Information

Claim Forms & Worksheets


Medical 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 at 800.865.6543 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).

A B C D E F G H I L M N O P R S T V W X
Over-the-Counter (OTC) Expenses
Ineligible Expenses



  • Cafeteria Flexible Spending Account Plan Eligible Expenses List

A

  • Acupuncture (to treat a medical condition)
  • Air Purifier (if prescribed by a physician)
  • Alcoholism (amount paid for inpatient treatment, including meals and lodging, at a therapeutic center for alcohol addiction)
  • Allergy medications (OTC)
  • Ambulance
  • Antacids (OTC)
  • Artificial limbs
  • Artificial teeth
  • Aspirin (OTC)
  • Automobile modifications for a physically handicapped person

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B

  • Birth control pills (if prescribed by a physician)
  • Blood pressure monitoring devices
  • Braille books and magazines (only amount paid above the cost of regular printed material for a visually impaired person)

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C

  • Chiropractors' fees (to treat a medical condition)
  • Christian Science practitioners' fees (to treat a medical condition)
  • Coinsurance
  • Contact lenses and related materials and equipment (OTC)
  • Contraceptive prescriptions
  • Co-payments
  • Cough syrups (OTC)
  • Crutches

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D

  • Deductibles
  • Dentists' fees
  • Dentures
  • Diabetic supplies
  • Diagnostic services

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E

  • Ear plugs (if prescribed by a physician)
  • Eye exams, eyeglasses, and related equipment and materials

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F

  • Fees associated with organ donations
  • Fees for the computer storage of medical records
  • Fertility treatments (includes shots, treatment, and surgery)
  • Flu shots
  • Fluoridation device (amount should be limited to cost allocable to current plan year)

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G

  • Guide dog or other animal aide (amount paid for purchase, training, and care of animals used by a visually impaired or hearing impaired person)
  • Gynecologists' fees

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H

  • Health insurance deductibles (associated with covered treatments)
  • Hearing aids/batteries
  • Hearing trained cat
  • Hospital services
  • Hypnosis for medical reasons

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I

  • Immunizations/vaccinations
  • Insulin

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L

  • Laboratory fees
  • Language training for child with dyslexia or disabled child
  • Laser eye surgery
  • Lead based paint removal (for the cost of removing lead-based paints from surfaces in the home to prevent a child who has or has had lead poisoning from eating the paint. The cost of repainting is not a medical expense)
  • Learning disability (amount paid to special school or specially-trained teacher for a child who has severe learning disabilities caused by mental or physical impairments at the direction of a physician)
  • Legal fees associated with the commitment of a mentally ill person

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M

  • Medical conference admission and transportation
  • Medical monitoring and testing devices (e.g., blood pressure monitor, syringes, glucose kit, etc.)
  • Mileage related specifically to an eligible medical visit

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N

  • Norplant insertion or removal
  • Nursing services

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O

  • Obstetrical fees
  • Occlusal guards to prevent teeth grinding
  • Orthodontics
  • Orthopedic shoes
  • Osteopath
  • Over-the-counter (OTC) items
  • Ovulation monitor
  • Oxygen (amount paid for oxygen and equipment for breathing problems caused by a medical condition)

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P

  • Pain relievers (OTC)
  • Physical exams (but not employment-related physicals)
  • Physical therapists' fees
  • Pregnancy test (OTC)
  • Prescription drugs
  • Prescription eyeglasses and/or contact lenses
  • Psychiatrists' fees
  • Psychologists' fees
  • Psychotherapists' fees

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R

  • Radial keratotomy
  • Routine physicals

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S

  • Seeing-eye dog (purchase, training & care)
  • Skilled nurses' fees
  • Smoking cessation treatments and prescriptions
  • Solutions for the care and maintenance of contact lenses
  • Speech therapists' fees
  • Sterilization fees
  • Sunglasses (prescription only)

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T

  • Telephone for hearing impaired
  • Therapy
  • Transplants (amounts paid for surgical, hospital, laboratory, and transportation expenses for organ donor)
  • Treatment for substance addiction
  • Transportation expenses (related to medical services and is reimbursed at 20 cents per mile)

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V

  • Vaccines
  • Vasectomy

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W

  • Wheelchair

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X

  • X-ray fees (associated with covered treatments)

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  • Cafeteria Flexible Spending Account Ineligible Expenses

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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