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List of Eligible and Non-Eligible Expenses

IRS Rulings Make Medical Flexible Spending Accounts More Attractive

​PARTIAL LIST OF ELIGIBLE MEDICAL EXPENSES

  • Abdominal Supports, if prescribed
  • Abortion Services, if legal
  • Acupuncture
  • Ambulance Hire
  • Anesthesia
  • Arches*
  • Artificial Limbs/Prosthesis
  • Alcoholism
  • Back Supports*
  • Birth control Pills (if prescribed by Doctor), other birth control products
  • Blood Donor Expense
  • Arm or leg braces, Ace bandages
  • Braille Books/Magazines (only the value above the regular price of the publication)
  • Breast Pumps
  • Car controls for Handicapped
  • Chiropodist Services
  • Chiropractic Services
  • Convalescent Home Expense (Medical Treatment only - not Custodial Care)
  • Contact lenses
  • Co-payments
  • Cosmetic Surgery necessary to correct deformity due to congenital abnormality or one caused by personal injury or disfiguring disease
  • Counseling, Individual or Group (Marriage and Family Counseling are not covered)
  • Crutches
  • Deductibles
  • Dermatologist fees
  • Diathermy
  • Doctors Office Visits (EOB may be required)
  • Drug Treatment
  • Fertilization Services
  • Flu Shots, pneumonia shots
  • Gynecological Exams
  • Hospital Bills (EOB may be required)
  • Hypnosis for treatment of illness
  • Hydrotherapy
  • Immunizations
  • Insulin
  • Invalid Chair and other supplies
  • Kidney Donor Expense
  • Lab Exams
  • Lip Reading Lessons for the deaf
  • Medical Clinic Visits
  • Medical Equipment/supplies*
  • Midwife Expense
  • Neurologist Fees
  • Nurse's Fee (including Room and Board Charges)*
  • Nursing Care*
  • Obstetrician Fees (proof of payment or date of service, delivery date required)
  • Orthopedic Shoes or inserts
  • Osteopath
  • Over-the-Counter (Certain drugs see website for list)
  • Oxygen
  • Pediatrician Fees
  • Physical Therapy
  • Physician Fees
  • Physical Exams
  • Podiatrist
  • Practical Nurse for Medical Care
  • Prescription Drugs
  • Psychiatric Care
  • Psychologist and/or Psychotherapist
  • Radial Keratotomy (Vision correction)
  • Rental of Medical Equipment
  • Saroiliac Belt
  • Sanitarium
  • "Seeing'eye" dog and its upkeep
  • Sex Therapy - if received as medical Treatment
  • Special Education for the Blind
  • Sterilization Fees
  • Stop Smoking Program
  • Support or Corrective Devices*
  • Surgeon Fees
  • Therapeutic Care for drug and alcohol abuse
  • Transportation and lodging Expense if paid primarily for and essential to medical care
  • Transplants
  • Vasectomy
  • Weight Loss Program attendance fees*
  • Well Baby Care
  • Wheelchair
  • Wigs (prescribed by doctor for hair loss by disease)*
  • X-Rays

*If necessary for medical care; Doctors Letter of medical necessity and diagnosis required.


DENTAL EXPENSES

Bridges, Crown, Dentures, Exams, Fillings, Orthodontic (proof of payment or financial contract required), x-rays, Insurance Deductibles, Co-payments after insurance


HEARING EXPENSES

Exams, Hearing Devices and Aids (including batteries), Special Communicatin Equipment for the Deaf


VISION CARE

Exams, Contact Lenses, Frames, Lenses, Oculist Services, Optician Services, Optometrist Services, Laser Vision correction


OTHER REIMBURSABLE HEALTH CARE EXPENSES

Special schools for handicapped persons - must have specific programs to deal with the handicap.  Special home modifications for handicapped; cannot increase value of Home.   Life fee to retirement home for medical care - contract must allocate an amount to medical fees and medical care must be rendered with the Plan Year.


TRANSPORTATION

 YOU MAY INCLUDE as medical expenses amounts paid for transportation primarily for and essential to medical care (2016 rate was 19 cents per mile; 2017 rate is 17 cents per mile).  YOU MAY NOT INCLUDE transportation expenses to and from work, even if your condition requires an unusual means of transportation; transportation expense if you choose to travel to another city, such as a resort area, for an operation or other medical care prescribed by your physician.


LODGING

YOU MAY INCLUDE in medical expenses the cost of meals and lodging at a hospital or similar institution if your main reason for being there is to receive medical care.  YOU MAY INCLUDE in medical expenses the cost of lodging (not provided in a hospital or similar institution) while away from home IF the lodging is primarily for and essential to medical care provided by a physician in a licensed hospital or equivalent and there is no significant element of personal pleasure.  The amount you include in meals and medical expenses may not exceed $50.00 a night for each individual.  Lodging expenses is eligible for a person; who must accompany the individual receiving medical care, for example, a parent traveling with a sick child.  Proof of medical care required.  Meals of a companion are not an eligible expense.       

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PARTIAL LISTING OF NON-ELIGIBLE EXPENSES

 

The following expenses are not eligible for reimbursement under a Health FSA:

  • Annual medical contract fees for exclusive provider care
  • Arch supports, (unless prescribed for a specific medical condition)
  • Bottled water
  • Clip-on sunglasses or regular non-prescription sunglasses 
  • Cosmetics, toiletries, battery toothbrush, etc.
  • Cosmetic procedures, surgeries or drugs (such as face lift, photo-facials, microdermabrasion)
  • Custodial Care in an institution
  • Dental bleaching or any other teeth whitening
  • Domestic help fees (for services of a non-medical nature)
  • Electric toothbrushes or replacement brushes
  • Electrolysis or hair removal
  • Funeral and burial expenses 
  • Hair transplant
  • Health club dues/membership fees, YMCA dues, steam bath, etc. for purposes of general health and well-being, even if prescribed by a physician
  • Hot tubs/pools/tanning equipment
  • Household and domestic help (even though recommended by a qualified physician because of an employee's or dependent's inability to perform physical housework
  • Humidifiers (unless prescribed by a physician to treat a specific medical condition)
  • Imported prescriptions from another country
  • Insurance premiums of any kind
  • Laetrile, even if prescribed by a doctor, is not reimbursable
  • Late fees or finance charges
  • Lens replacement insurance
  • Marijuana, even if prescribed for medicinal purposes, is not reimbursable
  • Marriage or family counseling
  • Massage therapy (unless prescribed by a physician to treat an injury or trauma, or for rehabilitative purposes)
  • Membership fees or costs associated with weight loss for purposes of general health and well-being even if prescribed by a physician
  • Naturopathic Supplements
  • Nursing for newborns; the salary expenses of a licensed practical nurse incurred in connection with the care of a normal and healthy newborn (even though such care may be required due to the death of the mother in childbirth)
  • Nursing Home Expenses
  • Operations: any expense incurred in connection with an illegal operation or treatment
  • Over the counter items/medical aids which are items not categorized as a medicine or drug and may include, but are not limited to, support pillows, nail clippers, pumice stones, feminine hygiene products, etc. are not reimbursable (unless used to treat a specific medical condition),toiletries or personal hygiene items, shampoo, toothpaste, conditioners, hand creams, deodorant, shaving cream, razors, dental floss, body powders, hair gels/sprays, make-up, nail polish accessories, soap, mouthwash, etc.) are not reimbursable (other than those approved, see list on our website)
  • Premiums: automobile insurance premiums, including the segment of premiums providing medical coverage for persons injured through accident by an employee's care - Any life insurance premiums paid for life insurance policies or for policies providing repayment for loss of earning or for accidental loss of life, limb, site, etc - any medical or dental insurance premiums 
  • Physical therapy treatments for general well-being
  • Service Agreements or Warranties
  • Seminars
  • Social Activities, such as dance lessons or classes even though recommended by a qualified physician for general health improvement
  • Special schools:  any expense incurred for sending a program child to a special school for anticipated benefit the child may receive from the course of study and the disciplinary method used
  • Supplements - The cost of supplements taken for general well-being are not reimbursable. However, the cost of supplements taken to alleviate a specific medical condition is reimbursable. A physician should substantiate the diagnosis of a specific medical condition and acknowledge that the supplement being used alleviates the medical condition diagnosed
  • Teeth Whitening
  • Transportation expense to and from work, even though a physical condition may require special means of transportation
  • Tuition for special schools (unless it is a special school to treat a specific condition such as blindness, speech, etc.)
  • Uniforms
  • Union dues
  • Vacations for travel taken for purposes of general health, a change in environment, improvement of morale, etc., or taken to relieve physical or mental discomfort not related to a particular disease or physical defect
  • Vitamins - Daily multi-vitamins taken for general well-being are not reimbursable. Vitamins taken to treat a specific medical condition are reimbursable. A diagnosis of the medical condition should accompany the vitamin claim. Prenatal vitamins obtained by prescription are reimbursable.
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    DEPENDENT CARE - IMPORTANT RESTRICTIONS


    If married, the total payments made in a taxable year, under this and any other Dependent Care Plan, cannot exceed the lesser of your earned income or your spouse's earned income, during that taxable year.  The expenses are necessary to enable you (and your spouse, if married) to work or actively searchfor employment.  Your Spouse, must work outside the home, be a full-time student or be disabled.  Your IRS Code 152 dependent as revised by WFTRA, including modificiations made by IRS code 105(b) and by IRS Notice 2004-79 must be under age 13, or your dependent is physical or mentally incapable of care for himself or herself (a disabled spouse or elderly parent, for example).  If services were provided outside the home, the dependent for who services were incurred spends at least eight (8) hours a day in your household and must have the same principle place of abode as the taxpayer for more than half of the year.  The person providing the service will not be claimed as a dependent on your income tax return for the Plan Year in which the service was provided.  Daycare expenses are reimbursable for the amount you current have deposited in your account.

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    CONSULT IRS PUBLICATIONS 502 AND 503 FOR ADDTIONAL GUIDANCE OR YOUR PERSONAL TAX ADVISOR
    PUBLICATION 502 AND 503 DO NOT DESCRIBE ALL FLEXIBLE SPENDING ACCOUNT RESTRICTIONS

    For more information contact the EBD Flexible Spending Account Department:
    (405) 232-1190 or (800) 219-8115

    (10/2016)