FSAFEDS Eligible Expenses: D 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 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
DAY CARE DCFSA X    

This includes non-medical day care as well as in-home babysitters for children under age 13, and/or for any individual who is incapable of self-care and can be claimed on your Federal Tax return. You (and your spouse if married) must be working, looking for work (income must be earned during the year), or attending school full-time.

Activities (such as swimming lessons or arts and crafts) are not eligible expenses.

Payment for day care services that have not been incurred - are not eligible for reimbursement. Only expenses for day care that have been incurred are eligible for reimbursement.
DANCING LESSONS HCFSA   X   Only for a short duration and if prescribed for a specific medical condition, such as part of a rehabilitation program after surgery.
DEDUCTIBLES HCFSA X     Cannot be reimbursed by secondary insurance or any other source.
DENTAL MAINTENANCE ORGANIZATION (DMO) HCFSA
LEX HCFSA		     X See INSURANCE PREMIUMS
DENTAL CARE HCFSA
LEX HCFSA		 X     Covered services include, but are not limited to:
  • Bridges
  • Cleanings
  • Crowns
  • Dental implants
  • Dentures
  • Endodontic care (root canal)
  • Extractions
  • Fillings
  • Orthodontia
  • Periodontal services
  • Routine prophylaxis
  • Sealants
  • X-rays
DENTAL CARE (cont.) HCFSA
LEX HCFSA		     X Expenses for cosmetic dentistry, such as teeth whitening or bleaching, porcelain veneers, or bonding are not eligible for reimbursement.
DIABETIC SUPPLIES HCFSA X     See the OTC Quick Reference Guide.
DIAPER RASH CREAMS HCFSA X     Examples include:
  • Balmex
  • Desitin
See the OTC Quick Reference Guide for more information.
DIAPERS, DIAPER SERVICE HCFSA     X Not for routine care of a healthy newborn.
DIAPERS, DIAPER SERVICE (cont.) HCFSA   X   To relieve or ameliorate the effect of a particular illness or disease on you, your disabled child or dependent, who would not need this product “but for” the medical condition.
DIETARY SUPPLEMENTS HCFSA   X   Examples include:
  • Ensure
  • Glucerna
  • Power drinks
  • Protein bars
For more information, see the OTC Quick Reference Guide.
DOCTOR FEES HCFSA X     In addition to all expenses for care not reimbursed by any other source, eligible expenses include fees for:
  • Out-of-network providers
  • Charges by your physician for letters of medical necessity to schools, etc.
  • Physician tele-advice, including email communication
DOULAS HCFSA   X   If the doula is a licensed health care professional who renders medical care, his or her fees can be reimbursed.
DRUGS HCFSA       See CONTROLLED SUBSTANCES, PRESCRIPTION DRUGS and OTC
DRUG ADDICTION, treatment of HCFSA X     Eligible expenses include:
  • Inpatient treatment, including meals and lodging provided by a licensed addiction center.
  • Outpatient care
  • Transportation expenses associated with attending outpatient meetings, including AA groups, if attending on a doctor’s advice.


Eligible expenses listed here are subject to change without notice.