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 |
CALCIUM SUPPLEMENTS |
HCFSA |
|
X |
|
Examples include:
- Calcium Carbonate
- Calcium Citrate
- Calcium Gluconate
- Calcium Lactate
- Caltrate
- Citrical
- Tricalcium Phosphate
For more information, see the OTC Quick Reference Guide.
|
CAMPS, summer or holiday (Day) |
DCFSA |
X |
|
|
This includes children under age 13, or any individual who is incapable of self-care and
can be claimed on your Federal Tax return.
Payment in advance is not covered. You can only be reimbursed for expenses that have been incurred.
|
CAMPS, summer or holiday (Overnight) |
DCFSA |
|
|
X |
Overnight camps are not eligible expenses. Camps that include both day and overnight stays are not eligible even if the provider can separate the day and night expenses. Day care provided during evening/night hours
is an eligible expense if you and your spouse work, look for work or attend school full-time during the evenings and nights, such that you need care for your eligible children. However, your children must return
to your home during the day (the evening/night day care cannot be 24 hours). If there is any question about whether your camp and/or day care receipts are for eligible expenses, you may be contacted for clarification.
|
CAPITAL EXPENSE |
HCFSA |
|
X |
|
A capital expense (permanent or portable) can be reimbursed if its purpose is to provide medical care for you, your spouse or dependent.
Expenses for improvements or special equipment added to your home can be reimbursed if the main purpose of the item is medical care. How much is reimbursed depends on the extent to which the expense permanently improves the property and whether others benefit.
The amount paid for the improvement is reduced by the increase in the value of your home or property. The difference between the cost of the improvement minus the increased value equals the eligible expense.
If the value of your home or property is not increased by the improvement, the entire cost is an eligible expense. Use the Capital Expense Worksheet to determine if your expense is eligible.
Examples of these expenses are: - Constructing entrance or exit ramps
- Widening or otherwise modifying doorways, hallways and stairways
- Installing railings, support bars, or other modifications to bathrooms
- Kitchen modifications, including lowering cabinets and other equipment
- Electrical and plumbing modifications
- Exterior grading of the property to provide access to your home
- Removal of carpeting, wall and/or window coverings (this does not include the cost of replacement of these items)
IRS regulations require that the cost comparison between a standard item and an item prescribed by a health care provider be submitted from an independent third party. For instance, you may provide a store circular showing the cost of a comparable standard item when submitting a claim for the reimbursement of the difference on the prescribed item.
This list is not exhaustive. If expenses are similar to those listed above, and are incurred to adapt a personal residence to yours or your spouse’s or dependent’s condition, the expenses are eligible subject to the terms noted above. Expenses must be reasonable, and directly related to the medical condition. Costs that are incurred for architectural or aesthetic reasons are not eligible.
Please refer to IRS Publication 502 for additional information, including operation and upkeep. |
CHAIRS, ergonomic |
HCFSA |
|
|
X |
Ergonomic chairs are not eligible. |
CHAIRS, reclining |
HCFSA |
|
X |
|
Reclining chairs that both elevate the
legs and tilt the torso may be considered for reimbursement.
The chair must be specifically prescribed by a physician to alleviate a specific
medical condition and you must submit a fully completed Letter of Medical
Necessity that clearly documents how the chair
will alleviate the condition or diagnosis for the expense to be considered.
Reimbursement will be limited to a maximum amount of $650 for one chair
purchased every 10 years per participant and/or his or her dependents. No other
types of chairs are eligible. |
CHILDBIRTH CLASSES |
HCFSA |
X |
|
|
Does not include:
- Breastfeeding Classes
- Newborn or New Infant Care Classes
- Parenting Classes
|
CHIROPRACTIC |
HCFSA |
X |
|
|
|
CHRISTIAN SCIENCE PRACTITIONERS |
HCFSA |
X |
|
|
Payments for medical care can be reimbursed. |
CIALIS |
HCFSA |
X |
|
|
|
CIRCUMCISION |
HCFSA |
X |
|
|
A bris performed in the home by a Rabbi is not an eligible expense. |
COBRA PREMIUMS |
HCFSA |
|
|
X |
Under IRS rules, insurance premiums cannot be reimbursed under a Health Care FSA. |
CO-INSURANCE |
HCFSA |
X |
|
|
Cannot be reimbursed by secondary insurance or any other source. |
COLD MEDICINES |
HCFSA |
X |
|
|
Examples include:
- Actifed
- Advil Cold and Sinus
- Alka Seltzer Cold and Flu
- Children's Advil Cold
- Dayquil
- Drixoral
- Neo-Synephrine 12-Hour
- Nyquil
- Pediacare
- Sudafed
- Tavist-D
- Theraflu
- Triaminic
- Tylenol Cold and Flu
- Cough Drops
- Nasal Sprays
- Throat Lozenges
See the OTC QRG for more information. |
COLD SORE MEDICINES |
HCFSA |
X |
|
|
Examples include:
For more information, see the OTC Quick Reference Guide. |
COMPANION ANIMALS |
HCFSA |
X |
|
|
See SERVICE ANIMALS |
CONTACT LENSES |
HCFSA LEX HCFSA |
X |
|
|
Contact lenses, cleaning and soaking solutions and lens storage cases are all eligible for reimbursement. |
CONTROLLED SUBSTANCES |
HCFSA |
|
|
X |
|
CO-PAYMENTS |
HCFSA |
X |
|
|
Cannot be reimbursed by secondary insurance or any other source. |
CORD BLOOD STORAGE |
HCFSA |
|
X |
|
Can be reimbursed if there is a specific medical condition that the cord blood is intended to treat. Indefinite storage “just in case” is not an eligible expense. |
CORNEAL RING SEGMENTS |
HCFSA |
X |
|
|
|
COSMETIC PROCEDURES |
HCFSA LEX HCFSA |
|
|
X |
Cosmetic procedures to improve or enhance appearance are not eligible. |
COSMETIC PROCEDURES (cont.) |
HCFSA LEX HCFSA |
|
X |
|
A cosmetic procedure or service necessary to improve a deformity arising from a congenital abnormality, personal injury from accident or trauma, or to restore appearance related to treatment for another medical diagnosis or condition can be reimbursed. |
COUGH MEDICINES |
HCFSA |
X |
|
|
Examples include: - Chloraseptic
- Cough drops
- Mucinex
- Robitussin
- Throat lozenges
- Vicks 44
For more information, see the OTC Quick Reference Guide. |
COUNSELING |
HCFSA |
X |
|
|
If counseling is provided to treat a medical or mental diagnosis and is rendered by a licensed provider.
Eligible expenses include psychotherapy, bereavement and grief counseling, sex counseling, etc. |
COUNSELING (cont.) |
HCFSA |
|
|
X |
Life coaching, career counseling and marriage counseling do not qualify. |
CROWNS |
HCFSA LEX HCFSA |
X |
|
|
See DENTAL CARE |
CRUTCHES |
HCFSA |
X |
|
|
|
Eligible expenses listed here are subject to change without notice.
|