exception for amounts paid for surgery necessary to improve a deformity arising from a congenital abnormality, personal injury from an accident or trauma, or a disfiguring disease.

Cough suppressants (OTC)

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Counseling

Eligible if primarily for medical care. Must submit a medical practitioner's recommendation with the medical condition, an EOB, or a practitioner's receipt listing the diagnosis code.

Decongestants (OTC)

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Diaper rash ointment/cream (OTC)

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Diapers or diaper service

Eligible if expenses incurred to relieve the effects of a diagnosed medical condition, such as urinary incontinence in adults. A medical practitioner's recommendation with the medical condition is required.

Diarrhea medicine (OTC)

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Dietary supplements (OTC)

Eligible if used primarily for medical care. Will not qualify if used to maintain general health. A medical practitioner's recommendation is required stating the item is to treat a specific medical condition.

DNA collection and storage

Temporary storage may be eligible if collected as part of a diagnosis, treatment or prevention of existing or imminent medical condition. A medical practitioner's recommendation with the medical condition is required.

Drugs and medicines

Must be primarily for medical care (and not for personal, general health, or cosmetic purposes), legally procured, and generally accepted as medicines and drugs. In addition, over-the-counter expenses incurred after December 31, 2010, will qualify only if the medicine or drug is prescribed or is insulin. A prescription for this purpose is one written by an individual legally licensed to issue prescriptions, meeting the same legal requirements and including the same information as required for a drug or medicine that is available by prescription only. The prescription must be submitted with the expense reimbursement request but the prescription does not have to be filled by a pharmacist.

Ear plugs (OTC)

Eligible if treating a specific medical condition. A medical practitioner's recommendation with the medical condition is required.

Eggs and embryos storage fees

Eligible if expense is for temporary storage, but only to the extent necessary for immediate conception.

Fertility treatments (e.g., surgery, in vitro fertilization (IVF), gamete intrafallopian transfer (GIFT) and shots)

Eligible to the extent procedure is intended to overcome an inability to have children. Expenses for IVF surrogate not eligible unless the surrogate is a tax dependent.

Fever reducing medications (OTC)

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Fiber supplements (OTC)

Eligible if used primarily for medical care. Will not qualify if used to maintain general health. A medical practitioner's recommendation is required stating the item is to treat a specific medical condition.

First aid cream and first aid kits (OTC)

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Fitness programs

See health club dues.

Gambling addiction treatment

Expense eligible for inpatient treatment at a therapeutic center for gambling addiction.

Genetic testing

Eligible if testing is done to diagnose a medical condition or to determine possible defects. However, testing done just to determine the sex of a fetus would not qualify.

Glucosamine (OTC)

Eligible if used primarily for medical care. Will not qualify if used to maintain general health. A medical practitioner's recommendation is required stating the item is to treat a specific medical condition.

Health club dues and fees

Only in very limited circumstances would fees paid to a health club qualify. Expense is eligible if a physician recommends to treat a specific medical condition (e.g., rehabilitation after back surgery or treatment for obesity). The expense must not have been incurred "but for" the disease (for example, if you belonged to the health club before being diagnosed, then the fees would not qualify). When treatment is no longer needed, the fees would no longer qualify. A medical practitioner's recommendation is required stating the expense is to treat a specific medical condition.

Herbal supplements (OTC)

See Dietary supplements

Home care

See Nursing services

Hormone replacement therapy

Eligible if expense is primarily for medical care. Will not qualify if used to maintain general health. Prior to January 1, 2011, a medical practitioner's recommendation is required. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Infertility treatments

See Fertility treatments.

Insect bite creams and ointments (OTC)

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Insurance premiums

FSA and HRA – no. HSAs can reimburse insurance premiums in limited circumstances. See information at www.irs.gov for more details.

Lamaze class

To the extent instruction relates to birth and not childrearing. Expenses for the coach or significant other do not qualify.

Language training for dyslexic/disabled child

Eligible if the expense is for a child with dyslexia or an otherwise disabled child. Amounts paid for regular schooling do not qualify. A medical practitioner's recommendation is required stating the expense is to treat a specific medical condition.

Laxatives (OTC)

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Learning disability, instructional fees

Eligible if expense is prescribed by a physician. Includes expenses for special school or specially trained teacher for a child who has severe learning disability caused by mental or physical impairment.

Lodging at hospital or similar institution

Eligible if principle reason for being there is to receive medical care.

Lodging not at hospital or similar institution

Up to $50/night, provided: (1) lodging is primarily for and essential to medical care; (2) medical care is provided in a hospital or medical facility related to or equivalent to licensed hospital; (3) lodging is not lavish; and (4) no element of personal pleasure, recreation or vacation in the travel. If a parent is traveling with a sick child, up to $100 may qualify ($50 for each person).

Lodging of a companion

If accompanying a patient for medical reasons and all of the conditions described under Lodging not at a hospital, are also met.

Long term care services

FSA – No
HRA – No
HSA - Yes

Massage therapy

Eligible if expense is to treat a specific injury or trauma. Will not qualify if to improve general health. A medical practitioner's recommendation is required stating the expense is to treat a specific medical condition.

Medic-alert bracelet/necklace (OTC)

Eligible if expense is recommended by a medical practitioner in connection with treating a medical condition. A medical practitioner's recommendation is required stating the expense is to treat a specific medical condition.

Medical conference admission/transportation/meals

Eligible if expense relates to a chronic disease suffered by you, your spouse, or your dependent and if the conference is primarily for and essential to the person in need of medical care.

Menstrual pain relievers (OTC)

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Mentally handicapped, special home for

The cost of keeping a mentally handicapped person in a special home (not a relative's home) on a psychiatrist's recommendation to help that person adjust from life in a mental hospital to community living may apply.

Motion sickness pills (OTC)

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Nasal sprays (OTC)

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Nasal strips (OTC)

Eligible if expense is incurred to treat medical condition. Will not qualify if used for run of the mill snoring. A medical practitioner's recommendation is required stating the expense is to treat a specific medical condition.

Naturopathic healers

See Alternative healers; Drugs and medicines; Vitamins

Nicotine gum or patches (OTC)

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Nursing services provided by a nurse or other attendant

Expenses incurred, such as wages, employment taxes, and other amounts you pay for nursing services (including extra costs for nurses' room and board) generally will qualify, whether provided in the participant's home or another facility. The attendant doesn't have to be a nurse, as long as the services are those generally performed by a nurse. These include services connected with caring for the patient's condition, such as giving medication or changing dressings, as well as bathing and grooming. But if the person providing nursing services also provides household and personal services only those expenses for nursing services qualify.

Nutritionist's professional expenses

Eligible if expense relates to a specifically diagnosed medical condition. Will not qualify if the expense is for general health. A medical practitioner's recommendation is required stating the expense is to treat a specific medical condition

Nutritional supplements (OTC)

See Dietary supplements.

Over-the-counter medicines (OTC)

See Drugs and medicines.

Pain relievers (OTC)

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Patterning exercises

Eligible if expense is for exercises for a mentally handicapped child. A medical practitioner's recommendation is required stating the expense is to treat a specific medical condition

Prenatal vitamins (OTC)

If taken during pregnancy (a medical condition). Vitamins taken at other times generally do not qualify. A medical practitioner's recommendation is required stating the expense is to treat a specific medical condition

Propecia

Eligible if used to treat a medical condition such as alopecia. When used for cosmetic purposes (i.e., to treat male pattern baldness) it is not an eligible expense. Must be prescribed. See Drugs and medicines.

Psychoanalysis or psychologist

Eligible if expense is treating a medical condition. Will not qualify if for the general improvement of mental health, to relieve stress or personal enjoyment. Must submit a medical practitioner's recommendation stating the expense is to treat a specific medical condition, an EOB, or a practitioner's receipt listing the diagnosis code.

Retin-A

Eligible if expense is treating a medical condition. Will not qualify if purchased for cosmetic purposes (for example, to reduce wrinkles), even if recommended by a medical practitioner. Prior to January 1, 2011, a medical practitioner's recommendation is required stating the expense is to treat a specific medical condition. Must be prescribed if incurred after December 31, 2010. See Acne treatment; Cosmetic procedures and Drugs and medicines.

Rogaine

Eligible if expense is treating a medical condition. Will not qualify if purchased for cosmetic purposes even if recommended by a medical practitioner. Prior to January 1, 2011, a medical practitioner's recommendation is required stating the expense is to treat a specific medical condition. Must be prescribed if incurred after December 31, 2010. See Propecia and Drugs and medicines.

Safety glasses

Eligible if prescription lenses.

Schools and education, residential

Eligible if expense is to treat an individual for behavioral, emotional, or addictive conditions (tuition, meals, and lodging) and the principal reason for attending the program is to receive medical care. If a child is at a school because the courses and disciplinary methods have a beneficial effect on the child's attitude, the expenses won't qualify. A medical practitioner's recommendation is required stating the expense is to treat a specific medical condition.

Schools and education, special

Eligible if expense is to treat an individual who is mentally impaired or physically disabled to attend a special school (tuition, meals, and lodging) and the principal reason for attending the school is to overcome or alleviate the disability. This includes teaching Braille to a visually impaired person, teaching lip reading to a hearing-impaired person, and remedial language training to correct a condition caused by a birth defect. If a child is at a school because the courses and disciplinary methods have a beneficial effect on the child's attitude, the expenses won't qualify. A medical practitioner's recommendation is required stating the expense is to treat a specific medical condition.

Sleep deprivation treatment

Eligible expense if the person is under the care of a medical practitioner. A medical practitioner's recommendation is required stating the expense is to treat a specific medical condition.

Spermicidal foam (OTC)

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Sperm, storage fees

Eligible if expense is for temporary storage, but only to the extent necessary for immediate conception.

St. John's Wort (OTC)

Eligible if used primarily for medical care. Will not qualify if used to maintain general health. A medical practitioner's recommendation is required stating the item is to treat a specific medical condition.

Stem cell, harvesting and/or storage of

Eligible if there is a specific and imminent medical condition that the stem cells are intended to treat. But collection and storage indefinitely, just in case an item might be needed, is not medical care. A medical practitioner's recommendation is required stating the item is to treat a specific medical condition.

Sunglasses

Prescription sunglasses would qualify.

Sunscreen with high SPF (OTC)

Potentially eligible if SPF is 30 or higher and used to alleviate a specific medical condition. Would also qualify if used by a person who has or has had skin cancer or another diagnosed skin disease that is affected by sun exposure. Does not include tanning lotions, make-up or moisturizers, etc., that contain a lower dose of SPF. Prior to January 1, 2011, a medical practitioner's recommendation is required stating the item is to treat a specific medical condition. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Throat lozenges (OTC)

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Toothache and teething pain relievers (OTC)

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Transportation to and from medical conference

See Medical conference admission, transportation, meals, etc.

Umbilical cord blood storage

Eligible expense if there is an existing or imminently probable disease that the umbilical cord blood is intended to treat, such a newborn who has a birth defect and the cord blood would be needed in the near future. Collection and storage as a precaution to treat a disease or condition that might possibly develop in the future is not medical care.

Vitamins (OTC)

Eligible if used primarily for medical care. Will not qualify if used to maintain general health. A medical practitioner's recommendation is required stating the item is to treat a specific medical condition.

Weight-loss programs and/or drugs prescribed to induce weight loss

Eligible expense if a physician recommends to treat a specific medical condition (such as obesity, heart disease, or diabetes). Will not qualify if only to improve general health. The costs of food associated with a weight-loss program would not qualify. Prior to January 1, 2011, a medical practitioner's recommendation is required stating the expense is to treat a specific medical condition. Drugs and medicines must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Expense

Special Rules

Advanced reimbursements

See special requirements under Orthodontia expenses and Prenatal expenses.

Autopsy

Babysitting/child care

See Dependent daycare expenses.

Cosmetics

Dependent daycare expenses

Dependent day care expenses are not eligible medical expenses but may be eligible for reimbursement from a Dependent Day Care FSA

Electrolysis or hair removal

Face creams, moisturizers (OTC)

Face lifts

Feminine hygiene products

Funeral expenses

Hair removal/transplant

Illegal operations and treatments

Late fees on medical bills

Lodging while attending a medical conference

Marijuana or other controlled substances

Missed appointment fee

Nursing services for a baby

Does not qualify if baby is normal and healthy.

Physician access retainer

Prescription drugs and medicines obtained from other countries

Prescription drug discount programs

A fee paid to get a drug discount card will not qualify; the cost of the prescription may qualify.

Suntan lotion/clothing to block sun

Surrogate expenses

Teeth whitening/bleaching

Toothbrushes or toothpaste (OTC)

Not eligible even if recommended by dentist to treat medical condition.

Veneers

The table illustrates expenses commonly requested from the Health FSA (Unreimbursed Medical Expense Account). This tool is for use by First Financial Administrators, Inc. (FFA) customers and any other use is strictly prohibited.