Generally, you may submit a reimbursement claim for those expenses which are not covered under any plan of insurance and which are paid for the diagnosis, cure, mitigation, treatment or prevention of disease or for the purpose of affecting any structure or function of the body. This includes costs incurred for transportation and amounts paid for lodging (but not meals) while away from home primarily for and essential to medical care provided by a physician in a licensed hospital (or hospital equivalent). Expenses that are merely beneficial to your general health or well-being are not reimbursable.
NOTE: Only those medical expenses specifically allowed by IRC Section 213 are eligible.
Below is a partial list of eligible expenses which may be reimbursed through the Health FSA Plan:
| Medical Expenses: |
|
| Air conditioning used to alleviate illness |
Lifetime care facility costs |
| Ambulance hire |
Oxygen equipment (when physician recommended) |
| Artificial teeth and limbs |
Physical examinations |
| Automobile controls or modifications for disabled individuals |
Radial Keratotomy/laser eye surgery |
| Birth control pills |
Rental of medical equipment |
| Braille publications |
Retirement home medical care costs |
| Drugs and vitamins (by prescription only) |
Sanitarium or rest home |
| Education for hearing impaired |
Seeing-eye dog |
| Eyeglasses or contact lenses |
Smoking cessation programs |
| Food and beverages (by prescription for ailments) |
Special education |
| Halfway house |
Support or elastic hose (when physician required) |
| Health spa or swimming (if physician prescribed) |
Therapy treatments |
| Hospitalization costs |
Vasectomy |
| Iron lung |
X-rays |
| Laetrile (if physician required) |
|
| Fees Incurred for: |
|
|
| Acupuncture |
Laboratory |
Physician |
| Anesthetist |
Medical information plan |
Physiotherapist |
| Blood donor |
Midwife |
Podiatrist |
| Chiropractor |
Nurse |
Practical nurse |
| Clinic |
Obstetrician |
Psychiatrist |
| Dentist |
Ophthalmologist |
Psychologist |
| Diagnosis |
Optician |
Psychoanalyst |
| Diathermy |
Oral Surgeon |
Sex Therapist |
| Eye Examination |
Osteopath |
Specialist |
| Gynecologist |
Pediatrician |
Surgeon |
Ineligible Expenses - NOT COVERED:
- Insurance Premiums, including those for Health Plans
- Any expenses covered by a health care plan
- Cosmetics treatment and related prescription drugs
- Marriage or family counseling
- Cosmetics, toiletries and toothpaste, vitamins taken for general health purposes, bottled water
- Physical fitness expenses, such as health club, YMCA or other dues
- Social activities such as dance lessons or classes, even if advised by your doctor
- Maternity clothes, diaper services and related items
- Funeral and burial expenses
- Household or domestic help - even if advised by your doctor, custodial care in an institution
- Transportation expenses to and from work, even though a physical condition may require special transportation
- Meals and lodging while away from home for medical treatment or for the relief of a special health condition
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