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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
Standard
FSA
Limited-
purpose
FSA
HRA
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 hearing aids and 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 Standard + Prescription

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 of eligible expenses include: cervical caps (e.g., FemCap), condoms, diaphragms, female condoms, birth control sponges (e.g., Today Sponge), spermicides (e.g., Nonoxynol-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 – dental Yes Yes Yes Standard
Co-insurance, co-payments, and deductibles – medical Yes No Yes Standard
Co-insurance, co-payments, and deductibles – vision 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, group counseling, nutritional counseling Potentially No Potentially Standard + Medical Determination Form

If recommended to treat a medical condition.

Counseling and therapy: Marriage counseling No No No Standard + Medical Determination Form

Marriage counseling typically does not qualify for reimbursement under the health FSA or HRA; however if the counseling is incurred to treat an underlying medical condition, the expense may be considered eligible.

CPR classes Potentially No Potentially Standard + Medical Determination Form
Defibrillator Yes No Yes Standard
Dental crowns (metal / porcelain) Yes Yes Yes Standard
Dental implants Potentially Potentially Potentially Standard + Medical Determination Form
Dental veneers Potentially Potentially Potentially Standard + Medical Determination Form
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 Standard
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 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 and repairs (crutches, wheelchairs, nebulizers, etc.) Yes No Yes Standard
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.

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 the 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), surgery (including reversal of surgical procedure meant for sterilization), shots, treatments, and 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.

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
Humidifier Potentially No Potentially Standard + Medical Determination Form

See vaporizer.

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

Only qualified insurance premiums are reimbursable if allowed under the HRA plan.  Examples: health, dental, and/or vision plan premiums. 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.

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
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
Medic Alert bracelet or necklace Yes No Yes Standard
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
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 Potentially Potentially Potentially Standard

Must be filled as a prescription.

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 inserts Yes Yes Yes Standard
Orthopedic shoes Potentially Potentially Potentially Standard + Medical Determination Form

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 prescription requirements and a list of specific OTC medicines 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
Psychotherapy Yes Yes 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 - residential No No No N/A
School and education - special Potentially No Potentially Standard + Medical Determination Form

Only if recommended by a physician.

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 up to 12 months.

Sterilization procedures Yes No Yes Standard
Student health fee No No No N/A
Sunglasses (prescription) Yes Yes Yes Standard
Sunglasses and clips (non-prescription) No No No N/A
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 Standard
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 or vision care Yes Yes Yes Standard

2014 Mileage Rate: Effective January 1, 2014, mileage is rembursable at $.235 per mile.

2013 Mileage Rate: January 1 - December 31, 2013, mileage is reimbursable at $.24 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

2014 Mileage Rate: Effective January 1, 2014, mileage is rembursable at $.235 per mile.

2013 Mileage Rate: January 1 - December 31, 2013, mileage is reimbursable at $.24 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, cord blood, and stem cells harvesting, freezing, and storage Potentially No Potentially Standard + Medical Determination Form

Collection and storage of indefinitely "in case needed" is not eligible for reimbursement. Must be an existing or imminent medical condition to be considered for reimbursement.

Vaccines Yes No Yes Standard
Vaporizers Yes No Yes Standard

A vaporizer is an eligible expense; however, a humidifier requires Medical Determination Form.

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
Warranties No No No N/A

Warranties for the replacement of items (eyeglasses, hearing aids, medical equipment, etc.) are not eligible expenses.

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
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