FSAFEDS Eligible Expenses: A 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 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
ACNE TREATMENT
(Coverage Code 117)		 HCFSA     X   Over-the-counter acne treatment products are eligible for reimbursement as long as the product’s primary purpose is for the treatment of acne. Cosmetics or other items that merely contain acne-fighting ingredients are not eligible. Eligible examples include:
  • Acne Free
  • Acnomel
  • Ambi Even & Clear
  • Bye Bye Blemish
  • Clean & Clear
  • Clearasil
  • Murad Acne Complex Kit
  • Nature's Cure Acne Treatment
  • Neutrogena Acne Treatment
  • OXY
  • Proactiv Solution
  • Stri-Dex
  • ZAPZYT Acne Treatment
  • Zeno Acne Clearing Device
Note: Generic and store brand equivalents of name brand acne treatments are also eligible. See the OTC Quick Reference Guide for information on submitting OTC expenses.

Laser therapy performed by a medical provider to treat acne is potentially eligible.
ACUPRESSURE
(Coverage Code 104)		 HCFSA   X      
ACUPUNCTURE
(Coverage Code 104)		 HCFSA X        
ADAPTIVE EQUIPMENT
(Coverage Code 104)		 HCFSA   X     Adaptive equipment for a major disability, such as a spinal cord injury, can be reimbursed.

Adaptive equipment to assist you with activities of daily living (ADL) for persons with arthritis, lupus, fibromyalgia, etc., can be reimbursed.

See CAPITAL EXPENSES
ADOPTION FEES HCFSA       X Medical expenses incurred by your adopted child who is claimed as a dependent are eligible. Care must be for the adopted child and incurred while the child qualifies as your dependent. Your child's medical care expenses are eligible only during the adoption process as long as the child qualifies as your dependent.
AIR CONDITIONERS/AIR PURIFIERS
(Coverage Code 102)		 HCFSA   X     See ALLERGY PRODUCTS
AIRWAY CLEARANCE VEST
(Coverage Code 102)		 HCFSA X        
ALCOHOLISM/DRUG/SUBSTANCE ABUSE TREATMENT
(Coverage Code 104) 		HCFSA X       Eligible expenses include:
  • Inpatient treatment, including meals and lodging provided by a licensed addiction center.
  • Outpatient care
  • Transportation expenses associated with attending outpatient meetings, including AA groups.
ALLERGY MEDICINES
(Coverage Code 117)		 HCFSA     X   Over-the-counter allergy treatments are eligible for reimbursement. Examples include:
  • Actifed
  • Benadryl
  • Chlor-Trimeton
  • Claritin
  • Sudafed
  • Zyrtec
For more information on submitting OTC expenses see the OTC Quick Reference Guide.
ALLERGY PRODUCTS AND MITIGATION
(Coverage Code 102)		 HCFSA   X     Eligible expenses include products and home improvements to treat severe allergies. Examples include:
  • Cost to remove carpet (but NOT the cost to replace flooring)
  • Electro-static air purifier
  • HEPA furnace filters and HEPA vacuum cleaner filters (only the difference in cost of the HEPA product minus the standard product can be reimbursed.)
  • Humidifier
  • Home/automobile air conditioners
  • Special vacuum cleaners for persons with respiratory problems (only the difference in cost of the special vacuum cleaner minus a standard vacuum can be reimbursed)
  • Special pillow cases, mattress covers, or other bedding barriers that provide protection against allergens to alleviate an allergic condition

Note: See CAPITAL EXPENSES for important information and guidance.
ALTERNATIVE MEDICAL SERVICES
(Coverage Code 104)		 HCFSA   X     Services must be prescribed and rendered by a licensed health care provider to treat a specific illness or disorder.
AMBULANCE
(Coverage Code 104)		 HCFSA X        
ANALGESICS
(Coverage Code 117)		 HCFSA     X   Examples include:
  • Advil
  • Aleve
  • Aspirin
  • Ibuprofen
  • Midol
  • Naprosyn
  • Pamprin
  • Tylenol

Topical examples include:

  • Aspercreme
  • BenGay
  • Icy Hot
  • Zostrix

For more information on submitting OTC expenses, see the OTC Quick Reference Guide.
ANTACIDS/ACID REDUCERS
(Coverage Code 117)		 HCFSA     X   Examples include:
  • AXID AR
  • Gas-X
  • Maalox
  • Mylanta
  • Pepcid AC
  • Prilosec OTC
  • Tagament HB
  • Tums
  • Zantac 75
For more information on submitting OTC expenses, see the OTC Quick Reference Guide.
ANTI-ARTHRITICS
(Coverage Code 102)		 HCFSA X       Examples include:
  • Glucosamine
  • Chondroitin
For more information on submitting OTC expenses, see the OTC Quick Reference Guide.
ANTIBIOTICS, topical
(Coverage Code 117)		 HCFSA     X   Examples include:
  • Bacitracin
  • Neosporin
  • Triple Antibiotic Ointment
For more information on submitting OTC expenses, see the OTC Quick Reference Guide.
ANTICANDIDAL, yeast infection
(Coverage Code 117)		 HCFSA     X   Examples include:
  • Femstat 3
  • Gyne-Lotrimin
  • Monistat
  • Mycelex-7
  • Vagistat-1
For more information on submitting OTC expenses, see the OTC Quick Reference Guide.
ANTI-DIARRHEAL
(Coverage Code 117)		 HCFSA     X   Examples include:
  • Immodium AD
  • Kaopectate
  • Pepto-Bismol
For more information on submitting OTC expenses, see the OTC Quick Reference Guide.
ANTIFUNGAL
(Coverage Code 117)		 HCFSA     X   Examples include:
  • Lamisil AT
  • Lotramin AF
  • Micatin
For more information on submitting OTC expenses, see the OTC Quick Reference Guide.
ANTIHISTAMINES
(Coverage Code 117)		 HCFSA     X   See ALLERGY MEDICINES
ANTI-ITCH PRODUCTS, lotions or creams
(Coverage Code 117)		 HCFSA     X   Examples include:
  • Bactine
  • Benadryl
  • Caldecort
  • Caladryl
  • Calamine
  • Cortaid
  • Hydrocortisone
  • Lanacort
Please note: This does not include healing ointments/lotions for extremely dry skin, such as Aquaphor, Eucerin or Cerave.

For more information on submitting OTC expenses, see the OTC Quick Reference Guide.
ASTHMA MEDICINES
(Coverage Code 117)		 HCFSA     X   Examples include:
  • Bronitin Mist
  • Bronkaid
  • Bronkolixer
  • Primatene
For more information on submitting OTC expenses, see the OTC Quick Reference Guide.
AU PAIRS DCFSA X       If the expense, such as a placement fee is necessary in order to obtain care it may be reimbursable. However you must only apply the expense proportionately over the duration of the agreement to employ the au pair.

For example, for an annual agreement with an au pair who is paid weekly, 1/52nd of the placement fee would be reimbursable each week. The weekly fee as well as other work-related expenses may qualify as a dependent care expense, depending on your tax situation.
AUTOMOBILE MODIFICATIONS
(Coverage Code 104)		 HCFSA   X     See ADAPTIVE EQUIPMENT


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