Eligible Expenses Juke Box

FSAFEDS Eligible Expenses: I

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
IMMUNIZATIONS	HCFSA	X			Includes those recommended for overseas travel
INCONTINENCE PRODUCTS	HCFSA		X		Incontinence products used for a diagnosed medical condition may be reimbursed. Examples include: Attends Poise See the OTC Quick Reference Guide.
INSURANCE PREMIUMS	HCFSA			X	Under IRS rules, insurance premiums cannot be reimbursed under a health care FSA.
IN VITRO FERTILIZATION	HCFSA	X			See ARTIFICIAL REPRODUCTIVE TECHNOLOGIES

Eligible expenses listed here are subject to change without notice.