Eligible Expenses
Medical Expenses: Health Care FSA, HRA and HSA
Over-the-Counter Expenses: Health Care FSA, HRA and HSA
Dependent Care Expenses: FSA only
Medical Expenses: Health Care FSA, HRA and HSA
There are thousands of eligible expenses for tax-free purchase with a Health Care Flexible Spending Account (FSA), Health Reimbursement Arrangement (HRA) and Health Savings Account (HSA), including prescriptions, doctor’s office copays, health insurance deductibles, and coinsurance.
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.
Eligible Medical Expenses
*Items marked are "potentially eligible expenses" that require a Note of Medical Necessity from your health care provider to qualify for reimbursement.
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
Vision Services
- Eye Examinations
- Eyeglasses
- Contact Lenses and Contact Lens Supplies
- Laser Eye Surgeries
- Prescription Sunglasses
- Radial Keratotomy/LASIK
Medical Procedures/Services
- Acupuncture
- Alcoholism (inpatient and outpatient treatment)
- Ambulance
- Drug Addiction
- Hair Loss Treatment*
- Hospital Services
- Infertility Treatment
- In Vitro Fertilization
- 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
- Air Purification Equipment*
- Arches/Orthotic Inserts
- Contraceptive Devices
- Crutches and Wheel Chairs
- Elastic Bandages and Wraps
- Exercise Equipment*
- First Aid Supplies
- Hospital Bed*
- Mattresses*
- Medic Alert Bracelet or Necklace
- Nebulizers
- Orthopedic Shoes*
- Oxygen*
- Pregnancy Test Kits
- Post Mastectomy Clothing
- Prosthesis
- Syringes
- Wigs*
Medication
- Insulin
- Prescription Drugs
Obstetric Services
- Doulas*
- 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*
- Optometrist
- Osteopath
- Physician
- Psychiatrist or Psychologist
Therapy
- Alcohol and Drug Addiction
- Counseling (not marital or career)
- Exercise Programs*
- Hypnosis*
- Massage*
- Occupational
- Physical
- Smoking Cessation Programs*
- Speech
- Weight Loss Programs*
Ineligible Expenses
*Items marked are "potentially eligible expenses" that require a Note of Medical Necessity from your health care provider to qualify for reimbursement.
- Cosmetic Surgery/Procedures
- Dancing/Exercise/Fitness Programs
- Diaper Service
- Electrolysis
- Personal Trainers
- Health Club Dues*
- Insurance Premiums and Interest
- Long Term Care Premiums (HSA only)
- Marriage Counseling
- Maternity Clothes
- Swimming Lessons
- Teeth Whitening/Bleaching
- Vitamins or Nutritional Supplements
Over-the-Counter Expenses: Health Care FSA, HRA and HSA
Many over-the-counter (OTC) treatments are also eligible now because the Coronavirus Aid, Relief and Economic Security (CARES) Act removed the requirement for a physician’s prescription or Letter of Medical Necessity for many OTC items.
There are a variety of items that are not generally eligible for reimbursement you should know. Please find a list of Eligible and Ineligible Items here.
The easiest way to purchase eligible items is with your Benefit Access Debit Card. The card is valid where VISA is accepted for payment.
Dual-Purpose OTC Items
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.
- 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
- 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
- Retin-A and other acne medicines—not reimbursable if used for cosmetic purposes such as wrinkle reduction
- 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
Dependent Care Expenses: 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.
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
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
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
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.
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