FSAFEDS Eligible Expenses: C PRINT THIS PAGE | Close this Window

For the FSAFEDS HCFSA and LEX HCFSA, services listed in this document as eligible (or that meet the "potentially eligible" requirements) are eligible for reimbursement, if the services are:

  • rendered by a health care professional appropriately licensed or certified in the state in which he or she practices; and
  • performed within the scope of the health care professional's license.

For the FSAFEDS DCFSA, services listed in this document as eligible (or that meet the "potentially eligible" requirements) are eligible for reimbursement, if the services are:

  • for an individual you claim as a dependent on your Federal Tax return who is under 13 or incapable of self-care; and
  • necessary to allow you and your spouse, if married, to work, look for work or attend school full-time.

*Please note, all "potentially eligible health care expenses" require a letter of medical necessity from your health care provider in order to be considered eligible for reimbursement. The letter must include the diagnosis or symptoms for which you, your spouse, dependent or adult child through age 26 are being treated, along with specific information on how the product or service is intended to alleviate symptoms or improve function. Submitting a LMN for your claim does not guarantee that the expense will be reimbursed. You must submit a new LMN each year if the medical condition persists - they cannot be approved indefinitely.

As of January 1, 2011 eligible over-the-counter (OTC) products that are medicines or drugs (e.g., acne treatments, allergy and cold medicines, antacids, etc.) will only be eligible for reimbursement from your Health Care FSA with a physician's prescription that includes his or her address and license number, as stated in IRS Notice 2010-59. The only exception is insulin - which will not require a prescription. OTC products or items that are not considered medicines or drugs, such as bandages and nasal strips, will continue to be eligible without a prescription. For information on submitting OTC expenses, see the OTC Quick Reference Guide.

Condition/Type of Service/Expense Account Type Eligible
Expense		 Potentially
Eligible
Expense*		 OTC
Prescription
Required		 Not
Eligible		 Additional Information
CALCIUM SUPPLEMENTS
(Coverage Code 102)		 HCFSA   X     Examples include:
  • Calcium Carbonate
  • Calcium Citrate
  • Calcium Gluconate
  • Calcium Lactate
  • Caltrate
  • Citrical
  • Tricalcium Phosphate
  • Viactiv
For more information on submitting OTC expenses, see the OTC Quick Reference Guide.
CAMPS, summer or holiday (Day) DCFSA X      

This includes children under age 13, or any individual who is incapable of self-care and can be claimed on your Federal Tax return.

Payment in advance is not covered. You can only be reimbursed for expenses that have been incurred.
CAMPS, summer or holiday (Overnight) DCFSA       X

Overnight camps are not eligible expenses. Camps that include both day and overnight stays are not eligible even if the provider can separate the day and night expenses. Day care provided during evening/night hours is an eligible expense if you and your spouse work, look for work or attend school full-time during the evenings and nights, such that you need care for your eligible children. However, your children must return to your home during the day (the evening/night day care cannot be 24 hours). If there is any question about whether your camp and/or day care receipts are for eligible expenses, you may be contacted for clarification.
CAPITAL EXPENSE
(Coverage Code 104)		 HCFSA   X     A capital expense (permanent or portable) can be reimbursed if its purpose is to provide medical care for you, your spouse or dependent.

Expenses for improvements or special equipment added to your home can be reimbursed if the main purpose of the item is medical care. How much is reimbursed depends on the extent to which the expense permanently improves the property and whether others benefit.

The amount paid for the improvement is reduced by the increase in the value of your home or property. The difference between the cost of the improvement minus the increased value equals the eligible expense. In addition, the cost should be divided by the number of individuals living in the household to determine the amount that is reimbursable for the person with the medical condition.

If the value of your home or property is not increased by the improvement, the entire cost is an eligible expense. Use the Capital Expense Worksheet to determine if your expense is eligible.

Examples of these expenses are:

  • Constructing entrance or exit ramps
  • Widening or otherwise modifying doorways, hallways and stairways
  • Installing railings, support bars, or other modifications to bathrooms
  • Kitchen modifications, including lowering cabinets and other equipment
  • Electrical and plumbing modifications
  • Exterior grading of the property to provide access to your home
  • Lead-based paint removal

IRS regulations require that the cost comparison between a standard item and an item prescribed by a health care provider be submitted from an independent third party. For instance, you may provide a store circular showing the cost of a comparable standard item when submitting a claim for the reimbursement of the difference on the prescribed item.

This list is not exhaustive. If expenses are similar to those listed above, and are incurred to adapt a personal residence to yours or your spouse’s or dependent’s condition, the expenses are eligible subject to the terms noted above. Expenses must be reasonable, and directly related to the medical condition. Costs that are incurred for architectural or aesthetic reasons are not eligible.

Please refer to IRS Publication 502 for additional information, including operation and upkeep.

CARPET REMOVAL
(Coverage Code 104)		 HCFSA   X     See ALLERGY PRODUCTS AND MITIGATION.
CHAIRS, ergonomic HCFSA       X Ergonomic chairs are not eligible.
CHAIRS, reclining
(Coverage Code 104)		 HCFSA   X     Reclining chairs that both elevate the legs and tilt the torso may be considered for reimbursement. The chair must be specifically prescribed by a physician to alleviate a specific medical condition and you must submit a fully completed Letter of Medical Necessity that clearly documents how the chair will alleviate the condition or diagnosis for the expense to be considered. Reimbursement will be limited to a maximum amount of $650 for one chair purchased every 10 years per participant and/or his or her dependents. No other types of chairs are eligible, including massage chairs that have a reclining feature.
CHILDBIRTH CLASSES
(Coverage Code 104)		 HCFSA X       Childbirth classes such as Lamaze and Bradley are eligible for reimbursement.

Does not include:

  • Breastfeeding Classes
  • Newborn or New Infant Care Classes
  • Parenting Classes
CHIROPRACTIC
(Coverage Code 104)		 HCFSA X       Services performed by a chiropractor are eligible such as:
  • TENS Treatment
  • Ultrasounds
CHONDROITIN
(Coverage Code 102)		 HCFSA X        
CHRISTIAN SCIENCE PRACTITIONERS
(Coverage Code 104)		 HCFSA X       Payments for medical care can be reimbursed.
CIALIS
(Coverage Code 103)		 HCFSA X        
CIRCUMCISION
(Coverage Code 104)		 HCFSA X       A bris performed in the home by a Rabbi or non-licensed provider is not an eligible expense.
COBRA PREMIUMS HCFSA       X Under IRS rules, insurance premiums cannot be reimbursed under a Health Care FSA.
COCHLEAR IMPLANTS
(Coverage Code 104)		 HCFSA X        
CO-INSURANCE
(Coverage Code 104)		 HCFSA X       Cannot be reimbursed by secondary insurance or any other source.
COLD & FLU MEDICINES
(Coverage Code 117)		 HCFSA     X   Examples include:
  • Actifed
  • Advil Cold and Sinus
  • Alka Seltzer Cold and Flu
  • Children's Advil Cold
  • Dayquil
  • Drixoral
  • Neo-Synephrine 12-Hour
  • Nyquil
  • Pediacare
  • Robitussin
  • Sudafed
  • Tavist-D
  • Theraflu
  • Triaminic
  • Tylenol Cold and Flu
  • Cough Drops
  • Nasal Sprays
  • Throat Lozenges
Please note: this does not include herbal cold remedies, such zinc or vitamin C drops.

For more information on submitting OTC expenses, see the OTC QRG.

COLD SORE MEDICINES
(Coverage Code 117)		 HCFSA     X   Examples include:
  • Abreva
  • Herpecin
For more information on submitting OTC expenses, see the OTC Quick Reference Guide.
COMPRESSION HOSIERY/SOCKS, medically approved
(Coverage Code 104)		 HCFSA X       Examples include:
  • Jobst Surgical Support Hose/Socks
CONTACT LENSES
(Coverage Code 303)		 HCFSA
LEX HCFSA		 X        
CO-PAYMENTS
(Coverage Code 104)		 HCFSA X       Cannot be reimbursed by secondary insurance or any other source.
CORD BLOOD STORAGE
(Coverage Code 104)		 HCFSA   X     Can be reimbursed if there is a specific medical condition that the cord blood is intended to treat. Indefinite storage “just in case” is not an eligible expense. If you pre-pay for 12 months of storage, you may only be reimbursed when the expenses have been incurred. The amount can be pro-rated in order to file claims for reimbursement once the service is rendered.
COSMETIC DENTISTRY HCFSA       X Expenses for cosmetic dentistry, such as teeth whitening or bleaching, porcelain veneers, or bonding are not eligible for reimbursement unless the procedure is necessary to improve a deformity arising from a congenital abnormality, personal injury from accident or trauma, or to restore appearance related to treatment for another medical diagnosis or condition.
COSMETIC PROCEDURES HCFSA
LEX HCFSA		       X Cosmetic procedures to improve or enhance appearance are not eligible.
COSMETIC PROCEDURES (cont.)
(Coverage Code 104)		 HCFSA
LEX HCFSA		   X     A cosmetic procedure or service necessary to improve a deformity arising from a congenital abnormality, personal injury from accident or trauma, or to restore appearance related to treatment for another medical diagnosis or condition can be reimbursed.
COUGH MEDICINES
(Coverage Code 117)		 HCFSA     X   Examples include:
  • Chloraseptic
  • Cough drops
  • Mucinex
  • Robitussin
  • Throat lozenges
  • Vicks 44
For more information on submitting OTC expenses, see the OTC Quick Reference Guide.
COUNSELING
(Coverage Code 104)		 HCFSA X       If counseling is provided to treat a medical or mental diagnosis and is rendered by a licensed provider.

Eligible expenses include psychotherapy, bereavement and grief counseling, sex counseling, etc.
COUNSELING (cont.) HCFSA       X Life coaching, career counseling and marriage counseling do not qualify.
CPAP DEVICES
(Coverage Code 104)		 HCFSA X        
CROWNS
(Coverage Code 202)		 HCFSA
LEX HCFSA		 X       See DENTAL CARE
CRUTCHES
(Coverage Code 104)		 HCFSA X        


PLEASE NOTE: Eligible expenses listed here are subject to change without notice.