Condition/Type of Service
Eligible
Potentially Eligible
 Not Eligible
Additional Information 
Abortion - FSA
 
 
 
Acupuncture - FSA
 
 
 
Adoption Fees - FSA

 

 
 
Air Purifiers - FSA
 
X requires LMN 
 

 

Download LMN

Alcoholism/Drug/Substance Abuse Treatment-FSA
 
 
 
Allergy Products - FSA
 
X requires RX 
 

Examples include: 

  • Zyrtec
  • Claritin
  • Allegra
  • Benadryl

Download OTC Reference Guide

Ambulance - FSA

 
X
 
 
 
Artificial Reproductive Technologies - FSA  
X
 
 
 
Automobile Modifications - FSA
 
X requires LMN 
 

Modifications needed to accomodate a physical handicap for you or a covered dependent are potentially eligible

Download LMN

Baby Formula - FSA
 
X requires LMN
 

Only the cost difference btw regular formula and the prescribed formula is eligible

Download LMN

Band-Aids/Bandages - FSA
 
 
 
Before & After School Care - DCA
X
 
 
 
Birth Control - FSA
 
 

Examples include:

  • condoms
  • diaphrams
  • Ovulation kits 

 

Blood Pressure Monitors - FSA

 
 
 
 
Blood Storage - FSA
 
 
X requires LMN
 

Blood storage is eligible if you're scheduled for an upcoming surgery which requires stored blood.  Storage fees should not exceed six months.

Download LMN

Body Scans - FSA  
X
 
 
CT, MRI, X-RAY
Braille Books/Magazine - FSA
 
 
 

Newly Eligible

Breast Pumps/Lactation Device and accessories - FSA

 
 

Please note you may not be able to purchase these items with your FlexCard at stores such as Babies R Us but you can purchase them along with any accessories and submit them for reimbursement.

Camps (daytime) - DCA  
X
 
 
If enrolled for the primary care of your covered dependents while you and/or your spouse is at work 
Camps (overnight) - DCA
 
 
 
X
 
Camps (soccer, baseball, football, etc.) - DCA  
X
 
 
If enrolled for the primary care of your covered dependents while you and/or your spouse is at work
         
Condition/Type of Service
Eligible
Potentially Eligible
Not Eligible
Additional Information
         
Capital Expense - FSA
 
X requires LMN 
 
If the value of your home is not increased by the improvement, the entire expense is approved.  If the value of your home is increased, only the cost difference between the increase of the value of your home and the expense is eligible.  
Childbirth Classes - FSA  
X
 
 

Examples include:

  • Breastfeeding classes
  • Newborn or new infant care classes
  • Parenting classes
  • Lamaze classes 
Chiropractic Care - FSA  
X
 
 
Most chiropractic expenses are covered
Cialis - FSA  
X
 
 
 
Circumcision - FSA  
X
 
 
 
Cobra Premiums - FSA
 
 
 
Co-Insurance - FSA
 
 
 
Compression Hosiery/Socks - FSA      X    

 

Contact Lenses  - FSA
 
 
To correct vision.  Colored contact lenses that are not corrective are not eligible.   
Contact Lens Solutions -      X    

Examples include

  • Complete
  • Bausch & Lomb
  • Sensitive Eyes
  • Re-Nu
  • Opti-Free

 

Co-Payments - FSA
 
 
 
Cord Blood Storage  - FSA
 
X requires LMN 
 
Can be reimbursed if there is a specific medical condition it is being used to treat.  Storage for "just in case" is not eligible.  Storage fees must not exceed 12 months.  
Cosmetic Procedures - FSA 
 
X requires LMN 
 
Possibly covered if used to correct a deformity arising from a congenital abnormality, personal injury from accident or trauma are potentially covered.   
Counseling - FSA 
 
 
Debt and marriage counseling are not eligible 
Cough, Cold and Flu Products - FSA 
 
X requires RX 
 

Examples include:

  • Thera Flu
  • Robitussin
  • Sudafed

Download OTC Reference Guide 

Crutches - FSA
 
 
 
Daycare/ChildCare Services - DCA 
 
 

Daycare facility, In-home care and babysitters for your covered dependent under the age of 13 are eligible if the care is being provided so that you can work.  If married, your spouse must also be working or going to school full-time.  If you are divorced, you must be the custodial parent for more than 50% of the year.

Please note that advanced payment for care that has not yet been provided is NOT eligible until the care has been realized.

Dancing Lessons - FSA
 
 
 
X
 
Dental Care - FSA
 
 
Exams, cleanings, x-rays, bridges, crowns, fillings and root canals are eligible expenses.  Does not include normal daily dental care such as toothbrushes, dental floss and mouthwash 
         
Condition/Type of Service
Eligible
Potentially Eligible
Not Eligible
Additional Information
         
Deductibles - FSA      X      
Dental Floss - FSA           X  
Diabetic Supplies - FSA 
 
 
Includes insulin, syringes, meters and test strips 
Diaper Rash Creams - FSA 
 
 
X requires RX
 
 
Diapers - FSA 
 
 
Adult diapers such as depends are eligible.  Diapers for the routine care of newborns and toddlers are not eligible. 
Dietary Supplements - FSA
 
X requires LMN 
 

Must be used to treat a specific medical condition or ailment.  Multi-Vitamins used to promote general health are not covered.  Meal replacement supplements are not eligible.  Even if purchased from a doctor or chiropractor, a letter of medical necessity is still required.

Download LMN

Discount Programs/Clubs           X Vision providers typically offer discounts on their prices if you pay to join their membership club which offers discounts on future purchases.  Please note that these expenses are not eligible under an FSA program, however, you can pay for them out of pocket so you don't lose out on the savings. 
Doula - FSA
 
 
If the doula is licensed health care professional, his or her fees can be reimbursed. 
Drug Addiction Assistance - FSA 
 
 
Includes inpatient care facility fees such as food and lodging provided by a licensed addiction center are eligible as well as the cost of.  Also included are the fees associated with outpatient facilities.   
Ear Plugs - FSA 
 
X requires LMN 
 
 Must be prescribed to treat a specific medical condition such as the presence of middle/inner ear tubes.
Elder Care - DCA 
 
 
Adult must live with you at least 8 hours a day and be claimed as a dependent on your federal tax return.  
Electrolysis - FSA 
 
 
 
Electrolyte Replacements - FSA 
 
 
Examples include: Pedialyte 
Eye Care - FSA 
 
 

Examples include: 

  • Eye patches
  • Reading glasses 
Eye Drops - FSA 
 
X requires RX 
 

Examples include: 

  • Visine
  • Murine
  • Opcon
  • Patanol 
Eyeglasses/Eye Exams - FSA 
 
 

Examples include:

  • RX sunglasses
  • Reading glasses
  • Lenses
  • Frames 
Excercise equipment - FSA
 
X requires LMN 
 
If used to treat a specific medical condition or ailment 
Excercise Programs - FSA
 
X requires LMN 
 
If used to treat a specific medical condition or ailment 
Feminine Hygiene Products - FSA 
 
X requires LMN 
 
Products used post-surgery or after childbirth may be reimbursed 
Fertility Enhacement - FSA
 
 
Includes fertility predictor kits and pregnancy tests 
Fertility Treatments - FSA
 
 

Examples include:

  • Artificial insemination
  • Egg donor and/or sperm donor for recipient
  • Embryo replacement and storage (storage fees must not exceed 12 months)
  • Embryo transfer
  • Fertility exams
  • FSH injections
  • In vitro/ In vivo fertilization
  • Sperm implants

 

Fiber Supplements - FSA
 
X requires LMN 
 

 Examples include:

  • Benefiber
  • Metamucil
         
Condition/Type of Service
Eligible
Potentially Eligible
Not Eligible
Additional Information
         
Finance Charges - FSA 
 
 
 
First Aid Kits/Supplies - FSA
 
 
 
Fish Oil - FSA 
 
X requires LMN 
 
Must be used to treat a specific medical condition or ailment such as High Cholesterol.  If taking it for general health it is not eligible.   
Flouride Rinse - FSA
 
 
 
Flu Shots - FSA 
 
 
 
Food - FSA 
 
 
 
Foot Care - FSA 
X  
 
 

Examples include:

  • Arch supports and insoles
  • Bunion, blister and corn treatments
  • Callous removers 
Funeral Expenses - FSA 
 
 
 
Glucosamine - FSA 
 
 
 
Guide Dogs - FSA
 
 
 
Gym Membership - FSA
 
X requires LMN 
 
Fees paid for a gym membership may be an eligible expense if prescribed by a physician and substantiated that treatment is necessary to alleviate a specific medical condition.  YOU CANNOT BE REIMBURSED FOR EXPENSES THAT WILL BE INCURRED IN THE FUTURE 
Hair Loss Treatment - FSA 
 
X requires LMN 
 
If the hair loss was the result of an injury or trauma 
Hair Transplant - FSA
 
 
 
Hand Sanitizer - FSA 
 
 
 
Health Screenings - FSA 
 
 
 
Hearing Aids - FSA 
 
 
 
Heart Rate Monitors - FSA 
 
 
 
Heating Pads - FSA      X      
Hemorrhoidal Treatments - FSA 
 
X requires RX 
 

Examples include:

  • Preparation H
  • Tucks
  • Tronolane 
Herbal Supplements - FSA 
 
X requires LMN 
 

Examples include:

  • Echinacea
  • Gingko Biloba
  • Valerian
  • St. John's Wort 
Home Diagnostic Kits - FSA 
 
 

Examples include:

  • Blood pressure monitors
  • Pregnancy tests
  • HIV tests
  • Cholesterol tests 
Home Medical Equipment - FSA
 
 
Potentially may need a LMN 
Hypnosis - FSA 
 
 
 
Immunizations - FSA 
 
 
 
Incontinence Products - FSA 
 
 

Examples include:

  • Attends 
  • Poise
  • Depends

 

         
Condition/Type of Service
Eligible
Potentially Eligible
Not Eligible
Additional Information
         
Insurance Premiums - FSA 
 
 
 
In Vitro Fertilization - FSA 
 
 
 
Kindergarten - DCA          X Half and full day kindergarten are considered primarily educational.
Lab Fees - FSA 
 
 
 
Lactation Consultant - FSA
 
 
Services rendered by a licensed health care provider can be reimbursed. 
Laser Eye Surgery - FSA 
 
 
 
Laser Hair Removal - FSA 
 
 
 
Latchkey - DCA      X      
Late Payment Fees - FSA & DCA 
 
 
 
Late Pick Up Fees - DCA 
 
 
 
Legal Fees - FSA 
 
 
Legal fees paid to authorize treatment for mental illness are eligible 
Levitra - FSA 
 
 
 
Lice Treatment - FSA 
 
X requires RX 
 

Examples include:

  • Nix
  • Rid 
Lodging - FSA 
 
 

Up to $50 per night/per person is eligible if the following conditions are met:

  • The lodging was primarily for, and essential to, medical care
  • The medical care was provided by a doctor in a licensed hospital or medical care facility
  • Expenses for food and beverage are not eligible 
Loding, for Companion - FSA 
 
 
If he or she is accompanying the patient ( you or your covered dependents) for medical reasons. 
Long Term Care Insurance - FSA 
 
 
 
Massage Therapy - FSA 
 
X requires LMN 
 
If used to treat a specific medical condition or ailment.  Reduce stress or improve general health is not eligible.  
Maternity Clothes - FSA 
 
 
 
Meals - FSA 
 
 
 
Medical Alert Bracelet/Necklace - FSA 
 
 
 
Medical Information/Records - FSA 
 
 
 
         
Condition/Type of Service
Eligible
Potentially Eligible
Not Eligible
Additional Information
         
Medicated Lip Products - FSA 
 
X requires RX 
 
 
Menstrual Relief - FSA 
 
X requires RX 
 
 
Migraine Relief - FSA 
 
X requires RX 
 
 
Mileage - FSA 
 
 

Effective 1/1/11 - 6/30/11, rate is 19 cents per mile

Effective 7/1/11, rate is 23.5 cents per mile

Must supply receipt that shows proof of the visit and the total mileage.  Mileage for trips to the pharmacy are not eligible.   

Missed Appointment Fees - FSA 
 
 
 
Motion Sickness Medicines - FSA 
 
X requires RX 
 
 
Mouthwash - FSA          X  
MRI - FSA      X     Patient portion after insurance pays
Nasal Spray - FSA 
 
X requires RX 
 
 
Nasal Strips - FSA 
 
 

Examples include:

  • Breathe Right
  • Snorezz 
Nursery School - DCA      X      
Occupational Therapy - FSA 
 
 
 
Optometrist - FSA 
 
 
 
Oral Care - FSA 
 
 
 
Orthodontia/Braces - FSA 
 
 
Download Reference Guide 
Orthopedic Shoes - FSA 
 
X requires LMN 
 
Only shoes custom fitted to the wearer's feet are eligible.  Only the cost difference between the custom made shoe and a comparable shoe are eligible.  Mass produced shoes are not eligible.  
Orthotic Inserts - FSA 
 
 
 
Osteopath - FSA 
 
 
 
Over-the-counter drugs/medications - FSA 
 
X requires RX 
 
Download OTC Reference Guide
Ovulation Monitor - FSA 
 
 
 
Oxygen - FSA 
 
 
 
Pain Relievers - FSA 
 
X requires RX 
 

Examples include:

  • Tylenol
  • Motrin
  • Advil
  • Aleve
  • Pamprin
  • Ben Gay
  • Icy Hot
  • Midol 

Download OTC Reference Guide

         
Condition/Type of Service
Eligible
Potentially Eligible
Not Eligible
Additional Information
         
Physical Therapy - FSA 
 
 

Examples include:

  • Orthopedic therapy
  • Rehabilitation 
Pre-Paid Fees - FSA & DCA
 
 
The expense must be incurred before it is eligible 
Pillows, Lumbar Support - FSA
 
X requires LMN 
 

Pillows or cushions that provide lumbar support may be eligible for reimbursement if prescribed by a licensed health care professional to treat or alleviate a specific medical condition

Download LMN 

Pre-kindergarten - DCA      X      
Pre-school - DCA      X      
Pregnancy Tests - FSA 
 
 
 
Prescription Drugs - FSA 
 
 
 
Prescription Drugs (imported) - FSA 
 
 
 
Preventative Screenings - FSA 
 
 
 
Prosthetics - FSA 
 
 
 
Protection Plans - FSA           X  
Psychiatric Services and Care - FSA 
 
 
 
Psychologists - FSA 
 
 
 
Reading Glasses - FSA 
 
 
 
Retin-A - FSA 
 
 
 
Rogaine - FSA 
 
 
 
Sales Tax - FSA 
 
 
 
Shampoo - FSA 
 
 
 
Shipping and Handling - FSA 
 
 
 
Sleep Aids - FSA 
 
X requires RX 
 

Examples include:

  • Unisom
  • Nytol
  • Tylenol PM
  • Sominex 

Download OTC Reference Guide

Smoking Cessation Products - FSA 
 
X requires RX 
 

Examples include:

  • Commit
  • Nicoderm CQ
  • Nicorette
  • Nicotrol 
         
Condition/Type of Service
Eligible
Potentially Eligible
Not Eligible
Additional Information
         
Smoking Cessation Programs - FSA 
 
 
 

Speech Therapy - FSA 

 
 
 
Sterilization Procedures - FSA 
 
 
 
Sterilization Reversal - FSA 
 
 
 
Student Health Fee - FSA 
 
 
 
Sunglass Clip-on - FSA          X Sunglass clip-ons that go over eyeglasses are not eligible
Sunscreen - FSA 
 
 
SPF 30 or higher 
Taxi Fare - FSA 
 
 
To and from medical appointments.  Receipt of the visit required.  
Teethwhitening - FSA             X Considered as cosmetic procedure
Thermometers - FSA      X      
Toothbrushes - FSA 
 
 
 
Tuition - FSA & DCA          X Considered primarily as educational
Ultra Sound - FSA
 
 
 
Vaccinations - FSA       X      
Vasectomy - FSA 
 
 
 
Vasectomy Reversal - FSA 
 
 
 
Viagra - FSA 
 
 
 
Vitamins - FSA 
 
X requires LMN 
 

If used to treat a specific medical condition.  Multi-vitamins used for general well-being are not eligible. 

Download LMN 

Walkers - FSA 
 
 
 
Warranties - FSA 
 
 
 
Wart Removal - FSA 
 
X requires RX 
 

Examples include:

  • Compound W
  • Wart-Off 
Weight Loss Programs - FSA 
 
X requires LMN 
 
Food is not eligible.  Programs such as Weight Watchers are eligible.  Keep in mind pre-paid programs are not eligible.   If your program requires full payment for a program that spans over multiple weeks, do not use your FSA to pay for it.  Rather, pay for it out of pocket and when the program is successfully completed, submit your documentation along with a completed reimbursement form and letter of medical necessity for processing. 

Wheelchairs - FSA 

 
 

 

Please note this is a general eligible list of items/services that are most commonly approved under a Flexible Spending Account (FSA) and Dependent Care Account (DCA).  To inquire about a specific item/service, please contact us at flexsupport@flexsaveamerica.com

 

Copyright 2013, Flexsave of America, Inc
.