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 |
FEMININE HYGIENE PRODUCTS |
HCFSA |
|
X |
|
Feminine hygiene products used post-surgery or after childbirth may be reimbursed. See the OTC Quick Reference Guide. |
FERTILITY ENHANCEMENT |
HCFSA |
X |
|
|
Includes ovulation predictor kits and pregnancy tests. |
FIBER SUPPLEMENTS |
HCFSA |
|
X |
|
Examples include:
For more information, see the OTC Quick Reference Guide. |
FINANCE CHARGES |
HCFSA LEX HCFSA |
|
|
X |
|
FINANCE CHARGES (cont.) |
DCFSA |
|
|
X |
|
FIRST AID KIT/SUPPLIES |
HCFSA |
X |
|
|
Examples include: - Antiseptics
- Bandages
- Cold/Hot Packs
- Joint Supports
- Liquid bandages
- Peroxide
- Rubbing Alcohol
- Splints
See the OTC Quick Reference Guide. |
FITNESS PROGRAMS |
HCFSA |
|
X |
|
Fees paid for a fitness program may be an eligible expense if prescribed by a physician and substantiated by his or her statement that treatment is necessary to alleviate a medical problem. You cannot be reimbursed for expenses that will be incurred in the future, even if the provider requires payment in advance for the entire period. You can provide a receipt for the entire period and several receipts incrementally that detail the dates of service, provider name and cost after the date of service that corresponds to each time increment. |
FLUORIDE RINSE/PILLS |
HCFSA |
X |
|
|
Examples include:
For more information, see the OTC QRG. |
FLU SHOTS |
HCFSA |
X |
|
|
|
FOOD |
HCFSA |
|
X |
|
Food may be eligible if prescribed by a medical practitioner to treat a specific illness or ailment and if the food does not substitute for normal nutritional requirements. However, the amount that may qualify for reimbursement is limited to the amount by which the cost of the food exceeds the cost of commonly available versions of the same product.
|
FOOT CARE |
HCFSA |
X |
|
|
Examples include: - Arch and insole supports
- Antifungal products
- Bunion, blister and corn treatments
- Callous removers
For more information, see the OTC Quick Reference Guide. |
FUNERAL EXPENSES |
HCFSA |
|
|
X |
|
Eligible expenses listed here are subject to change without notice.
|