Eligible Expenses Juke Box

FSAFEDS Eligible Expenses: M

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 health care 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, dependent or adult child through age 26 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. You must submit a new LMN each year if the medical condition persists - they cannot be approved indefinitely.

As of January 1, 2011 eligible over-the-counter (OTC) products that are medicines or drugs (e.g., acne treatments, allergy and cold medicines, antacids, etc.) will only be eligible for reimbursement from your Health Care FSA with a physician's prescription that includes his or her address and license number, as stated in IRS Notice 2010-59. The only exception is insulin - which will not require a prescription. OTC products or items that are not considered medicines or drugs, such as bandages and nasal strips, will continue to be eligible without a prescription. For information on submitting OTC expenses, see the OTC Quick Reference Guide.

Condition/Type of Service/Expense	Account Type	Eligible Expense	Potentially Eligible Expense*	OTC Prescription Required	Not Eligible	Additional Information
MASSAGE THERAPY	HCFSA				X	To reduce stress or improve general health.
MASSAGE THERAPY (cont.) (Coverage Code 104)	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/NECKLACE/USB DATA CARD (Coverage Code 104)	HCFSA	X				Watches with medical alert identifications are not eligible.
MEDICAL INFORMATION (Coverage Code 104)	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 (Coverage Code 104)	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 (Coverage Code 104)	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 (Coverage Code 104)	HCFSA	X
MEDICATED LIP PRODUCTS (Coverage Code 117)	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 For information on submitting OTC expenses, see the OTC Quick Reference Guide. Non-medicated lip products with moisturizers are not eligible.
MENSTRUAL RELIEF (Coverage Code 117)	HCFSA			X		Examples include: Midol Pamprin Premysyn PMS For information on submitting OTC expenses, see the OTC Quick Reference Guide.
MID-WIFE (Coverage Code 104)	HCFSA	X
MIGRAINE RELIEF (Coverage Code 117)	HCFSA			X		Examples include: Advil Migraine Excedrin Motrin Migraine For information on submitting OTC expenses, see the OTC Quick Reference Guide.
MILEAGE (Coverage Code 120)	HCFSA	X				Beginning January 1, 2012 the mileage rate will be 23 cents per mile. You will need to round your amount to the nearest value. For instance, for a 7 mile trip at 23.5 cents per mile, the amount will calculate to $1.645. Using standard rounding logic, this would be reimbursed at $1.65. If the amount was $1.644, it would be $1.64. Be sure to provide a statement indicating the reason for travel, the date(s) of service and number of miles traveled for reimbursement. See the Mileage Worksheet for a convenient list to submit along with your claim form. If you are submitting only a mileage claim, you must provide documentation indicating the provider’s name and address, the date(s) of service, reason for travel, and number of miles traveled for reimbursement. You may also use an online map tool as your statement as long as it also includes the number of miles traveled, date(s) of service and the provider’s name and address. If you are submitting a mileage claim along with a medical claim, no worksheet is needed, however you must include the number of miles traveled. If you are requesting reimbursement for parking as well as mileage, you must include a parking receipt which indicates date(s) of service and cost.
MINERALS (Coverage Code 102)	HCFSA		X			Examples include: Calcium Caltrate Feosol Ferrous Sulfate Folic Acid For information on submitting OTC expenses, see the OTC Quick Reference Guide.
MISSED APPOINTMENT FEES	HCFSA				X
MOTION SICKNESS MEDICINES (Coverage Code 117)	HCFSA			X		Examples include: Bonine Dramamine Marizine For information on submitting OTC expenses, see the OTC Quick Reference Guide.
MOTION SICKNESS WRISTBANDS (Coverage Code 102)	HCFSA	X

PLEASE NOTE: Eligible expenses listed here are subject to change without notice.