FSA Eligible Expenses

Below is a partial list of FSA eligible expenses. Benesyst has developed this list in accordance with IRS regulations and some items depending on use could be considered ineligible. Please call our customer service center if you have concerns or questions about a specific expense and its eligibility for reimbursement from your FSA. Please note, this list does not include eligible over-the-counter medicines.

Health Care FSA Eligible Expenses

• Abdominal Disorders
• Abortion:(Legal) See Family planning, Pregnancy termination
• Acupuncturist's fees
• Adoption (medical expenses)
• Airplane fare: See Transplants and Transportation.
• Air purifier, humidifier, and home window air conditioner: Prescribed by physician Physician's note required with claim.
• Alcoholism and Drug Abuse: Medical expenses paid to a treatment center
• Alternative healers, dietary substitutes, and drugs and medicines: If provided to treat a specific medical condition.
• Ambulance
• Anesthesiologist's fees
• Artificial limb
• Artificial Teeth
• Attendant: See Nursing services.
• Automobile: See Car.
• Birth Control Pills and Devices: OTC contraception and devices. See Family planning, Pregnancy termination.
• Braces: See Orthodontics.
• Braille books and magazines: Amount by which the cost of Braille books and magazines exceeds regular price
• Breast reconstruction surgery following mastectomy.
• Capital expenses: If their main purpose is medical care, capital expenses paid for special equipment installed in a participant's home or for improvements to the home are reimbursable.
• Car: Medical expenses for special hand controls and other special equipment installed for the use of a person with disabilities. Also, the amount by which the cost of a car specially designed to hold a wheelchair exceeds the cost of a regular car. However, the cost of operating a specially equipped car is not reimbursable.
• Child care: See Dependent daycare.
• Childbirth classes: Yes, limited to expenses incurred by the mother-to-be to address specific medical issues.
• Chiropodist's fees
• Chiropractor's fees
• Christian Science practitioner's fees: For medical care expenses only. Fees for other purposes do not qualify.
• Clinic
• Coinsurance amounts: Medical coinsurance amounts and deductibles
• Contact lenses: See Vision Care.
• Cosmetic Surgery: Only to improve congenital abnormality, personal injury, or disfiguring disease. Other types of cosmetic surgery are not reimbursable.
• Crutches
• Deductibles, medical: Insurance deductibles and coinsurance amounts under the employer's plan are reimbursable. Must be associated with services and service dates.
• Dental services: Medically necessary dental treatment including X-rays, fillings, braces, extractions, dentures, etc.
• Dermatologist's fees
• Diabetes management: See Insulin, Medicines.
• Diaper service: Only if needed to relieve the effects of a particular disease.
• Diagnostic services
• Diets: See Special foods.
• Drugs: See Medicines.
• Drug addiction: See Alcoholism and Drug Abuse
• Employment taxes: See Nursing services
• Eye examination fees: See Vision care.
• Eyeglasses: See Vision care.
• Family or group counseling or therapy: must be verified by a physician's written statement of medical necessity for the treatment of a medical condition. Physician's note must accompany claim. See Marriage counseling, Psychiatrist's fees, Psychoanalysis, Psychologist's fees, Psychotherapist's fees.
• Family planning: Birth control pills and devices including over-the-counter items. See Birth control pills and devices,
• Pregnancy termination, Vasectomy.
• Fertility treatment: Treatment of infertility, including in vitro fertilization. Surrogate and embryo storage do not qualify.
• Group medical insurance: See Insurance premiums.
• Guide dog or other animal
• Gynecologist's fees
• Healthy baby care: See Nursing services.
• Hearing aids: Hearing aid and batteries. Hearing aid insurance is not reimbursable.
• Hospital: Expenses incurred as a hospital in-patient or out-patient for laboratory, surgical and diagnostic services
• Impotence or sexual inadequacy: eligible if substantiated by a physician.
• In vitro fertilization: See Fertility treatment.
• Infertility: See Fertility treatment.
• Insulin: Insulin and other diabetic treatment aids
• Laboratory service fees
• Laser eye surgery
• Lasik surgery
• Lead-based paint removal: Cost of removing lead-based paints from surfaces in a home Physician's note required with claim. Learning disabilities: Tuition payments to a special school or tutoring fees for a child who has severe learning disabilities caused by mental or physical impairments, including nervous system disorders. Physician's note required with claim.
• Legal fees: Paid to authorize treatment for mental illness.
• Lodging: At a hospital or similar institution if the employee's main is to receive medical care. The cost of lodging not provided in a hospital or similar institution while an employee (or dependent) is away from home is reimbursable if four requirements are met: (1) the lodging is primarily for and essential to medical care; (2) medical care is provided by a doctor in a licensed hospital or in a medical care facility related to, or the equivalent of, a licensed hospital; (3) the lodging is not lavish or extravagant under the circumstances; and (4) there is no significant element of personal pleasure, recreation or vacation in the travel away from home. The reimbursable amount cannot exceed $50 per night per person. Lodging is included for a person whose transportation expenses count as medical expenses, due to the fact that they are traveling with the person receiving the medical care. For example, a parent traveling with a sick child, up to $100 per night.
• Massage: Must be substantiated by a physician.
• Mattresses: Only the difference between a special mattress used to treat a medical condition such as arthritis and a comparable quality mattress. Must be documented by a physician's note.
• Meals: For the traveling patient only at a hospital or medical institution
• Medical information plan: A plan that keeps medical information to be retrieved from a computer bank for medical care
• Medical services: If they bear a direct relationship to the provision of medical care to a taxpayer
• Medicines: Prescribed medicines for use by an individual that are medically necessary
• Mental health: See Psychiatrist's fees
• Mentally retarded, special home for: Must not be the home of a relative and on the recommendation of a doctor
• Midwife: Prenatal and birth expenses are reimbursable as the service is being incurred, upfront fees must be allocated with services that is being rendered or divided out over treatment plan.
• Native American healing ceremonies by medicine man
• Neurologist's fees
• Nursing services: Wages and other amounts paid for nursing services
• Obstetrical expenses
• Optometrist's fees
• Opthalmologist's fees: See Vision care.
• Orthodontics
• Orthopedic shoes: To the extent that cost exceed comparable shoes. Physician's note is required.
• Organ donor: See Transplants.
• Osteopath's fees.
• Over-the-Counter Drugs and Medicines: to alleviate or treat personal injuries or sickness are reimbursable. See OTC Guide on www.benesyst.net, after you log into the secure portal.
• Oxygen: For treatment of a medical condition only
• Parking: See Transportation.
• Pediatrician's fees
• Personal use items: Only if used primarily to alleviate a physical or mental defect or illness. For example, the cost of a wig purchased at the advice of a physician for the mental health of a patient who has lost all of his or her hair from disease
• Physical exams: Generally reimbursable, except for employment-related physicals.
• Podiatrist's fees
• Pregnancy termination: Termination of a pregnancy, including legal abortion
• Prescription drugs: See Medicines.
• Private hospital room: Extra cost of a private room
• Prosthesis: See Artificial limb
• Psychiatric social worker's fees: Expenses incurred for recommendation of an individual's specific treatment by psychiatrist are reimbursable.
• Psychiatrist's fees: For individual counseling
• Psychoanalysis
• Psychologist's fees: for individual counseling
• Psychotherapist's fees: For individual counseling
• Radial keratotomy
• Reasonable and customary charges, amounts in excess of: Medical expenses in excess of the plan's reasonable and customary charges
• Schools, special: Special school for a person who is mentally impaired or physically disabled if the main reason for using the school is its resources for treating the disability. This includes a school that:
  • teaches Braille to a child who is visually-impaired;
  • teaches speech-reading or American Sign Language to a child who is hearing-impaired; or
  • provides remedial language training to correct a condition caused by a birth defect.
  The cost of meals, lodging and ordinary education supplied by a special school is reimbursable only if the main reason for using the school is its resources for treating the mental or physical disability.
• Sexual inadequacy and incompatibility treatment
• Smoking program: Must be doctor prescribed
• Special foods (such as gluten-free or salt free dishes): if prescribed by a medical practitioner to treat a specific illness or ailment and if the foods do not substitute for normal nutritional requirements. But the amount that may qualify is limited to the amount by which the cost of the special food exceeds the commonly available versions of the same product. To show that expense is primarily for medical care, a note from a medical practitioner recommending it to treat a specific medical condition is normally required.
• Sterilization: Cost of a legal sterilization (operation performed to make a person unable to have children)
• Student health fee: if the expenses are separately broken down and are for specific medical services.
• Substance abuse: See Alcoholism and drug abuse.
• Telephone: Costs of special telephone equipment that allows a person who is hearing-impaired to communicate over a regular telephone
• Television: Difference between specially equipped television set in excess of the cost of the same model regular set.
• Therapy, physical: Therapy received as medical treatment.
• Transplants: Payments for surgical, hospital, laboratory and transportation expenses for a prospective or actual donor of an organ are reimbursable.
• Transportation: Amounts paid for transportation primarily for, and essential to, medical care are reimbursable (except as provided below). These include:
  • bus, taxi, train or plane fare, or ambulance service;
  • parking fees and tolls;
  • transportation expenses of a parent who must accompany a child who needs medical care;
  • transportation expenses of a nurse or other person who can give injections, medications or other treatment required by a patient who is traveling to get medical care and is unable to travel alone; and
  • transportation expenses for regular visits to see a dependent who is mentally ill if these visits are recommended as a part of treatment.
• Mileage to and from medically necessary trips are reimbursable at a flat rate of 20 cents per mile for calendar year 2007.The cost of tolls and parking may be added to this amount.
  Reimbursable expenses do not include:
  • transportation expenses to and from work, even if a medical condition requires an unusual means of transportation; or
  • transportation expenses incurred if, for non-medical reasons, a participant chooses to travel to another location (or to a resort or spa) for an operation or other medical care prescribed by a doctor.
  Trips: Transportation to another location, if the trip is primarily for and essential to receiving medical services
• Tutor's fees: See Learning disabilities.
• Umbilical cord, freezing and storing of: Might qualify if there is a specific medical condition that the umbilical cord is intended to treat.
• Vacation: See Trips.
• Vaccines
• Vasectomy
• Vision care: Optometry services and medical expenses for eyeglasses and contact lenses needed for medical reasons are reimbursable. Eye exams and expenses for eyeglasses and contact lens solutions are also reimbursable.
• Vitamins: Only if recommended by a physician for a specific medical condition. A physician's note is required.
• Weight loss program and/or drugs prescribed to induce weight loss: If recommended by a physician to treat a specific medical condition. However, the costs of food associated with a weight-loss program (such as pre-packaged meals) would not qualify, since it just meets normal nutritional needs. To show that the expense is primarily for medical care, a note from a medical practitioner is required.
• Wheelchair: Amounts paid for a wheelchair used mainly for the relief of sickness or disability, and not just to provide transportation to and from work, are reimbursable. The cost of operating and maintaining the wheelchair is also reimbursable.
• X-rays and X-ray treatments

Health Care FSA Expenses NOT Eligible for Reimbursement

• Breast pump
• Cancellation fee.
• Contact lenses, glasses and sunglasses that are non-prescription
• Contact lens replacement insurance
• Cosmetic surgery, procedures, prescriptions
• Dancing or swimming lessons
• DNA collection
• Domestic help fees of a non-medical nature
• Ear piercing
• Electrolysis or hair removal
• Funeral expenses
• Health club memberships/fitness programs, Exercise equipment
• Household help: does not qualify.
• Infant care: Nursing or babysitting services for a normal, healthy infant are not reimbursable.
• Insurance premiums: No premiums for any health plan, including health plans maintained by a spouse's employer, are reimbursable through a health care FSA.
• Late fees (late payments for bills)
• Life insurance premiums
• Long-term/Lifetime care insurance premiums
• Marriage counseling
• Massage (unless prescribed by a physician to treat a medical condition)
• Medical Savings Accounts
• Medicare Part A and/or B
• Nursing homes
• Over-the-counter drugs that are for general health purposes, cosmetics, skin care, toiletries, hygiene products
• Over-the-counter vitamins, supplements or dietary supplements
• Personal use expenses (i.e. toothbrushes, electric toothbrushes, clothing, home items, pillows, etc.)
• Physical therapy treatments for general well-being
• Prescriptions that are cosmetic related are not reimbursable. i.e. Retina-A, Propecia, Vaniqa, etc.
• Scientology "audits"
• Surrogate expenses
• Teeth whitening/Bleaching
• Union dues
• Vision discount programs or breakage coverage