FSAFEDS Eligible Expenses: O 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 for 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
OCCUPATIONAL THERAPY HCFSA X      
OPTOMETRIST HCFSA
LEX HCFSA		 X      
ORAL CARE HCFSA X     Examples include:
  • Anbesol
  • Orajel
Please refer to OTC Quick Reference Guide
ORTHODONTIA HCFSA
LEX HCFSA		 X     See Orthodontia Quick Reference Guide for more information.
ORTHOPEDIC SHOES HCFSA   X   Only shoes custom-fitted to the wearer’s feet are eligible. Only the cost difference between the custom-made shoe and a regular comparable shoe is reimbursable. Mass produced shoes are not eligible.
ORTHOTICS HCFSA X     Custom-made and over-the-counter inserts are eligible for reimbursement.
OSTEOPATH HCFSA X      
OVER-THE-COUNTER MEDICINES AND SUPPLIES HCFSA X     See OTC Quick Reference Guide for more details
OVER-THE-COUNTER MEDICINES AND SUPPLIES (cont.) LEX HCFSA X     Eligible dental or vision over-the-counter expenses, such as denture care products, and contact lens cleaning, soaking solutions and lens cases may be reimbursed.
OVULATION MONITOR HCFSA X      
OXYGEN HCFSA   X    

Eligible expenses listed here are subject to change without notice.