Eligible Expenses Juke Box

FSAFEDS Eligible Expenses: L

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
LAB FEES (Coverage Code 104)	HCFSA	X
LACTATION CONSULTANT (Coverage Code 104)	HCFSA		X			Services rendered by a licensed health care provider can be reimbursed.
LACTOSE INTOLERANCE SUPPLEMENTS (Coverage Code 102)	HCFSA	X				Examples include: DairyCare Digestive Advantage Lactaid Please note: Lactose-free milk and/or food products are not eligible for reimbursement. For information on submitting OTC expenses, see the OTC Quick Reference Guide.
LAMAZE CLASSES (Coverage Code 104)	HCFSA	X				See CHILDBIRTH CLASSES
LASER EYE SURGERY (Coverage Code 303)	HCFSA LEX HCFSA	X				See VISION CARE
LASER HAIR REMOVAL	HCFSA				X
LASER THERAPY (Coverage Code 104)	HCFSA		X			Laser therapy may be potentially eligible when used to treat the following medical conditions: Acne Jaundice Mood Disorders Pain Management Psoriasis Sinus-related disorders Sleep Disorders Wound Healing PLEASE NOTE: This is not a comprehensive list of medical conditions which may be treated with laser therapy.
LATE PAYMENT FEES	DCFSA				X
LATE PICK-UP FEES	DCFSA	X
LATEX GLOVES (Coverage Code 102)	HCFSA		X
LATISSE (Coverage Code 103)	HCFSA		X
LAXATIVES (Coverage Code 117)	HCFSA			X		Examples include: Dulcolax Ex-lax Kaopectate Miralax For information on submitting OTC expenses, see the OTC Quick Reference Guide
LEARNING DISABILITIES (Coverage Code 104)	HCFSA		X			The portion of tuition/tutoring fees covering services rendered specifically for your child's severe learning disabilities caused by mental or physical impairments (such as nervous system disorders, or closed head injuries) and paid to a special school or to a specially-trained teacher may be reimbursed under a HCFSA if prescribed by a physician. Examples of eligible expenses include: Remedial reading for your child or dependent with dyslexia Testing to diagnose
LEGAL FEES (Coverage Code 999)	HCFSA		X			Legal fees paid to authorize treatment for mental illness are eligible expenses.
LEVITRA (Coverage Code 103)	HCFSA	X
LICE TREATMENT (Coverage Code 117)	HCFSA			X		Examples include: Nix Rid For information on submitting OTC expenses, see the OTC Quick Reference Guide
LIFELINE/MEDICAL ALERT SERVICES	HCFSA				X
LIFETIME CARE	HCFSA				X	Fees or advance payments made to a retirement home or continuing care facility are not eligible expenses.
LODGING (Coverage Code 104)	HCFSA		X			Up to $50 per night/per person is eligible if the following conditions are met: The lodging is primarily for, and essential to, medical care The medical care is provided by a doctor in a licensed hospital or medical care facility related to/equivalent to a licensed hospital The lodging is not lavish or extravagant There is no significant element of personal pleasure or leisure in the travel. Expenses for food and beverages are not eligible.
LODGING, for companion (Coverage Code 104)	HCFSA		X			Your companion’s lodging can be reimbursed if he or she is accompanying the patient (you or your eligible dependents) for medical reasons and it meets the criteria listed above. Meals are not eligible for reimbursement. Example: Parents traveling with a sick child, up to $100 per night ($50 per person) may be reimbursed.
LODGING, special (Coverage Code 104)	HCFSA		X			The cost of a special home or step-down facility for your mentally handicapped dependent, recommended by a psychiatrist to help your dependent adjust after inpatient mental health care to community living, can be reimbursed.
LONG-TERM CARE INSURANCE PREMIUMS	HCFSA				X	Under IRS rules, insurance premiums cannot be reimbursed under a HCFSA.
LONG-TERM CARE SERVICES	HCFSA				X	Refer to Section 106(c) of the IRS Code for more information.

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