Resources and References

Qualified expenses - Health FSA

Check your Summary Plan Description for the Benefit(s) available in your plan.
Click here for a printer-friendly list (pdf).

Over-the-Counter Medicines Prescriptions and Co-Pays Doctor's Fees and Co-Pays Vision Services and Supplies Dental Services and Supplies	Health Improvement Programs and Supplies Health Related Expenses and Equipment Limitation on Qualified Expenses
Over-the-Counter Medicines Items marked (Rx) require a doctor's prescription beginning 1/1/2011
Over-the-counter items, drugs or medications must be medically necessary
Antiseptics Cold, Flu, Asthma, and Allergy Medications Diabetic supplies Ear/Eye Care Health Aids	Pain Relief Personal Test Kits Skin Care Stomach Care Dual use items that require a letter from health practitioner to qualify
Prescriptions and Co-Pays
Prescription medications qualify unless they are reimbursed by insurance. Co-pays for prescription medications qualify.
Doctor's Fees and Co-Pays
Co-pays and other payments to doctors and health care providers qualify unless they are reimbursed by insurance:
Acupuncture fees Chiropractor and podiatrist fees Christian Science practitioner's fees Diagnostic fees Doctor office co-pays Emergency room co-pays Eye exams Inpatient admission co-pays Lab fees Out-patient surgery co-pays Office visits Obstetrics and fertility Orthodontist and dentist fees Periodontist and endodontist fees	Physician and Osteopath fees Psychologist and psychiatrist fees Radiology Reconstructive surgery in connection with birth defects, disease or accident Routine check ups Routine physicals and other non-diagnostic services or treatments Surgical fees Weight loss programs and fees pertaining to a specific disease X-rays and MRI
Doctor's fees that DO NOT qualify:
Cosmetic surgery and procedures unless it is for reconstruction due to disease, birth defect or accident Dental bleaching Marriage and family counseling Weight loss programs for general health or appearance	Over-the-counter items, drugs or medications that are not medically necessary, or are not prescribed by your physician or health practitioner Top of page
Vision Services and Supplies
Vision services and supplies qualify unless they are reimbursed by insurance:
Cataract surgery Contact lenses, solutions and supplies Corrective eye surgery LASIK surgery Office visits and routine eye exams	Optometrist fees Physician and ophthalmologist fees Prescribed sunglasses and eyeglasses Surgical fees and x-rays Vision co-pays
Vision services and supplies that DO NOT qualify:
Cosmetic surgery and procedures unless it is for reconstruction due to disease, birth defect or accident	Over-the-counter items, drugs or medications that are not medically necessary, or are not prescribed by your physician or health practitioner
Dental Services and Supplies
Dental services and supplies qualify unless they are reimbursed by insurance:
Co-payments Dental fillings, crowns and bridges Deductibles Dentures Diagnostic fees Endodontist fees Oral surgery	Orthodontist and dentist fees Periodontist fees Prescribed medicines Routine checkups Dental sealants Surgical fees X-rays
Dental services and supplies that DO NOT qualify:
Cosmetic surgery and procedures unless it is for reconstruction due to disease, birth defect or accident	Over-the-counter items, drugs or medications that are not medically necessary, or are not prescribed by your physician or health practitioner
Health Improvement Programs and Supplies
Health improvement programs that qualify unless they are reimbursed by insurance:
Alcoholism and drug treatment Body scans Cholesterol tests and monitors Gastric bypass surgery Home blood tests Home drug tests Physical and speech therapy	Quit-smoking programs, patches and gums Reconstructive surgery associated with birth defect, disease or accident Special schooling for a disabled child Weight-loss programs (for specific disease)
Health improvement programs that DO NOT qualify:
Dental bleaching Cosmetic surgery and procedures unless it is for reconstruction due to disease, birth defect or accident Marriage and family counseling	Over-the-counter items, drugs or medications that are not medically necessary, or are not prescribed by your physician or health practitioner Weight-loss programs for general health or appearance
Health Related Expenses and Equipment
Generally, the following items require a doctor's prescription to qualify. Health related expenses and equipment that qualify unless they are reimbursed by insurance:
Ambulance expenses Arches and orthopedic shoes Artificial limbs and braces Bedpans and ring cushions Crutches and canes Elevated toilet seat First aid bandages, gloves and masks Hearing devices and batteries Hot and cold compress packs and wraps Humidifiers and vaporizers Medical alert bracelet and fees Oxygen	Pill boxes Shower bars and safety handles Shower protection for casts, prostheses, etc. Special school for disabled child Therapeutic support gloves Thermometers Wigs for hair loss caused by disease Wheelchairs, walkers and shower chairs Travel to doctors or health care facilities
Health care expenses that DO NOT qualify
Expenses and equipment that are not medically necessary or are not prescribed by your health practitioner	Weight-loss programs for general health or appearance
Limitation on Qualified Expenses
Your plan may restrict the reimbursement of one or more of these items. Check with your plan administrator. The total amount of all qualified expenses paid may not exceed the maximum allowed under the plan. Please review your Summary Plan Description or contact your plan administrator for more information. BACK

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