Health Care Flexible Spending Account
Eligible Expenses

Medical care is defined as amounts paid for the diagnosis, cure, mitigation, treatment, or prevention of disease, and for treatments affecting any part or function of the body. The medical care expenses must be primarily to alleviate or prevent a physical or mental defect or illness.

Expenses are eligible for reimbursement if they were incurred during the period when the participant (or the qualified dependent) was covered under the plan. Expenses are incurred when services are rendered, regardless of when the expense is paid.


The federal regulations regarding the eligibility of over-the-counter medications and supplies have changed. Effective January 1, 2011, you need a letter from your physician stating that the medication and/or supply is necessary for the treatment of a specific medical condition. You will be required to pay for the items out of pocket and submit a Health Care Expense Documentation form, your itemized receipt and a letter of medical necessity from your physician to request reimbursement.


Medical Care

  • Acupuncture
  • Ambulance Transportation
  • Chiropractic Services
  • Fertility Treatment
  • Hospitalization
  • Laboratory Fees
  • Nursing Homes and other long term care facilities
  • Office Visits
  • Prescription medicines
  • Psychiatric Care
  • Surgery
  • Therapy
  • X-rays

    Dental Care

  • Examinations
  • Dental Implants
  • Bridges and Crowns
  • Periodontal Services
  • Fillings
  • X-Rays
  • Occlusal guards to prevent teeth grinding
  • Orthodontia
  • Dentures
  • Teeth whitening is NOT eligible.

    Vision Care

  • Examinations
  • Contact Lenses
  • Materials needed for using lenses, such as saline solution and cleaner
  • Glasses
  • Laser eye surgery
  • Prescription sunglasses

    Preventive Care

  • Periodic health exams, including related lab and x-ray services
  • Routine prenatal and well child care exams
  • Immunizations, child or adult
  • Flu Shots
  • Diagnostic Screening services
  • Medical monitoring & testing supplies
  • Alcholism Treatment at an inpatient center or outpatient counseling
  • Drug Addiction Treatment at an inpatient center or outpatient counseling
  • Stop Smoking Programs, including nicotine gum and patches

    Equipment

  • Crutches
  • Hearing aid and the batteries necessary to operate it
  • Oxygen and related equipment
  • Prosthesis
  • Wheelchair and the cost of operating and maintaining the wheelchair

    Transportation

  • Transportation expenses necessary to receive medical care, including bus, taxi, train, plane fares, parking fees and tolls
  • Transportation expenses of a caretaker (parent, nurse, etc) who must accompany a person who needs medical care
  • Up to $50 per night for lodging, when such lodging is required to receive medical care
  • Out-of-pocket expenses for your car, such as gas and oil, when you use your car for medical reasons
  • Car expenses such as depreciation, insurance, general repair, or maintenance expenses are NOT eligible.

    If you do not want to use your actual expenses, you can use a standard rate (determined by the Internal Revenue Service) for use of your car for medical reasons. You can add fees and tolls to your medical expenses whether you use actual expenses or use the standard mileage rate.

    The standard mileage rate for expenses incurred from January 1, 2011 to June 30, 2011 is 19 cents/mile. The standard mileage rate for expenses incurred from July 1, 2011 to December 31, 2011 is 23.5 cents/mile. These mileage rates are subject to change at any time; please refer to the Internal Revenue Service guidelines for current rates. (The source of this information is IRS publications IR-2009-111 and IR-2008-131, last updated 12/8/2009)


    Potentially Eligible Expenses

    You may be reimbursed only if these items are prescribed by a physician for the treatment of a specific medical condition. To be eligible for reimbursement, you must submit a letter of medical necessity from your physician. These items are not eligible if their primary purpose is to maintain general good health.

    You will be required to pay for the items out of pocket and submit a Health Care Expense Documentation form, your itemized receipt and a letter of medical necessity from your physician to request reimbursement.

  • Over-the-counter drugs
  • Over-the-counter supplies
  • Vitamins and supplements
  • Fitness Classes
  • Health Club Dues
  • Weight Loss Program


    Ineligible Expenses

  • Child Care for a Normal, Healthy Child
  • Cosmetic Procedures
  • Hair Removal
  • Household Help
  • Insurance Premiums
  • Personal Care Items, such as toothpaste, soaps, and lotions
  • Teeth Whitening


    This list is not intended to be inclusive of all potentially eligible and ineligible expenses. If you have a question regarding a specific expense, please contact Customer Service.

    (888)537-3539
    info@benefitsworkshop.com


    The primary source of this information is IRS Publication 502, however, it has been paraphrased and/or modified to provide information specific to Health Care Flexible Spending Accounts. The primary differences between the rules outlined in Publication 502 and the regulations governing Health Care Flexible Spending Accounts are the expenses are eligible when they are incurred (when services are rendered), not when they are paid. Also, insurance premiums are not considered an eligible expense, unless the insurance plan is sponsored by the employer, and generally, those premiums are tax-free due to inclusion in a Section 125 Premium Conversion Plan.

    The titles and content of this page is offered for general information only. Please consult a qualified tax advisor for specific information.


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