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  Medical FSA and HSA Expense Eligibility List (IRS Code Section 213 (d) Eligible Expenses) The following is a summary of common expenses claimed against Medical Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs). Due
to frequent updates to the regulations governing FSAs and HSAs, this list does not guarantee reimbursement but instead is to be used as a guide for the
submission of claims. A definition of eligibility is as follows:

Yes: The expense is eligible for reimbursement.
Dual-Purpose: The expense can be used for both medical and general health, convenience, and/or cosmetic purposes. As such, a completed Medical Necessity
Form or a signed physician’s note must be on file for the expense to be considered eligible.
Potentially: The expense can be considered eligible, provided certain conditions or criteria (as specified in the Comments and Special Rules section) are satisfied.
Depending on the nature of the expenses, a completed Medical Necessity Form or signed physician’s note may need to be on file.
No: The expense is not eligible for reimbursement, even with a physician’s note or Medical Necessity Form.
 

Expense(s)

Eligible?
Comments and Special Rules
AA meetings, transportation to
Acne treatment
Examples: Skin ID, Proactiv, and anything that primarily treats acne; however, the cost of regular skin care (e.g., face creams) does not qualify. Acupuncture/Acupressure
Adaptive equipment
Includes various items that assist individuals in performing activities of daily living (e.g.,
feeding, bathing, and mobility). To qualify, the item must be used to relieve or alleviate
sickness or disability. Depending on the nature of the item, only amounts above the cost of
the regular version of the item will qualify. See also Capital expenses; Home
improvements
.
Adoption, pre-adoption medical expenses
Medical expenses incurred before an adoption is finalized will qualify if the child qualifies as your tax dependent when the services/items are provided. Airborne
Air purifier
Special rules may apply. See also Capital expenses.
Alcoholism treatment
Amounts paid for in-patient treatment (including meals and lodging) at a therapeutic center for alcohol addiction will qualify. Allergy medicines
Alternative healers, dietary substitutes,
Non-traditional healing treatments provided by professionals may qualify if provided to treat and drugs and medicines
a specific medical condition. The treatments must be legal, and the expenses will not qualify if the remedy is a food or substitute for food that the person would normally consume in order to meet nutritional requirements. Ambulance
Antacids
Antibiotic ointments
  Medical FSA and HSA Expense Eligibility List (IRS Code Section 213 (d) Eligible Expenses) Expense(s)
Eligible?
Comments and Special Rules
Antifungal products
Anti-itch creams
Anti-snore guards
The expense must be recommended to treat a diagnosed medical condition (e.g., sleep apnea). Appearance improvements
Cosmetic procedures; Cosmetics; Toiletries.
Arch supports
Arm sling
Arthritis gloves
Artificial limbs
Artificial teeth
Asthma treatments
Includes asthma medications and delivery devices (e.g., inhalers and nebulizers). Baby formula
If your baby requires a special formula to treat an illness or disorder, the difference in cost between the special formula and routine baby formula can qualify. Baby powder
Bandages, elastic
Examples: Ace bandages, arm sleeves, ankle braces Bandages, for torn or injured skin
Biofreeze
Birth control pills
Birthing classes
Expenses may qualify to the extent that instruction relates to birth and not childrearing. The fee should be adjusted to exclude instruction in topics such as newborn care. Expenses for the coach or significant other do not qualify. Blood-pressure monitoring devices

Blood storage

Fees for temporary storage may qualify under some circumstances, such as where the blood is collected as part of the diagnosis, treatment, or prevention of an existing or imminent medical condition (e.g., in advance of a scheduled surgery for use in a possible transfusion). Fees for indefinite storage just in case the blood might be needed would not be considered medical care and do not qualify. Blood-sugar test kits and test strips
Body scans
Body scans employing MRIs and similar technologies are diagnostic services. See also
Diagnostic items/services; Screening tests.
Breast pumps
Will not qualify if used merely to benefit general health or for convenience, scheduling, or other personal reasons; however, may qualify if used for medical reasons. To show that the expense is primarily for medical care, a note from a physician recommending the item to treat a specific medical condition (e.g., breast abscess) is required.   Medical FSA and HSA Expense Eligibility List (IRS Code Section 213 (d) Eligible Expenses) Expense(s)
Eligible?
Comments and Special Rules
Breast reconstruction surgery following
Will qualify to the extent that surgery was done following a mastectomy due to cancer. This mastectomy
is an exception to the general rules regarding cosmetic procedures. See also Cosmetic
procedures.

Bug spray
Caffeine pills
Calamine lotion
Callous removers
Both the tool and liquid/lotion removers qualify. Caltrate
Cane, walking
Capital expenses
May qualify if done to accommodate a disability. If the improvement is permanent and increases the value of the property, the expense will qualify only to the extent that the improvement cost exceeds the increase in property value. If the improvement doesn't increase the property value at all, then the entire cost may qualify. Items that usually don't increase property value include constructing entrance or exit ramps, widening or modifying doorways or hallways, installing railings or support bars to bathrooms, lowering or modifying kitchen cabinets or equipment, moving or modifying electrical outlets and fixtures, installing porch lifts, modifying fire alarms or smoke detectors, modifying other warning systems, and modifying stairways. To show that the expense is primarily for medical care, a note from a medical practitioner recommending the item to treat a specific medical condition is normally required. Cardiac therapy
Carpal tunnel wrist supports
Cast covers
Childbirth classes
Expenses may qualify to the extent that instruction relates to birth and not childrearing. The fee should be adjusted to exclude instruction in topics such as newborn care. Expenses for the coach or significant other do not qualify. Chiropractors
Chiropractic adjustments qualify; however, some chiropractors practice massage therapy. Massage therapy is considered dual-purpose and therefore must treat a specific medical condition to be considered a qualifying expense. Chondroitin
Circumcision
Cold medicine
Examples: Comtrex, Sudafed, Nyquil, Dayquil Cold/hot packs
Compression stockings
Contact lenses, materials, and equipment
Contact lenses for solely cosmetic purposes (e.g., to change one's eye color) do not qualify. Contraceptives
Examples: birth control pills, condoms, “morning-after” pills, spermicidal foam Controlled substances in violation of
If the substance violates federal law (e.g., the Controlled Substances Act), the expense federal law
would not qualify, even if a state law allows its use with a physician's prescription (e.g., marijuana or laetrile prescribed to treat a specific medical condition). Co-payments
  Medical FSA and HSA Expense Eligibility List (IRS Code Section 213 (d) Eligible Expenses) Expense(s)
Eligible?
Comments and Special Rules
Corneal ring segments
Cosmetic procedures
Most cosmetic procedures do not qualify. This includes cosmetic surgery or other procedures that are directed at improving the patient's appearance and don't meaningfully promote the proper function of the body or prevent or treat illness or disease. Examples include face lifts, hair transplants, hair removal (electrolysis), teeth whitening, and liposuction. However, procedures necessary to correct a deformity arising from congenital abnormality, personal injury from accident or trauma, or disfiguring disease may qualify. Cosmetics
Cosmetics are articles used primarily for personal purposes and are intended to be
rubbed, poured, sprinkled, sprayed, or otherwise applied to the human body for
cleansing, beautifying, promoting attractiveness, or altering the appearance.
Examples include skin moisturizers, perfumes, lipsticks, fingernail polishes, eye and
facial makeup, shampoos, permanent waves, hair colors, toothpastes, and
deodorants.

Cotton balls
Cough drops/suppressants
Counseling
Will qualify if for a medical reason. Marriage counseling doesn't qualify. CPAP machine and headgear
Crowns, dental
Crutches
Decongestants
Dental floss
Dental implants
Dental sealants
Dental treatment
Teeth whitening, veneers, and lumineers are the only exceptions, as they are considered cosmetic in nature and do not qualify. Dentures and denture adhesives
Denture brush
Denture cleaners
Diabetic supplies
Diagnostic items and services
Includes a wide variety of procedures to determine the presence of a disease or dysfunction
of the body, such as tests to detect heart attack, stroke, diabetes, osteoporosis, thyroid
conditions, psychological conditions, and cancer. See also Body scans, Blood-pressure
monitoring devices, Blood-sugar test kits and test strips.

Diaper rash ointments and creams
Diapers or diaper service
Diarrhea medicine
Examples: Imodium, Kaopectate, Pepto Bismol Dietary supplements
The cost of dietary supplements, nutritional supplements, vitamins, herbal supplements, and natural medicines do not qualify if they are merely beneficial for general health (e.g., One-a-Day vitamins).   Medical FSA and HSA Expense Eligibility List (IRS Code Section 213 (d) Eligible Expenses) Expense(s)
Eligible?
Comments and Special Rules
Diet foods
Disabled dependent care expenses
Such expenses will qualify if they are for medical care of the disabled dependent. Discount programs
Fees paid to get access to products/services at a reduced cost will not qualify. Will only qualify to the extent that the doula provides medical care for the mother or child. Services such as emotional support, parenting information, child care, and housekeeping will not qualify. Drug addiction treatment
Amounts paid for an inpatient's treatment at a therapeutic center for drug addiction will qualify. Drug overdose, treatment of
Drug screening
If court ordered or part of a treatment program, it will qualify. Ear plugs
Ear wax removal products
Egg donor fees
Amounts paid for the egg donor fee, an agency fee, an egg donor's medical and psychological testing, and the legal fees for preparation of the egg donor contract will qualify if preparatory to a procedure performed on you, your spouse, or your dependent. Eggs and embryos, storage fees
Fees for temporary storage qualify, but only to the extent necessary for immediate conception. Storage fees for undefined future conception aren't considered medical care Electrolysis or hair removal
Can be approved in very rare circumstances if recommended by a physician to treat a specific condition such as hirsutism. A signed note from a physician recommending the treatment is required. Epsom salt
Exercise equipment or programs
Qualifies only if a physician has recommended it to treat a diagnosed condition (e.g., obesity). Expectorants
Eye drops
Eye examinations, eyeglasses, equipment,
materials, and repair
Face creams

Face lifts
Cosmetic procedures.
Feminine hygiene products
Fever-reducing medications
Fiber supplements
Fiber-enriched foods such as wafers or yogurt will not qualify. Finance charges
First aid cream
First aid kits
Flavoring for medication
Flu shots
Funeral expenses
Gauze pads
  Medical FSA and HSA Expense Eligibility List (IRS Code Section 213 (d) Eligible Expenses) Expense(s)
Eligible?
Comments and Special Rules
This includes computer and reading glasses which may be purchased over the counter without a prescription. Eyeglass cleaning supplies, glasses cases, and repair kits are also eligible. Glucosamine
Glucose-monitoring equipment
Items such as blood glucose meters and glucose test strips are diagnostic items and are
primarily for medical care. See also Blood-sugar test kits and test strips.
Guide dog, other service animal
Expenses for buying, training, and maintaining a service animal used by a disabled person would qualify; this includes the expenses of food and inoculations. Veterinary fees for such animals also qualify as medical care. Hair removal and transplants
Can be approved in very rare circumstances if recommended by a physician to treat a specific condition such as hirsutism. A signed note from a physician recommending the treatment is required. Health club fees
Health screenings
Hearing aids
The costs of the hearing aid and batteries would qualify. Heating pad
Hemorrhoid treatments
Home improvements
May qualify if done to accommodate a disability. If the improvement is permanent and increases the value of the property, the expense will qualify only to the extent that the improvement cost exceeds the increase in property value. If the improvement doesn't increase the property value at all, then the entire cost may qualify. Items that usually don't increase property value include constructing entrance or exit ramps, widening or modifying doorways or hallways, installing railings or support bars to bathrooms, lowering or modifying kitchen cabinets or equipment, moving or modifying electrical outlets and fixtures, installing porch lifts, modifying fire alarms or smoke detectors, modifying other warning systems, and modifying stairways. To show that the expense is primarily for medical care, a note from a physician recommending the item to treat a specific medical condition is normally required. Homeopathic products
Dual-Purpose
Hormone replacement therapy (HRT)
Hospital services
Expenses of inpatient care (plus meals and lodging) at a hospital or similar institution qualify if the principal reason for being there is to get medical care. Humidifier
Special rules may apply. See also Capital expenses; Home improvements.
Hypnosis
Hysterectomy
Immunizations
Incontinence supplies
Insect-bite creams and ointments
  Medical FSA and HSA Expense Eligibility List (IRS Code Section 213 (d) Eligible Expenses) Expense(s)
Eligible?
Comments and Special Rules
Insurance premiums
Medical FSA (Flexible Spending Account): Insurance premiums are never eligible with a
Medical FSA.
HSA
(Health Savings Account): Payments for health insurance premiums or contributions
for self-funded health coverage generally aren't qualifying expenses; however, the following
premiums will qualify for reimbursement from an HSA: COBRA coverage, a qualified long-
term care insurance contract, any health plan maintained while the individual is receiving
unemployment compensation under federal or state law, or, for those age 65 or older
(whether or not they are entitled to Medicare), any deductible health insurance (e.g., retiree
medical coverage) other than a Medicare supplemental policy. (Note: Long-term care
insurance premium reimbursements that exceed certain limits will be treated as taxable and
may be subject to an additional 10% excise tax.)
Lamaze classes
Expenses may qualify to the extent that instruction relates to birth and not childrearing. The fee should be adjusted to exclude instruction in topics such as newborn care. Expenses for the coach or significant other do not qualify. Language training
expenses will qualify for a child with dyslexia or an otherwise disabled child. Laser eye surgery; Lasik
Late fees
No (e.g., for late payment of bills for medical services) Laxatives
Learning disability, instructional fees
Dual-Purpose
If prescribed by a physician, tuition fees paid to a special school and tutoring fees
paid to a specially trained teacher for a child who has learning disabilities caused by
mental or physical impairments (e.g
., nervous system disorders) will qualify.
Lifeline screenings
Lice treatments
Examples: Rid, professional hair combing Liquid adhesive for small cuts
See also Bandages, for torn or injured skin.
Lodging at a hospital or similar institution
Will qualify if the principal reason for being there is to receive medical care. Lodging not at a hospital or similar
Up to $50 per night will qualify if the lodging is primarily for and essential to medical care institution
provided by a physician in a licensed hospital or medical care facility related to (or equivalent to) a licensed hospital and there is no significant element of personal pleasure, recreation, or vacation in the travel. If a parent is traveling with a sick child, up to $100 may qualify ($50 for each person). Lodging while attending a medical
conference
Lotions

Lubricants
Lumbar support chair cushions
Marijuana or other controlled substances
See also Controlled substances in violation of federal law.
in violation of federal law
  Medical FSA and HSA Expense Eligibility List (IRS Code Section 213 (d) Eligible Expenses) Expense(s)
Eligible?
Comments and Special Rules
Massage therapy
Maternity clothing
Mattresses
In rare cases, a portion of the expenditure might qualify if a unique type of mattress is prescribed by a physician to treat a specific medical condition. Only the difference in cost between the specialized mattress and the cost of a regular mattress would be reimbursable. Meals at a hospital or similar institution
Meals that are part of the cost of inpatient care at a hospital or similar institution will qualify if the principal reason for the recipient’s being there is to receive medical care. Meals not at a hospital or similar
institution
Meals of a companion

Won't qualify even if accompanying a patient for medical reasons. Medical alert bracelet or necklace
Medical records charges
For example, the fee associated with transferring medical records to a new medical
practitioner will qualify.

Mentally handicapped, special home for
The cost of keeping a mentally handicapped person in a special home (not a relative's home) on a physician's recommendation to help that person adjust to community living may qualify. Mineral supplements
Missed appointment fees
“Morning-after” contraceptive pills
Motion sickness pills
Mouthwash
Multivitamins
Nasal strips or sprays
Nasal strips or sprays that are used to treat sinus problems qualify as being primarily for medical care, as would those that are used to prevent sleep apnea; however, nasal strips or sprays used to prevent snoring and those used by athletes are not eligible. Nebulizer
Needle container
Neti pots
Nicotine gum or patches
Norplant insertion or removal
Nutritional supplements
See also Dietary supplements; Mineral supplements.
Obstetrical expenses
Occlusal guards
Orthodontia
Orthopedic shoes
Costs of specialized orthopedic items qualify to the extent that they exceed ordinary personal use requirements (e.g., only the excess cost of the specialized orthopedic shoe over the cost of a regular shoe qualifies). Orthotic inserts
  Medical FSA and HSA Expense Eligibility List (IRS Code Section 213 (d) Eligible Expenses) Expense(s)
Eligible?
Comments and Special Rules
Osteopath fees
Ovulation monitor
Oxygen and equipment
Pain relievers
Examples: Advil, Aspirin, Tylenol, Aleve, Midol Pedialyte
Pedometer
Pellet insertion
Penile implants
Amounts paid for implants may be eligible if the diagnosis of impotence is due to natural causes such as diabetes, post-prostatectomy complications, or spinal cord injury. Peroxide
Personal trainer fees
Will qualify if a physician has recommended a supervised exercise regimen in order to treat a disease or injury (e.g., rehabilitation after surgery or the treatment of obesity) and if incurred for a limited duration. Physical exams
Physical therapy
Pregnancy test kits
Prescription drugs and medicines obtained
Importing prescription drugs from other countries violate federal law; however, a drug or from other countries
medicine may qualify for reimbursement if: (1) it is purchased and consumed in the other country and is legal in both that country and the U.S., or (2) the FDA announces that it can be legally imported. Prescription drug discount programs
Fees for discounts on drugs are not considered medical care. Probiotics
Prosthesis
Psychiatric care
Includes the costs associated at a special center that provides medical care. Psychoanalysis testing
Psychologist
Will qualify if the expense is for medical care and not just for the general improvement of mental health, relief of stress, or personal enjoyment. Recliner chairs
Can be approved, in very rare circumstances, if recommended by a physician to treat a specific condition. A signed note from a physician recommending the treatment is required, and only the difference in cost between the specialized recliner and the cost of a regular recliner would qualify. Rubbing alcohol
Safety glasses
Won’t qualify unless lenses are prescription.   Medical FSA and HSA Expense Eligibility List (IRS Code Section 213 (d) Eligible Expenses) Expense(s)
Eligible?
Comments and Special Rules
Schools and education, residential
Payments made to a residential school or program to treat an individual for behavioral, emotional, or addictive conditions (tuition, meals, and lodging) will qualify if the principal reason for attending the program is to receive medical care (ordinary education must be an incidental component). Whether someone is attending to receive medical care must be determined for each individual—just because a school or program provides medical care to some individuals does not mean that it provides medical care to all individuals. If a child is at a school because the courses and disciplinary methods have a beneficial effect on the child's attitude, the expenses won't qualify. Schools and education, special
Payments made for a mentally impaired or physically disabled person to attend a special school (tuition, meals, and lodging) will qualify if the principal reason for attending the school is to overcome or alleviate the disability (ordinary education must be an incidental component). This includes teaching Braille to a visually impaired person, teaching lip reading to a hearing-impaired person, and remedial language training to correct a condition caused by a birth defect. If a child is at a school because the courses and disciplinary methods have a beneficial effect on the child's attitude, the expenses won't qualify. Screening tests
Will qualify if the tests are used for medical diagnoses. Examples include hearing, vision, and cholesterol screenings. Seeing-eye dog
See also Guide dog, other service animal.
Shampoos
Shaving cream or lotion
Shipping and handling Fees
Reimbursable if incurred due to a qualifying medical expense. Sinus medications
See also Nasal strips or sprays.
Sleep aids
Smoking-cessation medications
Amounts paid for prescribed and OTC drugs used to stop smoking would qualify. Smoking-cessation programs
Amounts paid for a stop-smoking program would qualify. Special foods
Will qualify if prescribed by a physician to treat a specific illness or ailment and if the foods do not substitute for normal nutritional requirements. But the amount that may qualify is limited to the amount by which the cost of the special food exceeds the cost of commonly available versions of the same product (e.g., such as foods needed for a gluten-free or salt-free diet). Speech therapy
Spermicidal foam
Sperm, storage fees
Fees for temporary storage might qualify, but only to the extent necessary for immediate conception. Storage fees for undefined future conception aren't considered to be for medical care and do not qualify. Stem cell, harvesting and/or storage of
Might qualify if there is a specific and imminent medical condition that the stem cells are intended to treat. For example, the cost of harvesting and storing stem cells because a newborn has a birth defect and the stem cells would be needed in the near future might be allowable; however, collection and indefinite storage just in case they might be needed is not considered to be for medical care and does not qualify.   Medical FSA and HSA Expense Eligibility List (IRS Code Section 213 (d) Eligible Expenses) Expense(s)
Eligible?
Comments and Special Rules
Sterilization procedures
Sunburn creams and ointments
Sunglasses
Sunglasses clip-ons
Sunscreen with SPF 30 or higher
SPF of 30 or higher must be specified on the receipt, or a copy of the box/bottle displaying the price must be included. Sun protective clothing
Clothing that offers at least 30+ UVA and UVB sun protection for individuals with melanoma or other skin cancer, systemic lupus erythematosus (SLE), acute cutaneous lupus (ACLE), or other significant dermatologic conditions may be eligible. The clothing is reimbursed for the difference between “normal” apparel and this specially constructed clothing, up to 33% of the total cost. The receipt must show the purchase was from an accredited sun-protective company such as Solumbra® or Coolibar®. Support hose/TED stockings
Taxes on medical services and products
This includes local, sales, service, and other taxes. Teeth whitening
Telephone for hearing-impaired persons
The expenses of buying and repairing special telephone equipment for a hearing-impaired person will qualify. This includes teletypewriter (TTY) and telecommunications device for the deaf (TDD) equipment. Television for hearing-impaired persons
Equipment that displays the audio part of television programs as subtitles for hearing-impaired persons will qualify, but the amount that qualifies is limited to the excess cost over the cost of the regular item. For example, the cost of a specially equipped television qualifies only to the extent that it exceeds the cost of a regular model. Throat lozenges
Examples: Cepacol, Chloraseptic. See also Cough drops/suppressants.
Toiletries
A toiletry is an article or preparation that is used in the process of dressing and grooming oneself (e.g., toothpaste, shaving cream or lotion, and cologne). Toll bridges
Eligible if incurred due to a qualifying medical expense. See also Transportation
expenses for person to receive medical care
.
Toothache and teething pain relievers
Toothbrushes
Won't qualify, even if a dentist recommends special ones (e.g., electric or battery-powered) to treat a medical condition like gingivitis. Toothbrushes are items that are used primarily to maintain general health, and a person would still use one even without the medical condition; thus, they are not primarily for medical care. Toothpaste
Won't qualify, even if a dentist recommends a special one to treat a medical condition like
gingivitis. See also Toothbrushes.
Transplants
Includes surgical, hospital, and laboratory services as well as transportation expenses for organ donors.   Medical FSA and HSA Expense Eligibility List (IRS Code Section 213 (d) Eligible Expenses) Expense(s)
Eligible?
Comments and Special Rules
Transportation expenses for person to
Will qualify if the transportation is primarily for and essential to medical care. Includes car receive medical care
expenses; bus, taxi, train, plane, and ferry fares; and ambulance services. Instead of actual car expenses, a standard mileage rate for use of a car to obtain medical care is allowed. Parking fees and tolls can also qualify. Tuition for special-needs program
Will qualify if the primary purpose is for medical care. Umbilical cord, freezing and storing of
Can qualify if there is a specific medical condition that the umbilical cord is intended to treat; however, collection and indefinite storage just in case it might be needed is not considered to be for medical care and does not qualify. Vaccines
Vasectomy
Vasectomy reversal
Vitamins
Warranties/Insurance on a product
Wart remover treatments
Weight-loss programs and/or drugs
Dual-Purpose
prescribed to induce weight loss
Wheelchair

Might qualify if the wig is prescribed by a physician for the mental health of a patient who has lost all of his or her hair from disease or treatment (e.g., chemotherapy or radiation). Yeast infection medications

Source: http://www.ohr.gatech.edu/sites/default/files/benefits/Medical_Pharmacy/HSAandFSAEligibleExpenses.pdf

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