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 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 from which you, your spouse or dependent 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.
Condition/Type of Service/Expense |
Account Type |
Eligible Expense |
Potentially Eligible Expense* |
Not Eligible |
Additional Information |
WALKERS |
HCFSA |
X |
|
|
|
WART REMOVAL |
HCFSA |
X |
|
|
Examples include: - Compound W
- Dr. Scholl's Clear Away
- Wart-Off
Please refer to OTC Quick Reference Guide. |
WATER FLUORIDATION |
HCFSA |
|
X |
|
|
WEIGHT LOSS DRUGS |
HCFSA |
|
X |
|
Drugs prescribed by a health care provider for weight loss are eligible. However, OTC drugs, such as Alli, are only potentially eligible. See the OTC Quick Reference Guide. |
WEIGHT LOSS PROGRAMS |
HCFSA |
|
X |
|
Food is not eligible, even if it is part of the weight loss program. See FOOD |
WELL-BABY/WELL-CHILD CARE |
HCFSA |
X |
|
|
|
WHIRLPOOL BATHS |
HCFSA |
|
X |
|
See CAPITAL EXPENSE |
WHEELCHAIRS |
HCFSA |
X |
|
|
|
WIG |
HCFSA |
|
X |
|
The full cost of a wig purchased because the patient has lost all of his or her hair from disease or treatment. |
Eligible expenses listed here are subject to change without notice.
|