FSAFEDS Eligible Expenses: P 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
PAIN RELIEVERS HCFSA X     Examples include:
  • Advil
  • Aleve
  • Aspirin
  • Ibuprofen
  • Midol
  • Naprosyn
  • Pamprin
  • Tylenol
For more information, see the OTC Quick Reference Guide.
PARENTAL FEES HCFSA     X Fees or premiums paid to participate in a state-funded assistance program for the medical care of disabled dependents are not eligible for reimbursement from your HCFSA.
PARKING FEES AND TOLLS HCFSA X     See TRANSPORTATION
PATTERNING EXERCISES HCFSA   X   While these exercises are often done by family members, the expense to hire someone to perform patterning exercises is an eligible expense.
PEDICULICIDE HCFSA X     Examples include:
  • Nix
  • Rid
Please refer to OTC Quick Reference Guide
PENILE IMPLANTS HCFSA   X   Amounts paid for implants may be eligible if the diagnosis of impotence is due to organic causes, such as diabetes, post-prostatectomy complications, or spinal cord injury.
PERSONAL ITEMS HCFSA     X Items that are used for personal grooming and not to treat a specific medical condition are not eligible for reimbursement.
PHYSICAL THERAPY HCFSA X      
PHYSICIAN FEES, Pre-paid HCFSA     X Pre-paid physician fees that cover the cost of services such as exams, physicals, screenings, check-ups and immunizations, are not eligible for reimbursement. A common example is an annual pre-paid fee to access the services of an on-staff physician.
PILLOWS, lumbar support HCFSA   X   Pillows or cushions that provide lumbar support may be eligible for reimbursement if prescribed by a licensed health care provider to alleviate a specific medical condition.
PLACEMENT SERVICES DCFSA X     The up-front fee may qualify if it is an expense that must be paid in order to obtain care. However, the fee can only be reimbursed proportionately over the duration of the agreement to employ the dependent care provider, such as an au pair. The weekly stipend, as well as other work-related expenses, may also qualify as an expense for the care of a qualifying individual.
POST-MASTECTOMY CLOTHING HCFSA X     Prosthetic bras and related clothing purchased after any surgical procedure related to breast cancer (lumpectomy, mastectomy, etc.) are eligible for expenses. Prosthetic bras and inserts are reimbursable at 100%. Tank tops or swimwear with built-in prosthetic bras are reimbursed up to 50% of the total cost not to exceed $75.
PREGNANCY AIDS HCFSA X     Items that relieve or reduce the discomfort of pregnancy may be reimbursed under a HCFSA. Examples include:
  • Maternity girdles
  • Elastic hosiery
  • Maternity support belts
PREGNANCY TESTS HCFSA X     See OTC QRG for more information.
PRESCRIPTION DRUG DISCOUNT PROGRAM HCFSA     X Fees paid to get access to drugs at a reduced cost are not eligible for reimbursement under a HCFSA. Actual costs paid for prescription drugs are an eligible expense.
PRESCRIPTION DRUGS HCFSA X     Eligible expenses include deductibles, co-payments or co-insurance as well as the costs for prescription drugs that may not be covered under FEHB, such as drugs that treat erectile dysfunction. Your claim form should include the name of the drug, the provider's name and the date of service.
PRESCRIPTION DRUGS - IMPORTED HCFSA   X   With rare exception, a prescription drug purchased outside of the United States is not eligible for reimbursement from an FSA. However, if the FDA has approved importing a prescription drug into the U.S. under the “Compassionate Use Act”, it may be an eligible expense. This includes drugs recommended for treatment of a serious condition for which effective treatment may not be available in the U.S., or to continue treatment of a serious condition that was begun in a foreign country. Please see the prescription drug FAQ on the Summary of Benefits for more information.
PREVENTIVE CARE SCREENINGS HCFSA X     If the tests are designed to assess symptoms of a medical diagnosis, they are eligible for reimbursement. Examples include clinic and home testing kits for blood pressure, glaucoma, cataracts, hearing, cholesterol, etc.
PROSTHETICS HCFSA X      
PSYCHIATRIC SERVICES AND CARE HCFSA X      
PSYCHOANALYSIS HCFSA X      
PSYCHOLOGIST HCFSA X      

Eligible expenses listed here are subject to change without notice.