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Payroll-us.com

MEDICAL FLEXIBLE SPENDING ACCOUNT ELIGIBLE EXPENSES
Please note this listing is subject to change at any time and without notice due to new legislation.

Abortion
Acne Treatment
Acupuncture
Adaptive Equipment
Alcoholism treatment
Allergy medicine
Alternative healers/Chinese herbal
Ambulance
Appearance Improvements
Arthritis gloves
Artificial limbs
Artificial teeth
Bandages, elastic
Birth control pills
Blood Pressure monitoring devices
Blood Storage
Blood sugar test kits and test strips
Body Scans
Braille Books & magazines (only
amounts above the cost of regular
printed material will qualify)
Breast Pumps
Breast reconstruction surgery
following mastectomy
Capital expenses (Improvements or
special equipment added to a home)
Car Seats
Carpal tunnel wrist supports
Chelation therapy
Chiropractors
Circumcision
Classes, health related (prescribed by
doctor to treat the disease rather
than to promote general health)
Co-insurance amounts (if the
underlying service/item qualifies.)
Cold/hot packs (only those that are
sold as medical supplies, not hot
water bottles and heating pads)
Compression Hose (doctor
prescribed)
Cologne
MEDICAL FLEXIBLE SPENDING ACCOUNT ELIGIBLE EXPENSES
Please note this listing is subject to change at any time and without notice due to new legislation.

Compression Hose
Contact lenses, material and
equipment such as saline solution
and enzyme cleaner.
Co-payments (if the underlying
service/item qualifies.)
Cosmetic procedures
Counseling (for a medical reason only
does not include marriage
counseling)
Crowns, dental (not for cosmetic
purposes)
Crutches
Dancing Lessons
Deductibles (if underlying
service/item qualifies)
Dental Floss
Dental sealants
Dental services & procedures
Deodorant
Dentures and denture adhesives
Diabetic supplies
Diagnostic items/services
Diapers or Diaper Service
Dietary supplements
Disabled Dependent Care Expenses
Doula (only for the medical care of
the mother and/or child)
DNA collection & Storage
Drug addiction treatment (inpatient
treatment at a therapeutic center)
Drug overdose treatment
Drug testing kits
Dyslexia treatment
Ear Piercing
Egg donor fees
Eggs and embryos storage fees
Electrolysis or hair removal
Eye examinations
Eyeglasses, equipment and materials
MEDICAL FLEXIBLE SPENDING ACCOUNT ELIGIBLE EXPENSES
Please note this listing is subject to change at any time and without notice due to new legislation.

Face lifts
Fertility treatments
First Aid kits
Flu shots
Fluoridation services
Funeral expenses
Gambling problem treatment
Gauze pads
Genetic testing (to diagnose a
medical condition only)
Glucose monitoring equipment
Guide Dog
Hand lotion
Hand sanitizer
Hearing Aids & its batteries
Home Improvements
Hormone Replacement Therapy
Hospital Services (inpatient care)
Household help
Humidifier
Hypnosis
Immunizations
Incontinence supplies
Lactation consultant
Lamaze classes (extent that
instruction relates to birth and not
childrearing)
Laser eye surgery; Lasik
Late fees
Liquid adhesive for small cuts
Lodging of a companion (if parent is
traveling with a sick child, up to $100
per night will qualify)
Lodging while attending a medical
conference
Marriage counseling
Massage therapy
Mastectomy related special bras
MEDICAL FLEXIBLE SPENDING ACCOUNT ELIGIBLE EXPENSES
Please note this listing is subject to change at any time and without notice due to new legislation.

Maternity clothes
Mattresses
Medical alert bracelet or necklace
Medical Conference
Medical information plan charges
Medical monitoring and testing
devices
Medical records charges
Mentally handicapped, special home
Morning after contraceptive pills
Nicotine gum or patches
Nonprescription drugs
Norplant insertion or removal
Nursing Services
Nutritional supplements
Obstetrical expenses
Occlusal guards to prevent teeth
grinding
Occupational therapy
Operations
Optometrist
Organ donors
Orthodontia
Orthopedic shoe inserts
Orthopedic shoes (note from doctor
to treat a medical condition and then
only the excess cost of the specialized
shoe over the cost of a regular shoe)
Osteopath fees
Over the Counter drugs (with doctor
prescription only)
Ovulation monitor
Personal Trainer
Physical exams
Physical therapy
Pregnancy test kits
Prenatal vitamins (only taken during
pregnancy will they be approved)
Prescription drugs
MEDICAL FLEXIBLE SPENDING ACCOUNT ELIGIBLE EXPENSES
Please note this listing is subject to change at any time and without notice due to new legislation.

Prescription drugs obtained from
other countries
Preventive care screenings
Probiotics
Prosthesis
Psychiatric care
Psychoanalysis
Psychologist
Radial keratotomy
Reading glasses
Rehydration solution (Pedialyte)
Rubbing alcohol
Screening tests
Shampoos
Shaving cream or lotion
Shipping and handling fees (incurred
to obtain an item that constitutes
medical care)
Sleep deprivation treatment (doctor
prescribed)
Smoking cessation medications
Smoking cessation programs
Speech therapy
Sperm, storage fees (only if stored
and used within the same year)
Stem cell, harvesting and/or storage
of (only if used for the purpose of a
newborns birth defect, not a just in
case)
Sterilization procedures
Stop smoking program
Sunscreen/Sunburn creams and
ointments
Sunglasses (prescribed)
Sun protective clothing (if medical
condition (melanoma) prescribed by
doctor)
Supplies to treat medical condition
Support braces
MEDICAL FLEXIBLE SPENDING ACCOUNT ELIGIBLE EXPENSES
Please note this listing is subject to change at any time and without notice due to new legislation.

Swimming Lessons
Tanning salons
Taxes on medical services and
products (such as local, sales, service
and other taxes)
Teeth Whitening
Telephone for hearing impaired
Therapy (not just for the general
improvement of mental health, relief
of stress, or personal enjoyment)
(doctor note necessary)
Thermometers
Transplants
Transportation expenses for person
to receive medical care
Transportation of someone other
than the person receiving medical
care (a parent who must go with a
child who needs medical care, a
nurse or other person who give
injections/medications)
Tuition for special needs program (if
primary purpose if for medical care)
Ultrasound, prenatal (only if for
diagnosing fetal health &
development not for snapshots)
Umbilical cord blood storage (if
intended to treat a newborn with a
birth defect)
Vaccines
Vasectomy
Vasectomy reversal
Veterinary fees (only if fees incurred
are for the care of a guide dog or
other animal used by a disabled
person)
Viagra (doctor prescribed)
Vision correction procedures
Vitamins
Weight loss programs (only doctor
prescribed to treat obesity, heart
MEDICAL FLEXIBLE SPENDING ACCOUNT ELIGIBLE EXPENSES
Please note this listing is subject to change at any time and without notice due to new legislation.

disease or diabetes)
Wheelchair
Wigs (if hair loss is due to disease or
treatment of illness, chemo or
radiation)
X-Ray fees
*Potential y Eligible = In most cases you would need to provide a letter of medical necessity from your physician for this expense to be considered. Most over the counter drugs will be considered ineligible expenses unless you have a written prescription from your physician.

Source: http://payroll-us.com/employer/forms/FSA/FSA_Medical_Eligible_Expenses.pdf