Examples of Eligible Expenses

Note that if you simultaneously participate in a medical Health Savings Account (HSA), you may use your Health Care Flexible Spending Account only for eligible dental and vision expenses.

To qualify for reimbursement, health care expenses not covered by your medical and dental plan must be considered expenses for medical care under Section 105(b) or 213(d)(1) of the Internal Revenue Code. Examples include:

• Deductibles and copayments under your medical and dental plan or other medical and dental plan covering your eligible dependents, such as:
  

  Hospital deductible and copayment
  Physician visit copayment
  Prescription drug copayment
  Durable medical equipment, including diabetic test strips and syringes
  Dental copayments for restorative care or orthodontia or dental implants

• Expenses not paid by your medical and dental plan or by any other medical or dental plan covering your eligible dependents, such as:
  

  Prescription eyeglasses, contact lenses, and laser eye surgery
  Hearing care, including hearing aids and tests not reimbursed by your medical plan
  Blood pressure monitor with doctor's order for treatment of a medical condition
  Services and prescription drugs for infertility treatment
  Uncovered health care services obtained outside of the provider network
  Mental health copayments and services over medical limits
  Smoking cessation drugs prescribed by a physician

• Transportation expenses primarily for and essential to medical care

  Car reimbursement rate of 19 cents per mile for claims from January 1, 2008 to June 30, 2008
  Car reimbursement rate of 27 cents per mile for claims July 1, 2008 to December 31, 2008.

• Weight-loss programs related to hypertension, diabetes, or other medical conditions
• Expenses in excess of medical or dental plan limits (e.g., orthodontic expenses greater than the limit set by your dental plan)
• Eye care supplies, such as contact lens cleaning or saline solutions
• Charges for certain other medical services that would qualify as tax deductible medical expenses under IRS rules (note that not all expense items listed in IRS Publication 502 are reimbursable expenses under a Health Care Flexible Spending Account)
• Certain over-the-counter items purchased for treatment of a specific medical condition, provided they are purchased in reasonable quantities, such as one- to two-month supplies. Examples include:
  
  

  Allergy medicine	Incontinence supplies
  Analgesics (pain relievers)	Insect bite/sting medicine
  Antacids/anti-diarrhea	Menstrual pain relievers
  Calamine lotion	Motion sickness medicines
  Cold and flu medicines	Muscle/joint pain relievers
  Contraceptives	Nasal sprays for sinus conditions
  Corn and callus removers	Nicotine patches/gum/lozenges
  Cough drops/cold lozenges	Pain relievers
  Diaper rash ointment	Pregnancy tests
  Electrolyte replacement therapy	Sinus medications
  Expectorants/cough medicines	Sleeping aids
  Eye drops	Sunburn treatments
  First aid supplies	Sunscreen
  Hemorrhoid treatments	Wart removal treatments

• Certain over-the-counter expenses with additional substantiation; this includes a medical provider's statement that the over-the-counter item is being purchased for a specific, named medical condition. Examples include:
  
  

  Acne treatment	Hormone therapy
  Antiperspirants	Joint treatment (e.g., Glucosamine)
  Arthritis treatment (Chondroitin)	Lactose intolerance medicines
  Breast Pump	Nasal treatments for snoring
  Dietary supplements (certain vitamins and minerals)	Orthopedic inserts/shoes
  	Prenatal vitamins
  Fiber supplements	St. John's Wort
  Herbal medicines	Weight-loss drugs

Examples of Ineligible Expenses

• Cosmetic surgery or treatment, such as a facelift, liposuction, hair transplants, electrolysis, collagen injections, Botox injections
• Dental procedures done solely for cosmetic reasons, such as bleaching, bonding, laminates, or veneers
• Drugs, such as Retin-A, Minoxidril, Propecia, or Rogaine, used solely for cosmetic reasons
• Eye wear service agreement or insurance unless it includes a check-up
• Finance charges, late fees, or charges for failed/missed appointments
• Health club dues, YMCA/YWCA dues, or charges for steam baths or massages for your general health or to relieve physical or mental discomfort
• Non-prescription eyeglasses, sunglasses, clip-ons, and contact lenses
• Premiums for long-term care coverage
• Massage therapy unless prescribed by a physician for a specific medical condition
• Weight-loss programs for your general health even when prescribed by a physician
• Expenditures that are merely beneficial or educational for your general health
• Expenses that are incurred before your election effective date or after March 15 of the following year
• Expenses that are incurred after your termination date unless you elect to prefund your account or continue through COBRA (see Flexible Spending Account Guide for more details)
• Premium payments for any insurance or HMO contract, such as the insurance premium paid for an individual policy or for the group insurance/HMO premium for you or your eligible dependents even if the premium was paid with after-tax dollars
• Any expense that may be reimbursed from another source, such as insurance
• Certain over-the-counter expenses, such as:
  
  

  Blemish concealer	Hair growth treatments
  Cosmetics	Lip balms (e.g., ChapStick®)
  Dental care products (dental floss, toothpaste/brushes, cleaning systems)	Medicated shampoos
  	Moisturizers/skin lotions
  Deodorant	Mouthwash/fluoride rinse
  Depilatories	Soaps
  Dietary food or drink products	Suntan lotions
  Facial creams	Teeth-whitening products
  Feminine hygiene products	Most vitamins and minerals
  Toiletries