FSA Eligible Expenses: Health Care
Caring For The Handicapped
- Automobile Modifications*
- Language Training for Disabled Child*
- Mentally Handicapped or Disabled Persons cost for special home*
- Special Education for the Blind
- Special School Tuition for Handicapped
Child Birth and Well-Being
- Childbirth Expenses (Physician, Hospital, Etc.)
- Doula*
- Lactation Consultant*
- Lead Based Paint Removal*
- Midwife Services
- Pedialyte for Child’s Dehydration*
Dental
- Bridges
- Crowns (non-cosmetic)
- Dentures
- Exams and Teeth Cleaning
- Fillings
- Gum Treatment
- Implants
- Occlusal Guards
- Oral Surgery
- Orthodontia
- Root Canals
- X-Rays
Family Planning
- Birthing/Lamaze
- Condoms
- Fertility Treatments
- Oral Contraceptives
- Pregnancy Test Kit
- Prenatal Vitamins*
- Tubal Ligation
- Vasectomy
Hearing
- Hearing Aid Devices and Batteries
- Hearing Exams
- Telephone for the Hearing Impaired
Lab Exams/Tests
- Blood Tests
- Body Scans
- Cardiographs
- Cholesterol Testing
- Laboratory Fees
- Mammograms
- Radiology
- Urine/Stool Analysis
- X-Rays
Medical Equipment
- Artificial Limb/Prosthetics
- Autoette/Wheelchair
- Blood Pressure Monitor
- Blood Sugar Test Kit/Strips
- Compression Hosiery (For Treatment)
- Crutches
- Custom Orthotics
- Diabetic Supplies
- Heating Pads
- Hot/Cold Packs
- Medic-Alert Bracelet
- Nose Strips*
- Orthopedic Shoes* (to the extent the cost exceeds normal shoes)
- Prosthesis
- Room Vaporizer
- Syringes
- Wig*
Medical Procedures
- Acupuncture
- Breast Reconstruction Surgery (following Mastectomy due to disease)
- Operations (non-cosmetic)
- Organ Donor’s Medical Expenses
- Surgical Fees
Medicines/Drugs
- Fiber Supplements*
- Glucosamine/Chrondroitin*
- Herbal Supplements*
- Insulin
- Prescription Drugs
Routine or Preventative Care
- Flu Shots
- Immunizations/Vaccinations
- Physical Exams
Specialists
- Christian Science Practitioner*
- Dermatologist
- Nutritionist*
- Osteopath
- Psychiatrist
- Psychologist
Therapy
- Alcoholism Treatments
- Drug Dependancy Treatments
- Massage*
- Psychoanalysis*
- Physical Therapy
- Smoking Cessation Programs
- Speech Therapy
Vision
- Artificial Eyes
- Contact Lenses and Cleaning Solutions
- Eye Drops
- Eye Examinations
- Eye Surgery
- Eyeglasses
- Laser eye/LASIK Surgery
- Prescription Sunglasses
- Seeing Eye Dog and it’s upkeep
Other
- Ambulance Service
- Co-Insurance and Co-Pays
- Deductible Eligible Expenses
- Hospital Services
- Special Food/Beverage* (Cost Difference from Regular Food Purchase)
- Stem Cell Harvesting*
- Transportation Expenses incurred for rendering of Medical Services
- Weight Loss Program*
FSA Eligible Expenses: Health Care Over-the-Counter Items
- Asthma Flow Meters
- Bandages
- Blood Pressure Monitors
- Callous, Corn, and Wart Removers
- Cholesterol Tests
- Contact Lens Solution
- Crutches
- Cushions, Pads, Braces, and Arch Supports
- Denture Care Products
- Diabetes Care
- Blood Test Strips, Glucose Kits, Monitors and Testers
- Eye Drops
- Eyeglasses
- First Aid Kits
- Gauze and Gauze Pads
- Heart Rate Monitors
- Heating Pads
- Hydrogen Peroxide*
- Incontinence Supplies for Adults
- Medical Bracelets And Necklaces
- Medical Tape
- Nasal Strips
- Nebulizers
- Ointments
- Rubbing Alcohol
- Sunburn Cream
- Thermometers
- Wound Care Products
The IRS does NOT allow the following expenses to be reimbursed under FSAs, as they are not prescribed by a physician for a specific ailment.
FSA Ineligible Expenses: Health Care
- Baby Sitting and Child Care*
- Cosmetic Surgery/Procedures
- Dancing/Exercise/Fitness Programs*
- Diaper Service
- Electrolysis
- Exercise Equipment/Personal Trainers
- Hair Loss Medication
- Hair Transplant
- Health Club Dues*
- Insurance Premiums and Interest
- Long Term Care Premiums
- Marriage Counseling
- Maternity Clothes
- Swimming Lessons
- Teeth Bleaching or Whitening
- Vitamins or Nutritional Supplements*
Over-the-Counter Items
The IRS allows certain over-the-counter (OTC) items to be reimbursed using your FSA dollars. As of January 1, 2011 some of the items previously allowed will become ineligible for reimbursement through your FSA plan due to changes with Healthcare Reform. All OTC medicines and drugs will no longer be allowed unless the participant obtains a prescription or Note of Medical Necessity from their doctor.
If an employee has a Note of Medical Necessity or a prescription for an OTC drug or medicine, they must submit this note to PayPlans & Benefits annually to keep on file. Then, they must pay at the point of service and submit a manual Reimbursement. Which can be found here Request Form For Reimbursement.
Employees can continue to use their FSA funds to purchase OTC items that are not considered a drug or a medicine (e.g. bandages, wound care, contact lens solution). The Benny™ Prepaid Benefits Card can continue to be used for these purchases.
Mailing Address:
PO Box 730
25 Depot Street
Falmouth, MA 02540
Telephone:
(877) 972-9765 toll free within MA
(508) 457-0333 ex.102 or 106
Note of Medical Necessity from their doctor.
Fax:
(508) 457-9994
FSA Eligible Expenses: Dependent Care
Eligible expenses under a Dependent Care FSA are defined as those that enable the participant or the participant’s spouse to work or to look for work. For purposes of a Dependent Care FSA plan, a “qualified dependent” must be under the age of 13, unless mentally or physically handicapped. Per IRS regulations, the service provider cannot be an individual under the age of 19 whom a personal tax exemption may be claimed and, a child of the participant or spouse.
Eligible Expenses
- After-School Care or Extended Day Programs
- Babysitters (Not for Social Events)
- Caregivers for a Disabled
- Spouse or Dependant who lives with Participant
- Child Care Centers that care for six or more children and that meet the IRS’s definition of a qualified Day Care Center
- Day Camps
- Household Expenses provided that a portion of such expenses is incurred to ensure a qualifiying dependent’s well-being and protection
- Nursery Schools
- Transportation Services provided by the Dependent Care Provider
Ineligible Expenses
- Babysitting for Social Events
- Educational Expenses
- Expenses deducted from personal income tax return (dependent care)
- Kindergarten
- Overnight Camps
You must pay at the point of service and submit a manual Reimbursement Request Form for reimbursement.
Reimbursement Request Form
NOTE: This list is not meant to be all-inclusive. For a full list please refer to IRS Codes Section 213(d). Also, expenses marked with an asterisk (*) are potentially eligible expenses that require a Note of Medical Necessity from your health care provider to qualify for reimbursement.
To enroll in a Flexible Spending Account you can find the forms here: