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 (Publication 502). 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 (Effective January 1, 2011)*

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.

Click here to read more about OTC potentially eligible expenses.

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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 (Effective January 1, 2011)*

The following is a list of potentially eligible items.

Click here to read more about potentially eligible expenses.

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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

  • 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. This list of eligible and ineligible expenses is current as of October 28, 2010.

*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 are still being drafted and may change prior to January 1, 2011. This is not a legal document.

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mycafeteriaplan bullet imageCafeteria Flexible Spending Account INELIGIBLE Expenses

The following is a list of ineligible items.

Click here to read more about ineligible expenses.

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  • 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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