Take care® by wageworks - hsa eligible expenses

Below is the list of items typically covered by a standard HSA.
Prescription Requirement for OTC Drug PurchasesA doctor’s prescription is required in order to be reimbursed for over-the-counter (OTC) drugs. OTC drugs requiring a prescription are indicated in the following list with the abbreviation “(Rx).” Acne treatments (over-the-counter) (Rx) Deductible for dental, medical, prescription and (for non-cosmetic purposes, including sealants) Lice treatment (over-the-counter) (Rx) Allergy & sinus medicine and products (up to IRS tax-free limit, see IRS Publication 502) Dental reconstruction (including implants) Diabetic monitor, test kits, strips and supplies Antibiotic ointment (over-the-counter) (Rx) Aspirin or other pain reliever (over-the-counter) (Rx) Diaper rash ointments and creams (Rx) Medical equipment (for treatment of medical Bandages and related items (over-the-counter) Ear drops and wax removal (over-the-counter) (Rx) Birth control (over-the-counter) (Rx) Eye drops and treatments (over-the-counter) (Rx) Eye surgery or treatment to correct vision Braille books & magazines (difference in cost only) Medicare alternative insurance / plan premiums (paid with after-tax dollars only) Medicare Part B insurance / plan premiums Medicare alternative insurance / plan premiums Canker & cold sore treatments (over-the-counter) (Rx) Fertility treatment (for employee, spouse or dependent) (vs. Part A & Part B; paid with after-tax dollars only) Chest rubs (over-the-counter) (Rx) Childbirth classes (charges for mother only) Gastrointestinal medication (over-the-counter) (Rx) Mileage (for travel to/from eligible health care) Co-insurance (dental, medical, prescription, vision) Health insurance / plan premiums (paid with after-tax dollars only) Monitors & test kits (over-the-counter) Motion & nausea (over-the-counter) (Rx) Cold & flu medicine (over-the-counter) (Rx) Nasal sprays & strips (over-the-counter) (Rx) (dental, medical, prescription, vision; paid with after-tax dollars only) Contraceptives (over-the-counter) (Rx) Occlusal guards to prevent teeth grinding Corn and callus remover (over-the-counter) (Rx) (related to a medical condition or disability) Insurance or health insurance / plan premiums (chiro, dental, medical, psych/therapy, vision) Cough syrup (over-the-counter) (Rx) Counseling (for treatment of a medical condition) Lactose intolerance (over-the-counter) (Rx) Turn over for more E
HSA Eligible Health Care Expenses (Cont.) Toothpaste, medicated (difference in cost only of medicated toothpaste over the standard toothpaste) (Rx) Over-the-counter bandages and related items Transportation, parking and related travel Over-the-counter health care products (Rx) expenses (essential to receive eligible care) Over-the-counter drugs and medicines (including for Retin-A (for non-cosmetic purposes) (Rx) motion sickness, sleep aids and sedatives) (Rx) Over-the-counter products for dental, oral and Smoking cessation (programs / counseling) Varicose vein removal surgery (for medical care) Viagra and similar prescription medications Pain reliever (over-the-counter) (Rx) Parental fees (billed for actual services received for Student health fees billed for services actually received (dental / medical / vision / prescription) (canes, walkers, crutches and related supplies) Sunscreen with SPF 15+ and “broad spectrum”, Wart removal treatments (over-the-counter) (Rx) sunburn creams & ointments (over-the-counter) Prescription drugs (for non-cosmetic purposes) (for treatment of a medical condition) (Rx) Prescription insurance / plan premiums (paid with after-tax dollars only) Propecia (for treatment of a medical condition) (Rx) Therapy (for treatment of a medical condition) HSA “Maybe” Eligible Health Care Expenses Certain expenses require additional information in order to determine if they qualify. Products and services classified as “Maybe” require a written statement from your health care provider indicating (1) the diagnosis and (2) the medical necessity of the expense. Specialized items also require proof of the difference in cost: (1) the cost of standard, unmodified item, and (2) the cost of special or modified item. If you incur an expense that is classified as “Maybe,” you will need to submit the above documentation with your claim.
Alternative drugs, medicines and treatment (difference in cost only of specialized orthopedic Reconstructive surgery (following accident or Compression or anti-embolism socks, stockings Special foods (gluten-free, salt-free or other for Cord blood storage (for future treatment of a birth defect or known medical condition) Special school (for mental and physical disabilities) (limited to $50 per night for patient to receive Cosmetic procedures or surgery for birth defects, medical care and $50 per night for one caregiver) Modified equipment (difference in cost only) * As required or treatment for a medical condition diagnosed by a licensed health care professional.

Source: http://www.benefithelp.net/Flagler/TCWW_HSA_EXPENSE_LIST.pdf

Microsoft word - document6

Peripheral Artery Disease (PAD) We’ve all seen the TV ads that warn about the dangers of peripheral artery disease or PAD, and then promote some drug to treat it. PAD causes loss of normal blood circulation. The small arteries become blocked, reducing the amount of oxygen that can be supplied to the muscles. PAD usually affects the legs, but may involve the arms as well. Twelve to twenty

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MATERIAL SAFETY DATA SHEET Section I - IDENTITY Common/Trade Name: Doxycycline for Injection, USP Chemical Names: 2-Napthacenecarboxamide,4-(dimethylamino)-1,4,4a,5,5a,6,11,12a-octahydro- 3,5,10,12,12a-pentahydroxy-6-methyl-1,11-dioxo- Synonyms: Vibramycin Intravenous, Doxycycline, Liviatin, Doxiciclina, GS-3056 Manufacturer's Name: Address: Emergency Telephone Number:

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