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Eligible Expenses

Eligible Expenses

Medical Expenses – Health Care FSA, HRA and HSA

The list below outlines medical expenses the IRS typically considers eligible for tax deduction. These expenses can be reimbursed through your health care flexible spending account (FSA), health reimbursement arrangement (HRA) or health savings account (HSA).

To be eligible, medical expenses must be medically necessary. The IRS defines an eligible medical expenses as one incurred primarily to alleviate or prevent physical or mental defect or illness. This includes the costs of equipment, supplies, and diagnostic devices, as well as dental expenses, some insurance premiums and transportation costs. This does not include expenses that are merely beneficial to general health, such as vitamins or a vacation.

This is not an all inclusive list. Some health care expenses you incur may not be eligible for reimbursement. For a complete list, see IRS Publication 502 on irs.gov.

Eligible Medical Expenses

    Baby/Child to Age 13
  • Lactation Consultant*
  • Lead-Based Paint Removal
  • Special Formula*
  • Tuition: Special School/Teacher for Disability or Learning Disability*
  • Well Baby Care


  • Dental Services
  • Dental X-Rays
  • Dentures and Bridges
  • Exams/Teeth Cleaning
  • Extractions and Fillings
  • Gum Treatment
  • Oral Surgery
  • Orthodontia/Braces


  • Hearing
  • Hearing Devices and Batteries
  • Hearing Exams


  • Lab Exams/Tests
  • Blood Tests and Metabolism Tests
  • Body Scans
  • X-Rays
  • Cardiographs
  • Laboratory Fees
  • Spinal Fluid Tests
  • Urine/Stool Analysis


  • Vision Services
  • Eye Examinations
  • Eyeglasses
  • Contact Lenses and Contact Lens Supplies
  • Laser Eye Surgeries
  • Artificial Eyes
  • Prescription Sunglasses
  • Radial Keratotomy/LASIK
  • Reading Glasses
    Medical Procedures/Services
  • Acupuncture
  • Alcoholism (inpatient and outpatient treatment)
  • Ambulance
  • Drug Addiction
  • Hospital Services
  • Infertility Treatment
  • In Vitro Fertilization
  • Norplant Insertion or Removal
  • Physical Exam (non employment related)
  • Reconstructive Surgery (if medically necessary due to congenital defect or accident)
  • Service Animals*
  • Sterilization/Sterilization Reversal
  • Transplants (including organ donor)
  • Transportation*
  • Vaccinations/Immunizations
  • Vasectomy and Vasectomy Reversal


  • Medical Equipment/Supplies
  • Abdominal/Back Supports
  • Air Purification Equipment*
  • Arches/Orthopedic Shoes
  • Band-aids
  • Braces and Supports
  • Contraceptive Devices
  • Crutches and Wheel Chairs
  • Elastic Bandages and Wraps
  • Exercise Equipment*
  • First Aid Supplies
  • Hospital Bed
  • Mattresses*
  • Medic Alert Bracelet or Necklace
  • Oxygen*
  • Pregnancy Test Kits
  • Post Mastectomy Clothing
  • Prosthesis
  • Splints/Casts
  • Support Hose*
  • Syringes
  • Wigs*
    Medication
  • Birth Control
  • Homeopathic Medications*
  • Insulin
  • Prescription Drugs


  • Obstetric Services
  • Lamaze Class
  • Midwife Expenses
  • 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 or Naturopath*
  • Osteopath
  • Physician
  • Psychiatrist or Psychologist


  • Therapy
  • Alcohol and Drug Addiction
  • Counseling (not marital or career)
  • Exercise*
  • Hypnosis
  • Massage*
  • Occupational
  • Physical
  • Speech
  • Weight Loss Programs*

Ineligible Expenses

  • Cosmetic Surgery/Procedures
  • Dancing/Exercise/Fitness Programs
  • Diaper Service
  • Electrolysis
  • Personal Trainers
  • Hair Loss Medication
  • Hair Transplant
  • Health Club Dues*
  • Insurance Premiums and Interest
  • Long Term Care Premiums
  • Marriage Counseling
  • Maternity Clothes
  • Sunscreen
  • Swimming Lessons
  • Teeth Whitening/Bleaching
  • Vitamins or Nutritional Supplements
*Items marked are "potentially eligible expenses" that require a Note of Medical Necessity from your health care provider to qualify for reimbursement.

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Over-the-Counter Drugs

The new Health Care Reform Bill, the Patient Protection and Affordable Care Act (PPACA), imposes new restrictions on FSAs. Effective January 1, 2011, certain over-the-counter (OTC) drugs and medicines will require a Note of Medical Necessity (NMN) or a prescription from a doctor to be considered an eligible expense.

Beginning January 1, 2011
  • Over-the-counter (OTC) drugs and medicines will be considered ineligible expenses unless you have a Note of Medical Necessity (NMN) or a prescription from your physician.
  • Healthcare debit cards cannot be used to purchase OTC drugs and medicines. If a healthcare debit card is used to pay for these items after January 1, 2011, the transaction will be denied at the point of sale. In this case, you will need to pay for the expense out-of-pocket and submit a claim, along with an NMN or a prescription, to be reimbursed.

Examples of OTC Drugs and Medicines Requiring a Prescription

  • Acid Controllers
  • Acne Medications
  • Allergy & Sinus
  • Antibiotic Product
  • Anti-Diarrheals
  • Anti-Gas
  • Anti-Itch & Insect Bite
  • Anti-Parasitic Treatments
  • Baby Rash Ointments/Creams
  • Cold Sore Remedies
  • Cough, Cold & Flu
  • Digestive Aids
  • Feminine Anti-Fungal/Anti-Itch
  • Hemorrhoid Preps
  • Laxatives
  • Motion Sickness
  • Pain Relief
  • Respiratory Treatments
  • Sleep Aids & sedatives
  • Stomach Remedies

Please note that this listing is subject to change at any time and without notice due to new legislation.

Certain Medical Equipment and Supplies are eligible OTC expenses that do not require an NMN:

  • Abdominal/Back Supports
  • Arches/Orthopedic Shoes
  • Band-aids
  • Braces and Supports
  • Contraceptive Devices
  • Crutches and Wheel Chairs
  • Elastic Bandages and Wraps
  • First Aid Supplies
  • Hospital Bed
  • Medic Alert Bracelet or Necklace
  • Pregnancy Test Kits
  • Post Mastectomy Clothing
  • Prostheses
  • Splints/Casts

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Dual-Purpose OTC Items

The following OTC drugs and other expenses, when medically necessary, are reimbursable with a receipt.

NOTE: A Medical Determination Form completed by your health care provider listing the diagnosis of your medical condition and the recommendation of the OTC drug is required for reimbursement.

Dual-Purpose OTC Items

Drug Type Notes
Anti-baldness / hair loss / hair replacement such as Rogaine Only if to replace hair loss due to a medical condition (e.g., cancer treatment) and not for balding due to age
Fiber supplements Such as Benefiber and Metamucil
Glucosamine / Chondrotin for arthritis or other medical condition Not reimbursable if taken for overall joint health
Herbal supplements used to treat a specific disease Such as St. John’s Wort for depression
Hormone therapy drugs  
Medicated shampoos to treat a specific medical condition like psoriasis Only the amount in excess of the cost of normal shampoo
No Doz And other sleep prevention drugs
Nose strips For proper breathing or other medical conditions
Pedialyte For a child's dehydration
Retin-A and other acne medicines Not reimbursable if used for cosmetic purposes such as wrinkle reduction
Sleep aids  
Snoring cessation aids and medications Such as Breathe Right Spray and Snorezz
Sunscreen and sunblock  
Vitamins are not an eligible expense, unless prescribed by a physician to treat a specific medical condition For example, iron to treat, not prevent, anemia; calcium supplements to treat, not prevent, osteoporosis ― a doctor’s note detailing the specific medical condition will be required for reimbursement
Weight loss/dietary supplements Must be for a specific medical condition such as obesity

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Dependent Care Expenses – Dependent Care FSA Only

To be eligible for reimbursement, dependent care expenses must be for an eligible dependent and for care that allows the FSA participant to work or look for work. The expenses listed below are typically considered eligible by the IRS. These expenses can be reimbursed through your dependent care FSA. For a complete listing, see IRS Publication 503 on irs.gov.

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Child Care

Child care provided by a baby sitter, day care facility or before or after school program, as well as summer day camp, are eligible. Extracurricular activities such as dance or piano lessons are not eligible.

Child Care Expenses

After school programs
Babysitting (someone else's home)
Babysitting (your home)
Before school programs
Child care
Nursery school
Preschool
Sick child care
Summer day camp

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Senior Care

Senior care provided by a sitter or a day care facility is eligible if the senior is considered an eligible adult. See Eligible Dependent. Medical care, nursing care and transportation costs are not eligible.

Senior Care Expenses

Adult day care
Elder care (in your home)
Elder care (outside your home)
Senior day care

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Non-Reimbursable Dependent Care Expenses

The following expenses are not reimbursable through a dependent care FSA.

Child Care

Extracurricular activities such as music lessons
Private school tuition (for kindergarten and up)
Overnight camp
Transportation to and from eligible care
Tutoring

Senior Care

Day nursing care
Medical care
Nursing home care
Transportation to and from eligible care

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Additional Notes:

  • If married, both you and your spouse must be actively employed. If one spouse is actively employed, the other spouse must be incapable of self-care or a full-time student.
  • The funds to be used from your dependent care FSA must not exceed the lesser of your or your spouse's earned income for the plan year.
  • Care may be provided in your home or another location but not by someone who is your minor child or dependent for income tax purposes (e.g. an older dependent child).
  • If the services are provided by a day care facility that cares for six or more individuals at the same time, the facility must comply with state day care regulations.