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 |
MASSAGE THERAPY |
HCFSA |
|
|
X |
To reduce stress or improve general health. |
MASSAGE THERAPY (cont.) |
HCFSA |
|
X |
|
If prescribed by a physician for a specific illness, injury, trauma or condition. |
MATERNITY AIDS |
HCFSA |
|
|
|
See PREGNANCY AIDS |
MATERNITY CLOTHES |
HCFSA |
|
|
X |
|
MEALS |
HCFSA |
|
|
X |
|
MEDICAL ALERT BRACELET |
HCFSA |
X |
|
|
|
MEDICAL INFORMATION |
HCFSA |
X |
|
|
Amounts paid to a plan that maintains electronic medical information for you, your spouse or dependents are eligible for reimbursement under an HCFSA. |
MEDICAL RECORDS |
HCFSA |
X |
|
|
Costs associated with copying or transferring medical records to a new provider are eligible for reimbursement. |
MEDICAL SAVINGS ACCOUNTS |
HCFSA |
|
|
X |
|
MEDICAL SERVICES |
HCFSA |
X |
|
|
Expenses for medical services prescribed by physicians or other health care providers acting within their scope of licensure can be reimbursed under a HCFSA. |
MEDICAL SUPPLIES |
HCFSA |
X |
|
|
Please refer to OTC Quick Reference Guide |
MEDICATED LIP PRODUCTS |
HCFSA |
X |
|
|
Medicated lip products that are used to treat severely dry, chapped lips or cold sores are eligible for
reimbursement from your HCFSA. Examples include: - Blistex Medicated Lip Ointment
- Carmex Medicated Lip Balm
- Neosporin Lip Treatment
Please refer to OTC Quick Reference Guide. Non-medicated lip products with moisturizers are not eligible. |
MENSTRUAL RELIEF |
HCFSA |
X |
|
|
Examples include:
Please refer to OTC Quick Reference Guide |
MIGRAINE RELIEF |
HCFSA |
X |
|
|
Examples include: - Advil Migraine
- Excedrin
- Motrin Migraine
Please refer to OTC Quick Reference Guide |
MILEAGE |
HCFSA |
X |
|
|
The mileage rate from January 1 - June 30, 2008 is 19 cents per mile, and from July 1 - December 31, 2008 the mileage rate is 27 cents per mile for medical care received during the 2008 calendar year.
Beginning January 1, 2009 the mileage rate will be 24 cents per mile. Be sure to include the date(s) of service and number of miles traveled for reimbursement. |
MINERALS |
HCFSA |
|
X |
|
Examples include: - Calcium
- Caltrate
- Feosol
- Ferrous Sulfate
- Folic Acid
Please refer to OTC Quick Reference Guide |
MISSED APPOINTMENT FEES |
HCFSA |
|
|
X |
|
MOTION SICKNESS MEDICINES |
HCFSA |
X |
|
|
Examples include:
Please refer to OTC Quick Reference Guide |
Eligible expenses listed here are subject to change without notice.
|