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Eligible Healthcare Expenses
( See IRSPublication502 )

This list has been compiled for the convenience of our clients and participants and is designed to provide a general overview. Readers are cautioned to review their own employer-sponsored benefit plan descriptions and enrollment material for specific information or to consult with their employer or personal tax advisor as necessary. This information is subject to change at any time and without notice.

Eligible medical care expenses include amounts paid for the diagnosis, cure, mitigation, treatment or prevention of disease, and for treatments affecting any part or function of the body. The expenses must be primarily to alleviate or prevent a physical or mental defect or illness. Expenses solely for cosmetic reasons are not generally expenses for medical care and may not be eligible. Expenses that are merely beneficial to one's general health are not expenses for medical care. In some cases, you may be asked to provide a letter of medical necessity from your attending physician to substantiate your claim.

IMPORTANT:
As of January 1, 2011, over-the-counter (OTC) medicines and drugs require a written prescription (Rx) from your doctor in order to get reimbursed. In addition, OTC drugs or medicines cannot be purchased with a healthcare card such as the PayFlex Card®. Please keep this new federal requirement in mind when using your healthcare account for expenses incurred on or after January 1, 2011.

*Items marked with (Rx Required) require a prescription starting January 1, 2011


A (top)

Acne treatment, includes over-the-counter acne medications; excludes cost of regular skin care (Rx required – see notice above)

Acupuncture

Alcoholism treatment

Allergy treatments (over-the-counter drugs, prescription medications and allergy shots) (Rx required – see notice above)

Alternative healers, professional fees of

Ambulance service

Antacids (Rx required – see notice above)

Artificial insemination

Artificial limb/teeth

Autoette (wheelchair)

Automobile modifications (if medically necessary)

B (top)

Battery-powered toothbrush (if medically necessary and prescribed by physician)

Birth control prescriptions (also inclues Norplant, Mirena)

Birth control, over-the-counter drugs (spermicides) (Rx required – see notice above)

Birth control, over-the-counter supplies (condoms, ovulation kits)

Blood pressure monitoring devices

Body scans for diagnostic purposes

Bone density testing

Braille books and magazines (excess of amount paid over cost of regular printed editions) bought for visually impaired person

Breast pumps and supplies that assist lactation

C (top)

Capital expenditures (See IRSPublication502 - Capital Expenses [Only a qualified financial or tax consultant can make an absolute determination with regard to the qualification of capital expenditures])

Childbirth expenses (physician, midwife)

Childbirth preparation classes (excludes portion of mother’s coach, feeding and newborn care)

Chiropractor professional fees

Cholesterol testing

Christian Science Practitioner fees

Circumcision

Co-insurance, co-pay amounts and deductibles

Cold Medicine (over-the-counter drugs including sore throat sprays, lozenges, nasal sprays, cough syrups, cough drops, vapor rubs and prescription medications) (Rx required – see notice above)

Computer data bank fees, medical history

Contact lenses and cleaning solutions

Cosmetic surgery and procedures to correct congenital abnormality or treat injury resulting from accident

Counseling (for treatment of specific medical condition)

Crutches

D (top)

Deductibles

Dental treatment (includes exams, x-rays, fillings, root canals, gum disease treatment, crowns, bridges, dentures, implants, sealants, extractions, orthodontia; does not include cosmetic treatments such as teeth whitening, dental veneers, bonding, etc.)

Dental veneers (for non-cosmetic reasons)

Diabetic supplies (insulin, syringes, testing strips, glucometers)

Diagnostic services and tests

Diapers (if required due to medical condition)

Drug dependency treatments

Drugs (prescription drugs, insulin; see Over-the-counter Drugs/Medicines; does not include cosmetic drugs (e.g., Retin-A, Renova, Propecia, etc.)

Dyslexia treatment

E (top)

Egg donor charges for recipient

Eye surgery (cataract, LASIK, corneal rings, etc.)

Eyeglasses, prescription (includes prescription sunglasses; also includes over-the-counter reading glasses)

Eye examinations

F (top)

Fertility exams

Fertility treatments (ovulation predictor kits and pregnancy tests, in vitro fertilization, surgery or operations to reverse a prior surgery that prevents you from having children)

First Aid Kit

Flu shots

Fluoridation device (if medically necessary & prescribed by physician)

G (top)

Genetic testing

Guide dog or other animal used to assist persons with physical disabilities

Gynecologists’ fees

H (top)

Health institute

Health insurance deductibles (associated with specific costs)

Health screening (cholesterol checks, bone density testing, blood pressure testing, hearing exams)

Hearing aids and batteries

Home health care

Home medical equipment

Home modifications for handicapped person (see capital expense)

Hospital services

Hypnosis for medical reasons

I (top)

Immunizations

In vitro fertilization

Inclinator

Infertility treatments

Insulin and syringes

L (top)

Laboratory fees

Lamaze classes (see childbirth classes)

Language training for child with dyslexia or disabled child

Laser eye surgery (cataract, LASIK, corneal rings, etc.)

Lead-based paint removal

Learning disability caused by mental or physical impairment, or nervous system disorders (treatment must be recommended by physician - see IRSPublication502 - Learning Disability)

Legal fees (fees you pay that are necessary to authorize treatment for mental illness)

Lodging (see IRSPublication502 - Lodging)

Long-term care services

M (top)

Mastectomy-related special bras (the cost over & above the cost of a normal bra)

Meals (only as part of inpatient hospital care)

Medic-alert bracelet

Medical conference admission and transportation to/from (if concerns chronic medical condition of you, spouse or child)

Medical equipment (crutches, wheelchairs, walkers)

Medical information plan

Medical monitoring and testing devices

Medical records charges

Medical services provided by physicians, surgeons, specialists or other medical practitioners

Medical Supplies (bandages, band-aids, gauze pads, thermometers, hot/cold packs, heating pads, nasal (breathe-right) strips, etc.)

Medicines/Drugs (prescription drugs, see Over-the-counter Drugs/Medicines with a prescription, insulin; does not include cosmetic drugs)

Mentally handicapped, special home for person adjusting from life in mental institution to community living

Mileage or fares related specifically to an eligible medical visit to and from healthcare providers, hospitals and pharmacies. Effective January 1, 2013 and until further IRS notice, the standard mileage rate for the use of a car (also vans, pickups or panel trucks), for eligible medical visits has been increased to $.24 per mile. The prior rate for travel that occurred between January 1, 2012 through and December 31, 2012 is $.23. Actual fares for buses, taxis, trains and subways are reimbursable for the full cost. Submit an itemized statement showing date of service for each trip.

N (top)

Norplant insertion and removal

Nursing home (if necessary for medical care and only the portion for medical services)

Nursing services

Nutritionist’s professional expenses (if treating a specific medical condition; not for weight loss for general health)

O (top)

Obstetrical expenses

Occlusal guards to prevent teeth grinding

Occupational therapy

Operations (legal operations that are not cosmetic in nature)

Optometrist fees

Oral surgery

Organ donation fees

Orthodontia (see Claim Filing Instructions)

Orthopedic devices

Orthopedic shoes (to the extent the cost exceeds that of normal shoes)

Osteopath fees

Over-the-counter Drugs/Medicines with a prescription (allergy medicines, antacids, anti-diarrhea, anti-fungal ointments and creams, antiseptic ointments and creams, cold medicines including sore throat sprays, lozenges, nasal sprays, cough syrups, cough drops, vapor rubs, eye drops, first-aid and antibiotic creams and ointments, gas relief medicines, hemorrhoid ointments and creams, laxatives, lice treatments, motion-sickness pills, pain relievers including arthritis pain, head/back pain and menstrual pain, sleep aids, stop smoking gums/patches, yeast infection products. Cosmetic items, vitamins, herbal and dietary supplements or items for general good health are not considered OTC drugs/medicines and are not eligible even with a prescription.)

Over-the-counter Supplies (such as crutches, bandages, OTC eyeglasses)

Ovulation monitor

Oxygen equipment

P (top)

Pain Relievers (for arthritis pain, head/back pain, menstrual pain, muscle or joint pain, e.g., aspirin, ibuprofen; does not include vitamins or herbal supplements) (Rx required – see notice above)

Patterning exercises

Physical exams, routine physicals

Physical therapy

Physicians’ fees

Pregnancy test, over-the-counter

Prescription drugs (for non-cosmetic reasons)

Prescription eyeglasses or prescription sunglasses

Prosthesis

Psychiatrists’ fees (for medical reasons)

Psychologists’ fees (for medical reasons)

Psychotherapists’ fees (for medical reasons)

Psychoanalysis

Psychologist fees

R (top)

Radial keratotomy/Ortho keratology

Reading glasses (prescription glasses or over-the-counter glasses)

Reconstructive surgery following mastectomy

Reverse vasectomy

Routine physicals

S (top)

Schools and education, special (for mentally impaired or physically disabled person - see IRSPublication502)

Shipping & Handling charges for medical needs (for mail-order prescriptions and over-the-counter supplies and prescriped over-the-counter drugs and medicines)

Sick-child care facility (for medical care only)

Skilled nurses’ fees paid for medical reasons- including room, board and Social Security taxes

Sleep disorder and treatment

Speech therapy

Sterilization procedures (vasectomy or tubal ligation)

Stop-smoking programs (including hypnosis, over-the-counter gums and patches will require a prescription) (Rx required – see notice above)

Storage fees for embryo or sperm (fees for temporary storage of eggs or sperm only to extent used for immediate conception in current plan year)

Storage fees for umbilical cord blood (fees for temporary storage only to extent used for medical condition in current plan year)

Substance abuse treatment

Sunglasses (only if medically required due to specific medical condition & obtained at direction of physician)

Surgical fees (for legal operations not cosmetic in nature)

T (top)

Taxes charged for medical services and products

Telephone consultations with a health care provider

Telephone or Television for hearing-impaired persons, special equipment

Therapy, physical or speech

Transplants (donor expenses, if you pay those expenses)

Transportation including mileage, fare for bus, taxi, train, plane and related travel expenses for person seeking treatment (See 'Mileage' and IRSPublication502 - Transportation and Trips)

Treatment for substance addiction

U (top)

Usual and customary, charges in excess of

V (top)

Vaccines, vaccinations

Vasectomy

Vitamins (only if necessary to treat a specific medical condition and accompanied with a Letter of Medical Necessity)

W (top)

Walkers

Weight-loss program (only if medically necessary to treat existing disease (such as heart disease) and undertaken under physician’s direction)

Wheelchair

Wigs (if purchased upon advice of physician for mental health of patient)

X (top)

X-ray fees

 
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