Eligible Expenses

FSA + HRA Eligible Expenses

The key to making the most of your health FSA or HRA is knowing about the wide variety of eligible expenses. You can use your account funds for numerous health care-related products and services — for yourself, your spouse, and your qualifying child or relative.

IMPORTANT: Not all expenses are eligible under all plans. Refer to your Summary Plan Description (SPD) to find out which expenses are eligible under your plan.

IRS regulations state that expenses reimbursed under your health FSA or HRA may not be reimbursed under any other plan or program, and only your out-of-pocket expenses are eligible. These expenses must be incurred within the coverage period specified by the plan. Plus, expenses reimbursed under a health FSA or HRA may not be used to claim any federal income tax deduction or credit.

A full explanation of the information listed in the Required Documentation column in the table below is available on our health FSA guidelines and HRA guidelines pages.

Health FSA Expense List

Expense Description	Expense Eligibility			Required Documentation	Processing Notes
Expense Description	Standard FSA	Limited- purpose FSA	HRA	Required Documentation	Processing Notes
Acupuncture	Yes	No	Yes	Standard
Adoption, medical expenses	Potentially	No	Potentially	Standard + legal documents pertaining to adoption	For medical expenses incurred before an adoption is finalized, if the child was a legal dependent when services were provided
Alcohol and drug rehab	Yes	No	Yes	Standard
Allergy products and home improvements to treat severe allergies	Potentially	No	Potentially	Standard + Medical Determination Form	Examples of eligible expenses include: special vacuum cleaners, electro-static air purifiers, pillows and mattresses to alleviate certain allergies, etc. If the product would be owned without the allergy, then the expense is not considered eligible. See Capital expenses.
Alternative healers, dietary substitutes, drugs and medicines	Potentially	No	Potentially	Standard + Medical Determination Form
Ambulance transport	Yes	No	Yes	Standard
Artificial limbs	Yes	No	Yes	Standard
Artificial teeth	Yes	Yes	Yes	Standard
Bandages	Yes	No	Yes	Standard
Bariatric surgery (i.e., LAP-BAND®, gastric bypass)	Potentially	No	Potentially	Standard + Medical Determination Form	Only if recommended by a physician to treat a medical condition.
Batteries for durable medical equipment	Yes	No	Yes	Standard	Participant must note usage of batteries on receipt.
Birth control drugs	Yes	No	Yes	Standard	Birth control pills prescribed by a doctor are an eligible expense; examples: birth control implants (e.g., Implanon, Norplant), birth control patches (e.g., Ortho Evra), birth control pills, birth control shots (e.g., Depo-Provera), vaginal rings (e.g., NuvaRing), morning after pills (emergency contraception), hormonal IUDs (e.g., Mirena).
Birth control OTC medicines	Yes	No	Yes	N/A	OTC birth control pills (e.g., Plan B) require a doctor’s prescription to be an eligible expense
Birth control supplies	Yes	No	Yes	Standard	Examples: birth control sponges (e.g., Today’s Sponge), cervical caps (FemCap), condoms, diaphragms, female condoms, spermicides (e.g., Nonosynol-9)
Blood pressure monitoring devices	Yes	No	Yes	Standard
Body scan / diagnostic testing	Yes	No	Yes	Standard
Braille books and magazines	Potentially	No	Potentially	Standard + Medical Determination Form	If for the visually impaired person, only the amount above the cost of regular printed material is reimbursable.
Breast pumps and lactation supplies	Yes	No	Yes	Standard	Considered durable medical equipment.
Breast reconstruction surgery following mastectomy	Yes	No	Yes	Standard
Burn garment	Yes	No	Yes	Standard
Capital expenses	Potentially	No	Potentially	Standard + Medical Determination Form	The primary purpose of the expenditure must be for the medical care of the taxpayer, spouse, or dependent. The following information must be provided to determine eligibility: 1. A letter and/or prescription from a physician citing the medical necessity. 2. A written certification that states the item is for the patient’s individual use, or the percentage of use in relation to other members of the household. 3. Third-party appraisal of the participant’s home to substantiate the difference between the cost of capital expenditure and the increase in value to the participant’s home (the cost of the appraisal is not reimbursable).
Carpal tunnel wrist supports	Yes	No	Yes	Standard
Chelation (EDTA) therapy	Yes	No	Yes	Standard + Medical Determination Form	Only if used to treat a medical condition such as lead poisoning
Childbirth classes	Yes	No	Yes	Standard	See Lamaze classes.
Chiropractor services	Yes	No	Yes	Standard
Chondroitin sulfate	Potentially	No	Potentially	Standard + Medical Determination Form	Only if used to treat a medical condition
Christian Science practitioners	Yes	No	Yes	Standard	Only expenses for medical care are reimbursable.
Circumcision	Yes	No	Yes	Standard
Co-insurance, co-payments and deductibles – medical	Yes	No	Yes	Standard
Co-insurance, co-payments and deductibles – vision	Yes	Yes	Yes	Standard
Co-insurance, co-payments, and deductibles – dental	Yes	Yes	Yes	Standard
COBRA premiums	No	No	Yes	N/A
Concierge medical fee	No	No	No	N/A	A retainer fee (membership fee) that is billed for future services is not an eligible expense. Fees billed for actual qualified services rendered may be eligible for reimbursement.
Condoms and other contraceptive devices	Yes	No	Yes	Standard	See Spermicidal foam.
Contact lenses, equipment, and materials (e.g., Aosept, Allergan, Bausch & Lomb, Boston, Opti-Free, Renu)	Yes	Yes	Yes	Standard
Controlled substances in violation of federal law	No	No	No	N/A
Cosmetic prescriptions	No	No	No	N/A
Cosmetics and perfume	No	No	No	N/A
Counseling and therapy: Alcohol/drug counseling, psychology, psychoanalysis, psychiatry, sex counseling	Yes	No	Yes	Standard
Counseling and Therapy: Family counseling, nutrition counseling	Potentially	No	Potentially	Standard + Medical Determination Form	Notes: If recommended to treat a medical condition
Counseling and therapy: Marriage counseling	No	No	No	N/A
CPR classes	Potentially	No	Potentially	Standard + Medical Determination Form
Dental veneers	No	No	No	N/A
Dental visits (non-cosmetic)	Yes	Yes	Yes	Standard	Cosmetic dental procedures are not eligible.
Dentures	Yes	Yes	Yes	Standard
Deodorant	No	No	No	N/A
Diabetic supplies, test kits, and strips	Yes	No	Yes	Standard
Diagnostic services	Yes	No	Yes	Standard
Diapers or diaper service for newborns	No	No	No	N/A
Diet foods	No	No	No	N/A
Dietary supplements	Potentially	No	Potentially	Standard + Medical Determination Form
Disabled dependent's qualified dental or vision expenses	Yes	Yes	Yes	Standard
Disabled dependent's qualified medical expenses	Yes	No	Yes	Yes
DNA collection and storage	No	No	No	N/A
Doula (birthing coach)	Potentially	No	Potentially	Standard + Medical Determination Form	The expense is only eligible if the doula is a licensed health care professional and provides medical care. Participant must submit itemized statement detailing the medical services rendered.
Drug overdose, treatment of	Yes	No	Yes	Standard
Dual-purpose expenses (items that have both a medical and general/personal/cosmetic purpose)	Potentially	No	Potentially	Standard + Medical Determination Form
Durable medical equipment	Yes	No	Yes	Standard	Crutches, wheelchairs, nebulizers, etc.
Ear piercing	No	No	No	N/A
Ear plugs	Potentially	No	Potentially	Standard + Medical Determination Form
Electrolysis or hair removal	No	No	No	N/A
Exercise equipment or programs	Potentially	No	Potentially	Standard + Medical Determination Form	Not unless recommended by a physician to treat a specific medical condition and the equipment would not otherwise be purchased but for treatment of the condition
Expenses reimbursed by a health flexible spending account (FSA)	Yes	No	No	N/A
Expenses reimbursed by a health reimbursement arrangement (HRA)	No	No	Yes	N/A
Eye examinations, eyeglasses, equipment, and materials	Yes	Yes	Yes	Standard
Face creams and moisturizers	No	No	No	N/A
Face lifts	No	No	No	N/A
Family counseling	Potentially	No	Potentially	Standard + Medical Determination Form	Not unless recommended to treat a medical condition
Feminine hygiene products (tampons, etc.)	No	No	No	N/A
Fertility treatments	Potentially	No	Potentially	Standard + Medical Determination Form	Will qualify if procedures are intended to overcome inability to have children and are performed on the participant, their spouse, or eligible dependent. Treatment examples: gamete intrafallopian transfer (GIFT), in vitro fertilization (including temporary storage of eggs or sperm), shots, surgery (including reversal of surgical procedure meant for sterilization), zygote intrafallopian transfer (ZIFT).Expenses paid to or for an in vitro surrogate usually do not qualify nor do egg donor expenses unless preparatory to a procedure performed on the participant, spouse, or eligible dependent.
Fiber supplements (e.g., Benefiber, Metamucil)	Potentially	No	Potentially	Standard + Medical Determination Form	Only if recommended by a physician
Flu shots	Yes	No	Yes	Standard
Fluoridation device	Yes	No	Yes	Standard
Foods	Potentially	No	Potentially	Standard + Medical Determination Form	See Special foods; Meals; Alternative healers; and Dietary supplements.
Founder's fee	No	No	No	N/A
Gauze pads	Yes	No	Yes	Standard
Genetic testing	Potentially	No	Potentially	Standard + Medical Determination Form	If ordered for medical care
GIFT(gamete intrafallopian transfer)	Potentially	No	Potentially	Standard + Medical Determination Form	See fertility treatments.
Glucosamine	Potentially	No	Potentially	Standard + Medical Determination Form
Glucose monitoring equipment	Yes	No	Yes	Standard
Guide dog or other service animal aide	Potentially	No	Potentially	Standard + Medical Determination Form
Hair loss/replacement treatment (e.g., Rogaine)	Potentially	No	Potentially	Standard + Medical Determination Form
Hair removal and transplants	No	No	No	N/A
Hand lotion	No	No	No	N/A
Health club dues and fees	Potentially	No	Potentially	Standard + Medical Determination Form	Not unless recommended by a physician to treat a specific medical condition and expense would not otherwise be incurred but for treatment of the condition. Expenses incurred for general health purposes are not eligible.
Hearing aids and hearing aid batteries	Yes	No	Yes	Standard
Herbs and Herbal Supplements (e.g., St. John’s Wort)	Potentially	No	Potentially	Standard + Medical Determination Form	Only if used to treat a specific medical condition
Hormone replacement therapy (HRT)	Potentially	No	Potentially	Standard + Medical Determination Form	Only if used to treat a medical condition
Hospital services	Yes	No	Yes	Standard
Hot and cold packs	Yes	No	Yes	Standard
Household help	No	No	No	N/A
Illegal operations and treatments	No	No	No	N/A
Immunizations	Yes	No	Yes	Standard
Inclinator	Yes	No	Yes	Standard
Incontinence supplies (e.g., Depends, Serenity)	Yes	No	Yes	Standard	Products must have labels for bladder control/incontinence.
Insulin (prescription and over-the-counter)	Yes	No	Yes	Standard
Insurance premiums	No	No	Yes	Standard	Requires a copy of the insurance premium billing notice AND proof of payment (copy of front and back of check, credit card confirmation, etc.) for qualified insurance policies. Itemized bills should include the insurance carrier name, participant name, amount charged, and coverage dates.
Laboratory fees	Yes	No	Yes	Standard
Lactation consultant	Potentially	No	Potentially	Standard + Medical Determination Form
Lamaze classes	Yes	No	Yes	Standard	Only the portion of the class covering the birthing process is covered.
Language training	Potentially	No	Potentially	Standard + Medical Determination Form	Only qualifies for an individual with a diagnosed medical condition (e.g., dyslexia or disabled child)
Lasik eye surgery	Yes	Yes	Yes	Standard
Lead-based paint removal	Potentially	No	Potentially	Standard + Medical Determination Form	Eligible if done to prevent a child who has or had lead poisoning from eating the paint. The wall surface must be within the child's reach.
Lifetime care-advance payments	No	No	No	N/A
Lip balm (e.g., Burt’s Bees Lip Balm, Chapstick)	No	No	No	N/A
Lodging at a hospital or similar institution (patient only)	Yes	No	Yes	Standard
Lodging not at a hospital or similar institution	Yes	No	Yes	Standard	Up to $50 per night if the lodging is primarily for and essential to medical care. The service must be provided by a physician in a licensed hospital or medical care facility equivalent to a licensed hospital. An additional $50 per night may be reimbursable for a parent or companion who must accompany the patient.
Lodging of a companion	Yes	No	Yes	Standard	If accompanying a patient for medical treatment
Lodging while attending a medical conference	No	No	No	N/A
Long-term care premiums	No	No	Yes	Standard	Only qualified insurance premiums are reimbursable if allowed under your plan. Documentation requires a copy of the insurance premium billing notice AND proof of payment (copy of front and back of check, credit card confirmation, etc.) for qualified insurance policies. Itemized bills should include the insurance carrier name, participant name, amount charged, and coverage dates.
Marijuana or other controlled substances in violation of federal law	No	No	No	N/A
Marriage counseling	No	No	No	Standard + Medical Determination Form	Marriage counseling typically does not qualify for reimbursement under the health FSA; however, if the counseling is incurred to treat an underlying medical condition, the expense may be considered eligible.
Massage therapy	Potentially	No	Potentially	Standard + Medical Determination Form
Mastectomy-related special bras	Yes	No	Yes	Standard
Meals at a hospital or similar institution (Patient Only)	Yes	No	Yes	Standard	Only meals for the person receiving care are eligible.
Meals not at a hospital or similar institution	No	No	No	N/A
Meals of a companion	No	No	No	N/A
Meals when attending a medical conference	No	No	No	N/A
Medical conference admission	Potentially	No	Potentially	Standard + Medical Determination Form
Medical information plan changes	Yes	No	Yes	Standard
Medical monitoring and testing devices	Yes	No	Yes	Standard
Medical newsletter	No	No	No	N/A
Medical records charges	Yes	No	Yes	Standard
Medical services	Yes	No	Yes	Standard
MedicAlert bracelet or necklace	Yes	No	Yes	Standard
Medicare premiums	No	No	Yes	Standard	Requires a copy of the insurance premium billing notice AND proof of payment (copy of front and back of check, credit card confirmation, etc.) for qualified insurance policies. Itemized bills should include the insurance carrier name, participant name, amount charged, and coverage dates.
Medicated shampoo (to treat a specific medical condition like psoriasis; e.g., Dermarest shampoo)	Potentially	No	Potentially	Standard + Medical Determination Form	Only the amount in excess of the cost of normal shampoo is reimbursable.
Mouthwash	No	No	No	N/A
Nasal strips (nose strips)	Potentially	No	Potentially	Standard + Medical Determination Form
Naturopathic healers	Potentially	No	Potentially	Standard + Medical Determination Form	Treatments using natural agents (e.g., air, water, wind, etc.) are not reimbursable.
Nebulizer	Yes	No	Yes	Standard
Nursing services for a baby	No	No	No	N/A
Nursing services provided by a nurse or other attendant	Yes	No	Yes	Standard
Nutritionist's professional expenses	Potentially	No	Potentially	Standard + Medical Determination Form
OB/GYN	Yes	No	Yes	Standard
Occlusal guards	Yes	Yes	Yes	Standard
Office visits - dental	Yes	Yes	Yes	Standard
Office visits - medical	Yes	No	Yes	Standard
Office visits - vision	Yes	Yes	Yes	Standard
Operations - dental	Yes	Yes	Yes	Standard	Legal operations only. Cosmetic procedures are not eligible.
Operations - medical	Yes	No	Yes	Standard	Legal operations only. Cosmetic procedures are not eligible.
Operations- vision	Yes	Yes	Yes	Standard	Legal operations only. Cosmetic procedures are not eligible.
Optometrist	Yes	Yes	Yes	Standard
Organ donors	Yes	No	Yes	Standard
Orthodontia	Yes	Yes	Yes	Standard
Orthopedic shoes and inserts	Yes	No	Yes	Standard + Medical Determination Form	Only the excess cost over ordinary shoes
Osteopath fees	Yes	No	Yes	Standard
OTC pregnancy tests/fertility monitors	Yes	No	Yes	Standard
Over-the-counter drugs used for general health and /or cosmetic purposes	No	No	No	N/A
Over-the-counter medicines used to treat a specific medical condition	Yes	No	Yes	Standard + prescription	See our Over-the-counter Expenses page for examples of OTC medicine and supplies.
Over-the-counter supplies	Yes	No	Yes	Standard	See our Over-the-counter Expenses page for examples of OTC medicine and supplies.
Ovulation monitor	Yes	No	Yes	Standard
Oxygen	Yes	No	Yes	Standard
Physical exams	Yes	No	Yes	Standard	Not employment-related exams
Physical therapy	Yes	No	Yes	Standard
Podiatrist	Yes	No	Yes	Standard
Pregnancy termination	Yes	No	Yes	Standard	Legal terminations only
Pregnancy test kits	Yes	No	Yes	Standard
Prescription drug discount programs	No	No	No	N/A
Prescription drugs imported from another country	No	No	No	N/A
Prescription drugs used for general health and/or cosmetic purposes	No	No	No	N/A
Prescription drugs used to treat a specific medical condition	Yes	No	Yes	Standard
Prescription drugs – dual- purpose (e.g., Propecia, Rogaine)	Potentially	No	Potentially	Standard + Medical Determination Form	Not unless the item is used primarily to prevent or alleviate a physical or mental defect or illness
Prescription eyeglasses	Yes	Yes	Yes	Standard
Propecia	Potentially	No	Potentially	Standard + Medical Determination Form	Not unless hair loss is due to a medical condition
Prosthesis	Yes	No	Yes	Standard
Psychiatrist	Yes	No	Yes	Standard
Psychoanalysis	Yes	No	Yes	Standard
Psychologist	Yes	No	Yes	Standard
Radial keratotomy	Yes	Yes	Yes	Standard
Reading glasses	Yes	Yes	Yes	Standard
Retin-A	Potentially	No	Potentially	Standard + Medical Determination Form
Reversal of tubal ligation or vasectomy	Yes	No	Yes	Standard
Rogaine	Potentially	No	Potentially	Standard + Medical Determination Form	Not unless hair loss is due to a medical condition
Safety glasses	No	No	No	N/A
Sales tax on qualified medical expenses (e.g., OTC medications)	Yes	No	Yes	Standard	Sales tax will automatically be reimbursed if receipt contains only FSA-eligible expenses. If not the participant is responsible for calculating the sales tax in order for it to be reimbursed.
School and education, special	Potentially	No	Potentially	Standard + Medical Determination Form	Only if recommended by a physician
Schools and education, residential	No	No	No	N/A
Screening tests - medical	Yes	No	Yes	Standard
Screening tests – dental or vision	Yes	Yes	Yes	Standard
Shaving cream and lotion	No	No	No	N/A
Shipping and handling fees on eligible expenses	Yes	Yes	Yes	Standard
Sick-child facility	No	No	No	N/A
Skin moisturizers and lotion	No	No	No	N/A
Sleep deprivation treatment	Potentially	No	Potentially	Standard + Medical Determination Form
Smoking cessation programs	Yes	No	Yes	Standard
Snoring cessation aids and medications (e.g, Breathe Right Spray, Snoreeze)	Potentially	No	Potentially	Standard + Medical Determination Form
Special foods	Potentially	No	Potentially	Standard + Medical Determination Form	These foods are not eligible expenses unless recommended to treat a medical condition (e.g., gluten-free products). A cost comparison of the special food and the regular product must be provided, and the price difference will be reimbursed. Example: Gluten-free pasta = $2.50; Standard pasta = $1.25; Price difference = $1.25. Reimbursement amount = $1.25. Meal replacements are a substitute for food that an individual would normally consume. These products are not eligible for reimbursement (e.g., shakes, meal bars, etc.).
Sperm storage fees	Potentially	No	Potentially	Standard + Medical Determination Form	Temporary storage only
Stem cell, harvesting and/or storage	Potentially	No	Potentially	Standard + Medical Determination Form
Sterilization procedures	Yes	No	Yes	Standard
Student health fee	No	No	No	N/A
Sunglass clips	No	No	No	N/A
Sunglasses (non-prescription)	No	No	No	N/A
Sunglasses (prescription)	Yes	Yes	Yes	Standard
Supplies to treat medical condition	Yes	No	Yes	Standard
Surrogate expenses	No	No	No	N/A
Take-home drug test	No	No	No	N/A
Take-home pregnancy test	Yes	No	Yes	Yes
Take-home urinary tract infection test	Yes	No	Yes	Standard
Tanning salons and equipment	No	No	No	N/A
Teeth whitening	No	No	No	N/A
Telephone for hearing- impaired persons	Yes	No	Yes	Standard
Thermometers	Yes	No	Yes	Standard
Toiletries	No	No	No	N/A
Toothbrushes and toothpaste	No	No	No	N/A
Transplants	Yes	No	Yes	Standard
Transportation and travel expenses for person receiving dental care	Yes	Yes	Yes	Standard	2013 Mileage Rate: Effective January 1, 2013, mileage is reimbursable at $.24 per mile. 2012 Mileage Rate: January 1, 2012 through December 31, 2012, mileage is reimbursable at $.23 per mile. Note: Participants are required to itemize mileage expenses on the claim form. However, mileage expenses would not apply to reimbursement requests for taxi, bus, plane or train fare. A participant may be reimbursed for the full amount of the fare. If the participant cannot get a fare receipt, they must itemize the amount on the claim form and indicate no receipt is obtainable.
Transportation and travel expenses for person receiving medical care	Yes	No	Yes	Standard	2013 Mileage Rate: Effective January 1, 2013, mileage is reimbursable at $.24 per mile. 2012 Mileage Rate: January 1, 2012 through December 31, 2012, mileage is reimbursable at $.23 per mile. Note: Participants are required to itemize mileage expenses on the claim form. However, mileage expenses would not apply to reimbursement requests for taxi, bus, plane or train fare. A participant may be reimbursed for the full amount of the fare. If the participant cannot get a fare receipt, they must itemize the amount on the claim form and indicate no receipt is obtainable.
Transportation and travel expenses for person receiving vision care.	Yes	Yes	Yes	Standard	July 1 – December 31, 2011 Mileage Rate: Mileage is reimbursable at $.23.5 per mile. January 1 – June 30, 2011 Mileage Rate: Mileage is reimbursable at $.19 per mile. Note: Participants are required to itemize mileage expenses on the claim form. However, mileage expenses would not apply to reimbursement requests for taxi, bus, plane or train fare. A participant may be reimbursed for the full amount of the fare. If the participant cannot get a fare receipt, they must itemize the amount on the claim form and indicate no receipt is obtainable.
Transportation of someone other than the person receiving dental or vision care	Potentially	Potentially	Potentially	Standard	Only certain cases are reimbursable: 1. A parent who must travel with a sick child receiving medical care 2. A nurse or other person who administers medication or injections to a patient 3. An individual's visits to a mentally-ill dependent, if recommended as part of treatment
Transportation of someone other than the person receiving medical care	Potentially	No	Potentially	Standard	Only certain cases are reimbursable: 1. A parent who must travel with a sick child receiving medical care 2. A nurse or other person who administers medication or injections to a patient 3. An individual's visits to a mentally-ill dependent, if recommended as part of treatment
Transportation to and from medical conference	Potentially	No	Potentially	Standard + Medical Determination Form	See Medical conference admission and Meals for a medical conference.
Tubal ligation	Yes	No	Yes	Standard
Umbilical cord, freezing and storing of	Potentially	No	Potentially	Standard + Medical Determination Form	Collection and storage of indefinitely "in case needed" is not eligible for reimbursement
Vaccines	Yes	No	Yes	Standard
Varicose veins, treatment of	No	No	No	N/A
Vasectomy	Yes	No	Yes	N/A
Viagra	Yes	No	Yes	Standard
Virtual physical (body scan)	Yes	No	Yes	Standard
Vision discount programs	No	No	No	N/A
Vitamins	Potentially	No	Potentially	Standard + Medical Determination Form
Walker, wheelchair, or cane	Yes	No	Yes	Standard
Weight-loss programs and/or drugs prescribed to induce weight loss	Potentially	No	Potentially	Standard + Medical Determination Form	Only if recommended by a physician
Wigs	Potentially	No	Potentially	Standard + Medical Determination Form	Not unless hair loss is due to a medical condition
X-rays - dental	Yes	Yes	Yes	Standard
X-rays - medical	Yes	No	Yes	Standard