Eligible Medical Expense Matrix

The matrix below describes common expenses which may be eligible for reimbursement from your Health Reimbursement Arrangement (HRA), Health Flexible Spending Account (FSA), and/or Health Savings Account (HSA). Please keep in mind that this matrix does not address all medical expenses. Please review your Summary Plan Description to ensure certain items are not restricted or excluded from your HRA or FSA. If you are enrolled in an HSA and FSA, your FSA must be a Limited-Purpose FSA to be in compliance with IRS regulations.

Throughout the list, you may see items considered to be a "Dual Purpose Expense." If an item can be used for both general health (medical) and cosmetic (personal) reasons, then you might be required to submit proof (such as a letter of medical necessity from your attending physician) that the item is to be used primarily for medical purposes. This letter must be on the physician’s letterhead and include the following items: physician name, patient name, item prescribed, reason for the prescription (diagnosis), and the expected length of treatment.

Due to the fact that some rules and regulations are not always obvious, interpretations may differ. While every attempt has been made to insure accuracy of this chart, you should not rely on this chart as legal advice. If you desire more information about your specific situation please consult with your personal tax advisor or legal counsel. This matrix is made available "as is," without warranty of any kind, and with the understanding that Employee Benefit Resources, Inc. is not engaged in rendering legal, accounting, or other professional service.

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Expense Type	Qualifies For Reimbursement?	Exceptions/Explanations
Abortion	Yes	Expenses for operations that are illegal do not qualify.
Acupuncture	Yes
Acne Treatments	Dual Purpose Expense	Generally, yes. Includes the amount you pay for treatment of acne as a disease, including over-the-counter medications. The cost of regular skin care, such as face creams, does not qualify. You must provide a letter of medical necessity from your attending physician to support the item.
Adoption & Pre-Adoption Medical Expenses	Yes	Medical expenses incurred before the adoption is final only if the child qualifies as your tax dependent when services are provided.
Air Conditioner	Dual Purpose Expense	The unit must be recommended by a medical physician to treat a specific medical condition and must be used primarily by the person who has the medical condition. If it is attached to the home (such as central air conditioning), only the amount spent that is more than the value added to the property will qualify. If others benefit from the air conditioning, then only the pro rata amount allocable to the person with the medical condition will qualify.
Air Purifier	Dual Purpose Expense	The unit must be recommended by a medical physician to treat a specific medical condition such as severe allergies. You must provide a letter of medical necessity from your attending physician to support the item..
Alcoholism	Yes	Includes amounts paid for in-patient treatment at a therapeutic center for alcohol addiction including meals and lodging. Transportation expenses to and from Alcoholics Anonymous meetings would also qualify if the attendance is pursuant to medical advice.
Allergy Medicine	Yes	See Drugs & Medicines.
Allergy Treatment Products	Dual Purpose Expense	Not reimbursable if the product would be owned even without allergies (pillow, vacuum cleaner). An air purifier or water filter necessary to treat a medical condition may be reimbursable.
Alternative Healers, Dietary Substitutes, Drugs & Medicines	Dual Purpose Expense	Non-traditional healing treatments provided by professionals must be legal. The IRS looks at these expenses very closely. The expenses do not qualify if the remedy is a food or substitute for food that the person would normally consume in order to meet nutritional requirements.
Ambulance	Yes
Antacid Medicine	Yes	See Drugs & Medicines.
Antihistamine	Yes	See Drugs & Medicines.
Appearance Improvements	No	See Cosmetic Procedures.
Artificial Limbs & Teeth	Yes
Aspirin	Yes	See Drugs & Medicines.
Automobile Modifications	Dual Purpose Expense	Yes, if for physically handicapped persons.
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Baby-Sitting & Child Care	No	Baby-sitting, child care, and nursing services for a normal, healthy baby do not qualify as medical care. See Dependent Care Expenses and Disabled Dependent Care Expenses.
Bactine	Yes	See Drugs & Medicines.
Bandages	Yes
Birth Control Pills	Yes	See Contraceptives.
Birthing Classes	Dual Purpose Expense	See Lamaze Classes.
Blood Pressure Monitoring Devices	Yes	Yes, if they are diagnostic in nature.
Blood Sugar Test Kit & Test Strips	Yes	Yes, if they are diagnostic in nature.
Body Scan	Yes	Body scans utilizing MRIs and comparable technologies are diagnostic services. See Diagnostic Items/Services and Screening Tests.
Braille Books & Magazines	Dual Purpose Expense	Includes the cost of Braille books and magazines for use by a visually impaired person. Amounts above the cost of the regular printed material will qualify.
Breast Pumps	Dual Purpose Expense	Not eligible if used for convenience, scheduling, or other personal reasons. The item may be eligible if there is a medical reason. A letter of medical necessity from your attending physician is required for this expense.
Breast Reconstruction Surgery Following Mastectomy	Yes	Yes, if the surgery was performed following a mastectomy for cancer. This is an exception to the general rules regarding cosmetic procedures.
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Calamine Lotion	Yes	See Drugs & Medicines.
Capital Expenses	Dual Purpose Expense	Includes amounts you pay for special equipment installed in a home, or for improvements, if their main purpose is medical care for you, your spouse, or your dependent. How much of the expense would qualify depends on the extent to which the expense permanently improves the property and whether others besides the person with the medical condition will benefit.
Car Modifications	Dual Purpose Expense	For physically handicapped persons only. This does not include the cost of operating a specially equipped car.
Carpal Tunnel Wrist Supports	Yes
Cayenne Pepper	Dual Purpose Expense	Yes, if used to treat a specific medical condition. A letter of medical necessity from your attending physician is required.
Chelation (EDTA) Therapy	Yes	Yes, only if used to treat a medical condition (e.g., lead poisoning).
Child Birth Classes	Dual Purpose Expense	See Lamaze Classes.
Chinese Herbal Practitioner Herbal Treatments	Dual Purpose Expense	See Alternative Healers.
Chiropractor	Yes
Chondroitin	Dual Purpose Expense	Yes, if used primarily for medical care (e.g. to treat arthritis), not just to maintain general health. A letter of medical necessity from your attending physician is required for this expense.
Christian Science Practitioner	Dual Purpose Expense	Medical expenses paid to a Christian Science practitioner are eligible. Expenses paid for other purposes generally do not qualify. See Alternative Healers.
Circumcision	Yes
Claritin	Yes
Club Dues & Fees	Dual Purpose Expense	See Health Club Fees.
COBRA Premiums (Health FSA Only)	Not Allowed	COBRA Premiums are not eligible for reimbursement from a Health FSA.
COBRA Premiums (HSA Only)	Dual Purpose	COBRA Premiums are eligible for reimbursement from a HSA.
Co-Insurance Amounts & Deductibles	Yes	Reimbursable to the extent that underlying expenses would be reimbursable if paid by the individual.
Cold Medicine	Yes	See Drugs & Medicines.
Cold/Hot Packs	Dual Purpose	Only if used to alleviate a medical condition (e.g. elbow injury).
Condoms	Yes	See Contraceptives.
Contact Lenses, Materials, & Equipment	Yes	The lenses must be needed for medical reasons. The cost of equipment and materials required for using contact lenses, such as saline solution and enzyme cleaner are also eligible. Lenses for solely cosmetic purposes are not eligible.
Contraceptives	Yes	Includes birth-control pills, condoms, and spermicidal foam.
Controlled Substances In Violation Of Federal Law	Not Allowed	If the substance violates federal law (Controlled Substances Act), the expense would not qualify even if a state law allows its use with a physician’s prescription.
Cosmetic Procedures	Dual Purpose Expense	Most cosmetic procedures do not qualify. This includes cosmetic surgery or other procedures that are directed at improving the patient’s appearance and don’t meaningfully promote the proper function of the body or prevent or treat illness or disease (face lifts, hair removal or transplants, teeth whitening, liposuction, etc.). There is an exception for procedures necessary to ameliorate a deformity arising from congenital abnormality, personal injury from accident or trauma, or disfiguring disease – these may qualify. See Breast Reconstruction Surgery.
Cosmetics	No
Cough Suppressants	Yes	See Drugs & Medicines.
Counseling	Dual Purpose Expense	Includes treatments for medical reasons, but does not include marriage counseling. You must provide a letter of medical necessity from your attending physician to support the item.
Crutches	Yes	The cost of purchasing or renting the crutches is eligible.
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Dancing Lessons	Dual Purpose Expense	Generally the cost of dancing lessons, swimming lessons, etc., does not qualify, even if recommended by a medical practitioner, if the lessons are to improve general health. But the expenditure might qualify if recommended to treat a specific medical condition (such as part of a rehabilitation program after surgery). A letter of medical necessity from your attending physician is required for this expense.
Decongestants	Yes	See Drugs & Medicines.
Dental Treatment	Yes	Includes fees paid for X-rays, fillings, braces, extractions, dentures, etc., but not teeth whitening.
Dentures & Denture Adhesives	Yes
Deodorant	No	This is used primarily for personal purposes.
Dependent Care Expenses	No	Not even if you are paying for dependent care (for example, hiring a baby-sitter) so that you can receive medical care. But see Disabled dependent care expenses. Such expenses might be reimbursable under a DCAP if applicable rules are met (but the same expenses may not be reimbursed under a health FSA or HSA and a DCAP-there is no "double-dipping" allowed). See Baby-Sitting & Child Care.
Diabetic Supplies	Yes	See Blood Sugar Test Kits & Test Strips and Insulin.
Diagnostic Items/Services	Yes	Includes procedures to determine the presence of a dysfunction or disease of the body (heart attack, stroke, diabetes, etc.).
Diapers or Diaper Service	Maybe	Standard diapers or diaper services for newborn babies is not eligible. Diapers or diaper services that are used to relieve the effects of a diagnosed medical condition do qualify. (e.g. adult diapers used to relieve incontinence).
Diaper Rash Ointments & Creams	Yes	See Drugs & Medicines.
Diarrhea Medicine	Yes
Dietary Supplements	Dual Purpose Expense	Items purchased to maintain general health are not eligible. Items may be eligible if recommended by a medical physician to treat a specific medical condition. A letter of medical necessity from your attending physician is required.
Diet Foods	Maybe	Costs of special foods to treat a specific disease (e.g. obesity) are not eligible to the extent that they satisfy ordinary nutritional requirements. Includes any excess cost that reflects amounts spent beyond ordinary nutritional requirements. See Special Foods.
Disabled Dependent Care Expenses	Dual Purpose Expense	Eligible if the expenses are for medical care of the disabled dependent. Some disabled dependent care expenses that qualify as medical expenses may also qualify as work-related expenses for purposes of the dependent care tax credit under Code 21 or for reimbursement under a dependent care assistance program under Code 129. You must not use the same expenses for more than one purpose (medical expenses reimbursed under a Health FSA cannot be used to claim a dependent care tax credit). Contact us for more information.
DNA Collection & Storage	Generally, No	Includes expenses amounts you pay for an inpatient's treatment at a therapeutic center for drug addiction, including meals and lodging during treatment.
Drug Addiction Treatment	Yes	Includes expenses amounts you pay for an inpatient's treatment at a therapeutic center for drug addiction, including meals and lodging during treatment.
Drug Overdose, Treatment Of	Yes
Drugs & Medicines - Available By Prescription Only	Dual Purpose Expense	Eligible if they are used to treat a specific condition. Cosmetic items are not eligible for reimbursement.
Drugs & Medicines - Available For Purchase Without A Prescription (Over-The-Counter Drugs Or Medicines)	Dual Purpose Expense	Eligible if they are used to treat a specific condition, are not for personal, general health, or cosmetic purposes, are legally obtained, and generally accepted as drugs and medicines.
Dual Purpose Expenses	Maybe	Dual-purpose items are items that may be used for both medical purposes and personal purposes, such as rubbing alcohol. Includes amounts spent if the items are used primarily for medical care. Letters of medical necessity from the attending physician are usually required to approve these expenses.
Dyslexia	Yes	See Language Training.
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Ear Plugs	Dual Purpose Expense	If recommended by a medical physician to treat a specific medical condition. You must provide a letter of medical necessity from your attending physician to support the item.
Egg Donor Fees	Yes	Includes egg donor fees, an agency fee, the donor’s medical and psychological testing, insurance costs for post-procedure donor medical and psychological assistance and legal fees for preparation of the egg donor contract.
Eggs & Embryos, Storage Fees	Maybe	Temporary storage fees are eligible, but only to the extent necessary for immediate conception.
Electrolysis or Hair Removal	No	This expense is considered to be cosmetic in nature.
Elevator	Dual Purpose Expense	May includes amounts spent to install an elevator upon a physician advice so that a person with heart disease does not have to climb stairs to the extent of the excess enhancement in the fair market value of the property. See Capital Expenses.
Exercise Equipment Or Programs	Dual Purpose Expense	Only if required to treat an illness (obesity) diagnosed by a physician. The purpose of the expense must be to treat the disease rather than promote general health, and the expense must not have been paid “but for” this purpose. See Capital Expenses and Health Club Fees. You must provide a letter of medical necessity from your attending physician to support the item. See Capital Expenses and Health Club Fees.
Eyeglasses, Exams, Equipment, & Materials	Yes	Materials and equipment needed for using the eyeglasses (e.g. eyeglass cleaners) are eligible. See Contact Lenses and Sunglasses.
Eye Surgery (Lasik)	Yes	Eye surgery to treat defective vision, including laser eye surgery or radial keratotomy is eligible for reimbursement.
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Face Creams & Moisturizers	No	These items are considered to be cosmetic in nature.
Face Lift	No	See Cosmetic Procedures.
Feminine Hygiene Products	Maybe	These expenses are ordinarily used to maintain general health. There may be exceptions where a medical physician recommends a product to alleviate a specific medical condition. A letter of medical necessity from your attending physician would be required.
Fertility Treatments	Maybe	Yes, to the extent that procedures are intended to overcome an inability to have children. Examples are IVF (in vitro fertilization—including temporary storage of eggs or sperm), surgery (including an operation to reverse prior surgery preventing someone from having children), shots, treatments, and GIFT (gamete intrafallopian transfer). Expenses paid to or for an in vitro surrogate do not qualify.
Fiber Supplements	Maybe	No, if used as a daily supplement to maintain general health. The expense may qualify if it is used to treat a diagnosed medical condition (such as irritable bowel syndrome) until the condition is alleviated. You must provide a letter of medical necessity from your attending physician to support the item.
First Aid Cream	Yes	See Drugs & Medicines.
First Aid Kits	Yes
Fitness Programs	Dual Purpose Expense	See Exercise Equipment or Programs.
Flu Shots	Yes	Immunizations to prevent disease are eligible for reimbursement even if no medical condition has been diagnosed.
Fluoridation Device or Service	Yes	Yes, if the device or service is recommended by a dentist to prevent tooth decay. The reimbursable amount is limited to the cost allocable to the current plan year. You must provide a letter of medical necessity from your attending physician to support the item.
Founder's Fee	No	Founder’s fees are amounts you pay under an agreement with a retirement home. Even if a portion is allocable to medical care, these expenses do not qualify.
Funeral Expenses	No
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Gambling Problem	Maybe	See Alcoholism.
Gauze Pads	Yes	See Bandages.
Genetic Testing	Maybe	To the extent that testing is done to determine possible defects (for example, the possible defects of an unborn child if the mother is over age 35), it is probably medical care. Testing done just to determine the sex of the fetus does not qualify. You must provide a letter of medical necessity from your attending physician to support the item.
GIFT (Gamete Intrafallopian Transfer)	Maybe	See Fertility Treatments.
Glucosamine	Maybe	See Chondroitin.
Glucose Monitoring Equipment	Yes	Includes amounts spent on blood glucose meters and glucose test strips and other diagnostic items. See Diagnostic Items/Services.
Guide Dog or Other Animal	Yes	If the expense is for buying, training, and caring for an animal used by a physically disabled person. Veterinary fees for the care of such animals also qualify as medical care. You must provide a letter of medical necessity from your attending physician to support the item. See Veterinary Fees.
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Hair Colorants	No	These expenses are considered to be personal and/or cosmetic in nature.
Hair Removal & Transplants	No	These expenses are considered to be personal and/or cosmetic in nature.
Hand Lotion	No	These expenses are considered to be personal and in nature.
Health Club Dues & Fees	Dual Purpose Expense	Only in very limited circumstances would fees paid to a health club qualify. One instance might be where fees are incurred upon the advice of a medical practitioner to treat a specific medical condition such as rehabilitation after back surgery or treatment for obesity. The expense must not have been incurred “but for” the disease (for example, if you belonged to the health club before being diagnosed, then the fees would not qualify). When treatment is no longer needed, the fees would no longer qualify. You must provide a letter of medical necessity from your attending physician to support the item. See Weight-Loss Programs.
Health Institute Fees	Dual Purpose Expense	If the treatment at the health institute is prescribed by a physician who provides a letter of medical necessity stating that the treatment is necessary to alleviate a physical or mental defect or illness of the individual receiving the treatment, it may be eligible.
Health Reimbursement Arrangements (HRAs)	No	Expenses reimbursed by an HRA cannot also be reimbursed under a health FSA (no double-dipping).
Hearing Aids	Yes	The cost of the hearing aid and the batteries to operate it are eligible for reimbursement.
Hemorrhoid Treatments	Yes	See Drugs & Medicines.
Herbs	Dual Purpose Expense	See Vitamins.
Holistic Or Natural Healers	Dual Purpose Expense	See Alternative Healers.
Home Care	Dual Purpose Expense	See Nursing Services.
Home Improvements	Dual Purpose Expense	The expense may be eligible if completed to accommodate a disability. If the improvement is permanent and increases the value of the property, the expense will qualify only to the extent that the improvement cost exceeds the increase in property value. If the improvement doesn’t increase the property value at all, then the entire cost may qualify. Items that usually don’t increase property value include constructing entrance or exit ramps, widening or modifying doorways or hallways, installing railings or support bars to bathrooms, lowering or modifying kitchen cabinets or equipment, moving or modifying electrical outlets and fixtures, installing porch lifts, modifying fire alarms or smoke detectors, modifying other warning systems, and modifying stairways. See Capital Expenses, Elevator, and Air Conditioner.
Hormone Replacement Therapy (HRT)	Dual Purpose Expense	If the item used primarily for medical care (hot flashes, night sweats, etc.) then it may be eligible for reimbursement. If the item is used to maintain general health, it is not eligible for reimbursement. You must provide a letter of medical necessity from your attending physician to support the item. See Drugs & Medicines.
Hospital Services	Yes	Includes expenses for inpatient care at a hospital or similar institution if the principal reason for being there is to receive medical care. Amounts paid for meals and lodging are also included. See Lodging At A Hospital.
Hot/Cold Packs	Dual Purpose Expense	Only if used to alleviate a medical condition (e.g. elbow injury).
Household Help	No	No, even if a medical practitioner recommends such help. See Nursing Services. In some cases, limited household services may be reimbursable under a Dependent Care Assistance Plan (DCAP), if the household services are incidental to the custodial care of a dependent or of a spouse incapable of self-care.
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Illegal Operations & Treatments	No	These expenses are not eligible for reimbursements even if they are rendered or prescribed by licensed medical practitioners.
Immunizations	Yes	Immunizations to prevent disease are eligible for reimbursement even if no medical condition has been diagnosed
Inclinator	Yes	Yes, if it otherwise qualifies as medical care, is detachable from the property, and is purchased only for use by the person with the medical condition. See Capital Expenses.
Incontinence Supplies	Dual Purpose Expense	If used to relieve the effects of a particular disease, the expense may be reimbursable. For example, adult diapers used to relieve incontinence may qualify, even though diapers for healthy newborns do not. Although a personal element may be involved in using adult diapers, they wouldn’t have been bought “but for” the medical condition. See Diapers.
Infertility Treatments	Yes	See Fertility Treatments.
Insect Bite Creams & Ointments	Yes	See Drugs & Medicines.
Insulin	Yes	See Glucose Monitoring Equipment.
Insurance Premiums (Health FSA Only)	No
Insurance Premiums (HSA Only)	Dual Purpose Expense	Generally, an HSA cannot reimburse payments for health insurance premiums or contributions for self-funded health coverage. Consequently, neither the account holder nor his or her spouse can pay for high-deductible health plan (HDHP) coverage or other health coverage from the HSA. However, an HSA can reimburse expenses for coverage under any of the following: COBRA coverage; a qualified long-term care insurance contract; any health plan maintained while the individual is receiving unemployment compensation under federal or state law; or, for those age 65 or older (whether or not they are entitled to Medicare), any deductible health insurance (e.g., retiree medical coverage) other than a Medicare supplemental policy. Note: Long-term care insurance premium reimbursements that exceed certain limits will be treated as taxable and may be subject to an additional 10% excise tax. Also see COBRA Premiums.
IVF (In Vitro Fertilization)	Yes	See Fertility Treatments.
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Laboratory Fees	Yes
Lactation Consultant	Dual Purpose Expense	If a woman is having lactation problems and cannot breastfeed her child, then the expense of a lactation consultant helping to overcome this dysfunction might qualify. You must provide a letter of medical necessity from your attending physician to support the item.
Lamaze Classes	Yes, To An Extent	Includes expenses to the extent that instruction relates to birth and not childbearing.
Language Training	Yes	If the training is for a child with dyslexia or for a disabled child, it is eligible for reimbursement. School fees for regular schooling normally don’t qualify.
Laser Eye Surgery, Lasik	Yes
Learning Disability	Maybe	Only if prescribed by a physician. Tuition fees paid to a special school and tutoring fees paid to a specially-trained teacher for a child who has severe learning disabilities caused by mental or physical impairments (such as nervous system disorders) are eligible for reimbursement. You must provide a letter of medical necessity from your attending physician to support the item. See Schools & Education, Special.
Legal Fees, General	Dual Purpose Expense	Legal fees may qualify as medical care if they bear a direct or proximate relationship to the provision of medical care to you, your spouse or your dependent—for example, if the medical care could not have been provided without legal assistance. Fees for legal services retained to authorize treatment for mental illness may qualify. But legal fees for management of a guardianship estate for conducting the affairs of the person being treated or other fees that aren’t necessary for medical care do not qualify; neither do divorce costs. See Legal fees in connection with fertility treatments.
Legal Fees In Connection W/Fertility Treatments	Dual Purpose Expense	If the legal fees are in connection with a medical procedure performed upon you (or your spouse or dependent), they may be eligible for reimbursement. Legal fees for preparing a contract for you to obtain a donated egg from an egg donor may also qualify. Legal fees incurred in connection with a procedure performed on a surrogate mother do not constitute medical care. See Fertility Treatments and Legal Fees, General.
Lipstick	No	These expenses are considered to be personal and/or cosmetic in nature.
Liquid Adhesive For Small Cuts	Yes	See Bandages.
Lodging At A Hospital Or Similar Institution	Yes	If the main reason for being there is to receive medical care, it may be eligible for reimbursement. See Meals At A Hospital or Similar Institution and Schools & Education, Residential.
Lodging NOT At A Hospital Or Similar Institution	Dual Purpose Expense	Yes, up to $50 per night if these conditions are met: (1) the lodging is primarily for and essential to medical care; (2) the medical care is provided by a physician in a licensed hospital or medical care facility related to (or equivalent to) a licensed hospital; (3) the lodging isn’t lavish or extravagant; and (4) there is no significant element of personal pleasure, recreation, or vacation in the travel. If a parent is traveling with a sick child, up to $100 may qualify ($50 for each person).
Lodging Of A Companion	Dual Purpose Expense	If accompanying a patient for medical reasons and all of the conditions described under Lodging not at a hospital are also met, the expense may be eligible for reimbursement. For example, if a parent is traveling with a sick child, up to $100 per night ($50 for each person) will qualify. See Lodging NOT At A Hospital Or Similar Institution.
Lodging While Attending A Medical Conference	No
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Makeup	No	These expenses are considered to be personal and/or cosmetic in nature.
Marijuana	No	See Controlled Substances and Illegal Operations & Treatments.
Massage Therapy	Dual Purpose Expense	If the massage therapy was recommended or prescribed by a physician to treat a specific injury or trauma, then it may be eligible for reimbursement. A letter of medical necessity from your attending physician is required for this expense.
Maternity Clothes	No
Mattresses	Dual Purpose Expense	A portion of the expenditure might qualify if a unique type of mattress is prescribed by a physician to treat a specific medical condition. A letter of medical necessity from your attending physician is required for this expense. See Capital Expenses.
Meals At A Hospital Or Similar Institution	Yes	These expenses would be eligible for reimbursement if the main reason for being there is to receive medical care. See Lodging At A Hospital Or Similar Institution, Schools and Education, Residential, and Schools and Education, Special.
Meals NOT At A Hospital Or Similar Institution	No
Meals Of A Companion	No
Meals While Attending A Medical Conference	No
Medic Alert Bracelet or Necklace	Yes	If recommended by a medical physician in connection with treating a specific medical condition. A letter of medical necessity from your attending physician is required for this expense.
Medical Conference Admission, Transportation, Meals, etc.	Dual Purpose Expense	Yes. Expenses for admission and transportation to a medical conference qualify, if they relate to a chronic disease suffered by you, your spouse, or your dependent and if the conference is primarily for and essential to the person in need of medical care. Includes transportation expenses to the city where the conference is held, plus local transportation to the conference. Most of the time at the conference must be spent attending sessions on medical information. The expenses of meals and lodging while attending the conference don’t qualify. You must provide a letter of medical necessity from your attending physician to support the item.
Medical Information Plan Charges	Yes	The storage costs paid to a plan to keep medical information so that it can be retrieved from a computer databank for your (or your spouse’s or dependent’s) medical care is eligible for reimbursement.
Medical Monitoring & Testing Devices	Yes	Includes blood pressure monitors, syringes, glucose kit, etc.
Medical Newsletters	No
Medical Records Charges	Yes	Includes costs associated with the transfer of medical records to a new physician.
Medical Services	Yes	Includes expenses for legal medical services recommended by physicians, surgeons, specialists, and other medical practitioners.
Medicare Part B Premiums	No	Medicare Part B Premiums, like health insurance premium, are not reimbursable under a health FSA. See Insurance Premiums.
Medicines & Drugs	Dual Purpose Expense	See Drugs & Medicines.
Menstrual Pain Relievers	Yes	See Drugs & Medicines.
Motion Sickness Pills	Yes	See Drugs & Medicines.
Mouthwash	No
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Nasal Strips or Sprays	Yes
Naturopathic Healers, Dietary Substitutes, & Drugs & Medicines	Dual Purpose Expense	See Alternative Healers; Drugs and Medicines, Special Foods, and Vitamins.
Nicotine Gum & Patches	Yes
Non-Prescription Drugs & Medicines	Dual Purpose Expense	See Drugs & Medicines.
Norplant Insertion Or Removal	Yes	See Contraceptives, Birth Control Pills, Vasectomy, and Spermicidal Foam.
Nursing Services For A Baby	No	These expenses would only be eligible when the baby is not normal and healthy.
Nutritional Supplements	Dual Purpose Expense	See Drugs & Medicines.
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Obstetrical Expenses	Yes
Occlusal Guards To Prevent Teeth Grinding	Yes
One-A-Day Vitamins	Generally, No	See Vitamins.
Operations	Yes	As long as the operations are legal and are not cosmetic in nature, they are eligible for reimbursement.
Optometrist	Yes	See Eyeglasses, Exams, Equipment, & Materials.
Organ Donors	Yes	See Transplants.
Orthodontia	Generally, Yes	Since orthodontic expenses may span two or more plan years, reimbursements are limited to the amounts attributable to the current plan year. Reimbursements are made as the services are incurred throughout the Plan Year. See Dental Treatment and Pre-Payments.
Orthopedic Shoes & Inserts	Dual Purpose Expense	Costs of specialized orthopedic items qualify to the extent that they exceed ordinary personal use requirements. For example, only the excess cost of the specialized orthopedic shoe over the cost of a regular shoe qualifies for reimbursement. You must provide a letter of medical necessity from your attending physician to support the item.
Osteopath	Yes
Over-The-Counter (OTC Medicines)	Dual Purpose Expense	See Drugs & Medicines.
Ovulation Monitor	Yes	See Medical Monitoring & Testing Devices.
Oxygen	Yes	Includes amounts paid for oxygen and oxygen equipment to relieve breathing problems caused by a medical condition.
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Pain Relievers	Yes	See Drugs & Medicines.
Patterning Exercises	Yes	Expenses of hiring someone to give patterning exercises to a mentally retarded child qualify. These exercises consist mainly of coordinated physical manipulation of a child’s arms and legs to imitate crawling and other normal movements.
Perfume	No	These expenses are considered to be personal and/or cosmetic in nature.
Permanent Waves	No	These expenses are considered to be personal and/or cosmetic in nature.
Personal Trainer Fees	Dual Purpose Expense	If the expenses are incurred for a limited time and a medical physician has recommended a professionally supervised exercise program to treat a specific disease or injury (for example, rehabilitation after surgery or the treatment of obesity), it may be eligible for reimbursement. The expense must not have been incurred “but for” the disease (e.g., if you were working with a personal trainer before being diagnosed, the expense would not qualify). You must provide a letter of medical necessity from your attending physician to support the item. See Weight-Loss Programs.
Physical Exams	Generally, Yes	Does not include employment-related physicals.
Physical Therapy	Yes
Pregnancy Test Kits	Yes	See Medical Monitoring & Testing Devices.
Prenatal Vitamins	Dual Purpose Expense	The vitamins are eligible for reimbursement during pregnancy only. Vitamins taken at other times generally do not qualify. A letter of medical necessity from your attending physician is required for this expense and should include the approximate length of the pregnancy. See Vitamins.
Pre-Payments	Maybe	Generally, pre-payments for services/items that have not yet been incurred/obtained are not reimbursable under a health FSA. See Orthodontia.
Prescription Drugs	Dual Purpose Expense	See Drugs & Medicines.
Prescription Drug Discount Programs	No	The fee to purchase a discount card is not eligible for reimbursement. However, the prescribed drug itself may be eligible for reimbursement. See Drugs & Medicines.
Propecia	No	Generally no, if purchased for cosmetic purposes (for example, to treat male pattern baldness), even if recommended by a medical physician. But the expense may qualify if it is for a specific medical condition such as the propecia ameliorates a deformity arising from congenital abnormality, personal injury from accident or trauma, or disfiguring disease. See Cosmetic Procedures and Drugs & Medicines.
Prosthesis	Yes	See Artificial Limbs & Teeth.
Psychiatric Care	No	Includes the cost of supporting a mentally ill dependent at a medical center.
Psychoanalysis	Dual Purpose Expense	Yes, if provided for medical care, and not just for the general improvement of mental health, relief of stress, or personal enjoyment, nor if the expense stems from training to be a psychoanalyst. See Psychologist and Therapy.
Psychologist	Dual Purpose Expense	Yes, if the expense is for medical care, and not just for the general improvement of mental health, relief of stress, or personal enjoyment. See Therapy.
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Radial Keratotomy	Yes	Corneal ring segments (removable plastic half-rings that correct vision) would also qualify. See Laser Eye Surgery and Vision Correction Procedures. See Laser Eye Surgery and Vision Correction Procedures.
Reading Glasses	Yes	See Eyeglasses, Exams, Equipment, & Materials.
Retin-A	Dual Purpose Expense	Generally no, if purchased for cosmetic purposes (for example, to reduce wrinkles), even if recommended by a medical physician. The expense may qualify if prescribed by a physician for a specific medical condition (such as for acne vulgaris) and not for cosmetic purposes. A letter of medical necessity from your attending physician is required for this expense. See Acne Treatment and Cosmetic Procedures.
Rogaine	No
Rubbing Alcohol	Dual Purpose Expense	Yes, if used primarily for medical care (for example, as a disinfectant for medical items); no, if used for personal purposes (for example, cleaning your motorcycle).
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Safety Glasses	No
Schools & Education, Residential	Dual Purpose Expense	Certain payments made to a residential school or program to treat individuals for behavioral, emotional, and/or addictive conditions qualify if the primary purpose of the program is medical care. (Educational services can be an incidental but not primary component.) Whether someone is attending to receive medical care is a question of fact that must be determined for each individual—just because a school or program provides medical care to some individuals does not mean that it necessarily provides medical care to all individuals. If the child is at the school simply to benefit from the courses and disciplinary methods, the expenses won’t qualify—sending a person to attend a program to resolve bad personal attitudes in a structured environment does not constitute medical care. s taken at other times generally do not qualify. You must provide a letter of medical necessity from your attending physician to support the item. See Schools & Education, Special.
Schools & Education, Special	Dual Purpose Expense	Payments made to a special school for a mentally impaired or physically disabled person qualify if the main reason for using the school is its resources for relieving the disability. This includes teaching Braille to a visually impaired person, teaching lip reading to a hearing impaired person, and giving remedial language training to correct a condition caused by a birth defect. Meals, lodging, and ordinary education supplied by the special school is only medical care if the child is at the school primarily for relieving the disability. If the child is at the school simply to benefit from the courses and disciplinary methods, the expenses won’t qualify. You must provide a letter of medical necessity from your attending physician to support the item. See Schools & Education, Residential.
Screening Tests	Yes	Yes, if the tests are used for medical diagnoses. Examples include hearing, vision, and cholesterol screenings. Also see Body Scans and Diagnostic Items/Services.
Seeing-Eye Dog	Yes	See Guide Dog.
Shampoos & Soaps	No	These expenses are considered to be personal and/or cosmetic in nature.
Shaving Cream Or Lotion	No	These expenses are considered to be personal and/or cosmetic in nature.
Shipping & Handling Fees	Yes	Shipping and handling fees incurred to obtain an item that constitutes medical care (e.g., drugs or medicine) are inextricably linked to the cost of the medical care and therefore qualify.
Sinus Medicines	Yes	See Drugs & Medicines.
Skin Moisturizers	No	These expenses are considered to be personal and/or cosmetic in nature.
Sleep Deprivation Treatment	Yes	Reimbursable if the person is under care of a medical practitioner for treatment of a medical condition.
Smoking Cessation (Stop-Smoking) Programs	Yes	Amounts paid for a stop-smoking program are reimbursable as are the amounts for prescribed drugs. See Drugs & Medicines.
Special Foods (Such as foods needed for a gluten-free or salt-free diet.)	Dual Purpose Expense	Yes, 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 cost of commonly available versions of the same product. See Drugs & Medicines and Vitamins.
Spermicidal Foam	Yes	See Contraceptives.
Sperm, Storage Fees	Maybe	Reimbursable only to the extent necessary for immediate conception.
St. John's Wort	Dual Purpose Expense	If the item is used primarily for medical care (for example, to treat a diagnosed medical condition such as depression), then it is eligible for reimbursement. The item is not eligible is used to maintain general health. You must provide a letter of medical necessity from your attending physician to support the item.
Stem Cell, Harvesting and/or Storage of	Dual Purpose Expense	Perhaps, if there is a specific and imminent medical condition that the stem cells are intended to treat. For example, the cost of harvesting and storing stem cells because a newborn has a birth defect and the stem cells would be needed in the near future might be allowable. But collection and storage indefinitely, just in case an item might be needed, is not medical care. You must provide a letter of medical necessity from your attending physician to support the item. See DNA Collection & Storage, Pre-Payments, and Umbilical Cord, Freezing & Storing Of.
Sterilization	Yes	Includes the cost of a legal sterilization.
Student Health Fee	Dual Purpose Expense	The cost of being a member of the program is not eligible for reimbursement, but specific medical services may qualify.
Sunglasses	Dual Purpose Expense	The glasses must be prescription sunglasses in order to be eligible for reimbursement.
Sunburn Creams & Ointments	Dual Purpose Expense	If used to treat a sunburn (and not as regular skin moisturizers). See Drugs & Medicines and Sunscreen.
Sunscreen	Dual Purpose Expense	Sunscreen generally does not qualify. But it would qualify if used by a person who has or has had skin cancer or another diagnosed skin disease that is affected by sun exposure. Items like face lotion that contain a small sunscreen component do not qualify, nor do suntan lotions. You must provide a letter of medical necessity from your attending physician to support the item.
Supplies To Treat Medical Conditions	Yes	Reimbursable to the extent the medical supply is used to diagnose or treat a specific medical condition.
Surgery	Yes	See Operations.
Surrogate Expenses	No	Generally no, even if they are for medical care of the surrogate or her unborn child. The procedure must be performed upon you, your spouse, or your dependent in order to be medical care. See Fertility Treatments, Egg Donor Fees; Eggs and Embryos, Storage Fees, Legal Fees In Connection With Fertility Treatments, and Sperm, Storage Fees.
Swimming Lessons	Dual Purpose Expense	See Dancing Lessons.
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Tanning Salons & Equipment	No	These expenses are considered to be personal and/or cosmetic in nature.
Teeth Whitening	No
Telephone for Hearing-Impaired Persons	Yes	Includes the cost of special telephone equipment that lets a hearing-impaired person communicate over a regular telephone. See Capital Expenses.
Television for Hearing-Impaired Persons	Yes	Yes, for equipment that displays the audio part of television programs as subtitles for hearing impaired persons. But the amount that qualifies is limited to the excess of the cost over the cost of the regular item. For example, the cost of a specially equipped television qualifies only to the extent that it exceeds the cost of a regular model. See Capital Expenses.
Therapy	Yes	Eligible if provided for medical care (and not just for the general improvement of mental health, relief of stress, or personal enjoyment). See Patterning Exercises, Psychoanalysis, Psychologist, and Schools & Education, Residential/Special.
Thermometer	Yes	Yes, if for medical use. See Supplies To Treat Medical Conditions.
Throat Lozenges	Yes	See Drugs & Medicines.
Toiletries	No	This is a personal use item.
Toothache and Teething Pain Relievers	Yes	See Drugs & Medicines.
Toothbrushes	No
Toothpaste	No
Transplants	Yes	Includes expenses for medical care received by a donor or a possible donor of a kidney or other organ, including transportation.
Transportation Expenses for Person to Receive Medical Care	Yes	Will qualify if the expenses are primarily for and essential to medical care. It must be incurred to alleviate some specific ailment or disease of the participant and not merely be for the general improvement of the participant's health. Sufficient documentation must be submitted to approve this expense and may require a physician's letter of medical necessity. For example, if a doctor prescribes an operation or other medical care, and if the participant chooses for purely personal considerations to travel to another locality (such as a resort area) for the treatment, then the cost of the transportation will not qualify. These include car expenses, but, taxi, train, plane, and ferry fares, and ambulance services. Instead of actual car expenses, a standard mileage rate (18 cents per mile for 2006; 20 cents per mile for 2007) for use of a car to obtain medical care is allowed. Parking fees and tolls can also qualify.
Treadmill	Dual Purpose Expense	See Exercise Equipment and Capital Expenses.
Tuition For Special Needs Program	Dual Purpose Expense	If the primary purpose is for medical care, it may be eligible for reimbursement. Includes reading program for dyslexia. See Learning Disability.
Tuition Evidencing Separate Breakdown For Medical Expenses	Yes	Yes, to the extent that charges for medical expenses are separately broken down in a bill for tuition for a college or private school and are for specific qualified medical services/items that have been incurred/obtained (and are not premiums for medical care generally). See Student Health Fee and Insurance Premiums.
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Umbilical Cord, Freezing & Storing Of	Dual Purpose Expense	Perhaps, if there is a specific medical condition that the umbilical cord is intended to treat. Collection and storage indefinitely, just in case it is needed, is not medical care. “Temporary” is not defined—one consideration might be whether it is stored and used within the same year. The cost of storing cord blood where a newborn has a birth defect and where the cord blood would be needed in the near future might qualify. You must provide a letter of medical necessity from your attending physician to support the item. See Pre-Payments.
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Vaccines	Yes	See Immunizations.
Varicose Veins	Maybe	Generally no, if the procedure merely improves appearance and doesn’t meaningfully promote the proper function of the body or prevent or treat illness or disease. May qualify if the procedure promotes the proper function of the body or prevents or treats an illness or disease. You must provide a letter of medical necessity from your attending physician to support the item. See Cosmetic Procedures.
Vasectomy	Yes
Veterinary Fees	Dual Purpose Expense	Yes, if the veterinary fees are incurred for the care of a guide dog or other animal used by a disabled person. Otherwise, no.
Viagra	Yes	If prescribed by a physician to treat a medical condition.
Vision Correction Surgery	Yes	Yes, medical procedures that correct vision, including laser procedures such as Lasik and radial keratotomy, qualify. See Laser Eye Surgery and Radial Keratotomy.
Vision Discount Programs	No	Generally no. See Insurance Premiums. But will qualify to the extent that an expense is for actual medical treatment (such as an eye exam).
Vitamins	No	No, if they are used to maintain general health (e.g., one-a-day vitamins). But under narrow circumstances, vitamins might qualify if recommended by a medical practitioner for a specific medical condition (for example, a prescribed dosage of Vitamin B-12 daily to treat a specific vitamin deficiency). A letter of medical necessity from your attending physician is required for this expense. See Prenatal Vitamins, Dietary Supplements, and Special Foods.
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Wart Removal Treatments	Yes
Weight-Loss Programs And/Or Drugs Prescribed To Induce Weight-Loss	Dual Purpose Expense	Yes, if the weight-loss program is recommended by a physician to treat an existing disease (such as obesity, heart disease, or diabetes) and is not simply to improve general health. However, the costs of food associated with a weight-loss program (such as special pre-packaged meals) would not qualify, since it just meets normal nutritional needs. You must provide a letter of medical necessity from your attending physician to support the item. See Exercise Programs, Health Club Fees, and Special Foods.
Wheelchair	Yes	Includes amounts paid for an autoette or a wheelchair used mainly for the relief of sickness or disability, and not just to provide transportation to and from work. The cost of operating and keeping up the autoette or wheelchair is also a medical expense.
Wigs	Maybe	Maybe, if the wig is prescribed by a physician for the mental health of a patient who has lost all of his or her hair from disease or treatment (e.g., chemotherapy or radiation). A letter of medical necessity from your attending physician is required for this expense.
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X-Ray	Yes	Includes amounts paid for X-rays for medical reasons.

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