Eligible Expenses

mycafeteriaplan bullet imageMedical Expenses Eligible for Reimbursement

This list is NOT comprehensive and is intended only as a guide to reimbursable deductible and over-the-counter (OTC) expenses as governed by IRS Section 213.  To find out about specific items or items not mentioned here, contact a myCafeteriaPlan representative or use myCafeteriaPlan’s Online Request for Information. Please note: cosmetic services and preventative medicines (such as vitamins) are not covered unless prescribed by a physician (general practice).

 OTC and FSA Expense Guide

FSA Eligible Expenses and Items

mycafeteriaplan bullet imageEligible Over-the-Counter Items*

The following is a high level list of Over-the-Counter (OTC) items that clearly are not medicine or drugs and may be eligible for purchase with FSA or HRA dollars depending on your plan.

 

Baby Electrolytes

  • Pedialyte

Denture Adhesives, Repair, and Cleansers

  • PoliGrip, Benzodent, Efferdent

Diabetes Testing and Aids

  • Insulin, Ascencia, One Touch, Diabetic Tussin, insulin syringes; glucose products

Diagnostic Products

  • Thermometers, blood pressure monitors, cholesterol testing

Elastics/Athletic Treatments

  • ACE, Futuro, elastic bandages, braces, hot/cold therapy, orthopedic supports, rib belts

Eye Care

  • Contact lens care solution

Family Planning

  • Pregnancy and ovulation kits

First Aid Dressings and Supplies

  • Band Aid, 3M Nexcare, non-sport tapes
  • Hearing Aid/Medical Batteries

Incontinence Products

  • Attends, Depends, GoodNites for juvenile incontinence

Reading Glasses and Maintenance

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mycafeteriaplan bullet imageEligible Items*

The following is a list of potentially eligible items.

BABY/CHILD TO AGE 13

  • Lactation Consultant*
  • Lead-Based Paint Removal
  • Special Formula*
  • Tuition: Special School/Teacher for Disability or Learning Disability*
  • Well Baby /Well Child Care

DENTAL

  • Dental X-Ray
  • Dentures and Bridges
  • Exams and Teeth Cleaning
  • Extractions and Fillings
  • Oral Surgery
  • Orthodontia
  • Periodontal Services

EYES

  • Eye Exams
  • Eyeglasses and Contact Lenses
  • Laser Eye Surgeries
  • Prescription Sunglasses
  • Radial Keratotomy

HEARING

  • Hearing Aids and Batteries
  • Hearing Exams

LAB EXAMS/TESTS

  • Blood Tests and Metabolism Tests
  • Body Scans
  • Cardiograms
  • Laboratory Fees
  • X-Rays

MEDICAL EQUIPMENT/SUPPLIES

  • Air Purification Equipment*
  • Arches and Orthotic Inserts
  • Contraceptive Devices
  • Crutches, Walkers, Wheel Chairs
  • Exercise Equipment*
  • Hospital Beds*
  • Medic Alert Bracelet or Necklace
  • Nebulizers
  • Orthopedic Shoes*
  • Oxygen*
  • Prosthetics
  • Syringes
  • Wigs*

MEDICAL PROCEDURES/SERVICES

  • Acupuncture
  • Alcohol and Drug/Substance Abuse (inpatient treatment and outpatient care)
  • Ambulance
  • Fertility Enhancement and Treatment
  • Hair Loss Treatment*
  • Hospital Services
  • Immunization
  • In Vitro Fertilization
  • Physical Examination (not employment-related)
  • Service Animals
  • Sterilization/Sterilization Reversal
  • Transplants (including organ donor)

MEDICATIONS

  • Insulin
  • Prescription Drugs

OBSTETRICS

  • Breast Pumps and Lactation Supplies
  • Lamaze Class
  • OB/GYN Exams
  • OB/GYN Prepaid Maternity Fees (reimbursable after date of birth)
  • Pre- and Postnatal Treatments

PRACTITIONERS

  • Allergist
  • Chiropractor
  • Christian Science Practitioner*
  • Dermatologist
  • Homeopath
  • Optometrist
  • Osteopath
  • Physician
  • Psychiatrist or Psychologist

THERAPY

  • Counseling (not marital or career)
  • Hypnosis
  • Occupational
  • Physical
  • Smoking Cessation Programs*
  • Speech
  • Weight Loss Programs*

The list above is not meant to be an all-inclusive list of potentially eligible FSA and or HRA expenses, as other expenses not specifically mentioned may also qualify. Also, expenses marked with an asterisk (*) are “potentially eligible expenses” that require a Note of Medical Necessity from your health care provider to qualify for reimbursement. Each plan is different; for additional information specific to your plan, check your Summary Plan Document or contact myCafeteriaPlan.

*DISCLAIMER: Every effort has been made to present this information accurately, however, this is just a summary overview. An overview means that details, explanations, and qualifiers are left out. This information is intended only to provide general guidance, and you should not rely on it as a complete explanation of this topic. OTC rules and guidelines changed effective January 1, 2011, in IRS Notice 2010-59.


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mycafeteriaplan bullet imageCafeteria Flexible Spending Account INELIGIBLE Expenses

The following is a list of ineligible items.

  • Concierge Doctor’s Fees
  • Cosmetics
  • Cosmetic surgery
  • Dancing lessons
  • Ear piercing
  • Electrolysis
  • Exercise equipment or programs
  • Face lifts
  • Fitness programs
  • Funeral expenses
  • Hair removal
  • Hair transplant
  • Herbs and herbal treatments
  • Illegal operations and treatments
  • Marijuana or other controlled substances
  • Massage therapy to relieve stress or depression
  • Maternity clothes
  • Rogaine
  • Teeth whitening
  • Varicose vein/spider vein treatments
  • Vitamins
  • Weight-Loss programs and/or drugs

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