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Medical FSA and HSA Expense Eligibility List
The following is a summary of common expenses claimed against Medical Flexible Spending Account (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 utilized as a guide for the submission of claims. A
definition of eligibility is as follows (all expenses are assumed to have been incurred during the active plan year):

Yes: The expense is eligible for reimbursement.
No: The expense is not eligible for reimbursement under any circumstance.
Dual-Purpose: The expense may be eligible for reimbursement if a Medical Necessity letter or signed doctor’s note is
provided to U.S. Bank Healthcare Payment Solutions for any Flexible Spending Account (FSA) expenses. For Health
Savings Account (HSA) expenses, the Medical Necessity Form or signed doctor’s note should be maintained with tax
records in the event of an audit. In either case, the expense must be used to treat a medical condition.
Potentially: The expense may be eligible for reimbursement provided certain conditions or criteria (as specified in the
Comments and Special Rules section) are satisfied.
Rx:
The expense is eligible for reimbursement once a doctor’s prescription has been obtained prior to purchase. The
purchase must be at a drug store, pharmacy, non-healthcare merchant that has a pharmacy (Target, Walgreens, etc.) or
mail/web based vendors that sell prescription drugs.
Eligible?
Comments and Special Rules
AA meetings, transportation to
Acne treatment
Products for the treatment of acne only, regular skin care products do not qualify. Examples: Skin ID, Proactiv and anything that primarily treats acne. Acupuncture/Acupressure
Adaptive equipment
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. Includes various
items that assist individuals in performing activities of daily living (e.g.,
feeding, bathing). See also Capital expenses; Home
improvements
.
Adoption, pre-adoption medical
Medical expenses incurred before an adoption is finalized will qualify if expenses
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
Non-traditional healing products may qualify if provided to treat a substitutes, and drugs and
specific medical condition. The treatments must be legal and the medicines
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
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
Medical FSA and HSA Expense Eligibility List
Asthma treatments
Includes asthma medications and delivery devices (e.g., inhalers and nebulizers). Athletic mouth guards
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 and supplies
Examples: Bottles, storage bags, cleaning wipes, car adapter Breast reconstruction surgery
Will qualify to the extent that surgery was done following a following mastectomy
mastectomy due to cancer. This is an exception to the general rules
regarding cosmetic procedures. See also Cosmetic procedures.
Breath rite strips
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 does not increase the property value at all, then the entire cost may qualify. Items that usually do not 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. Cardiac therapy
Carpal tunnel wrist supports
Medical FSA and HSA Expense Eligibility List
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. Chiropractic Adjustments
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
Contact lenses for solely cosmetic purposes (e.g., to change one's eye equipment
Controlled substances in
If the substance violates federal law (e.g., the Controlled Substances violation of federal law
Act), the expense 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
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 do not 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 (not stress). Marriage counseling CPAP machine and headgear
Crowns, dental
Crutches
Decongestants
Dental floss
Dental implants
Dental sealants
Dental treatment
Teeth whitening, veneers, and lumineers are the only exception as they are considered cosmetic in nature and do not qualify. Dentures and denture
adhesives
Denture brush

Denture cleaners
Medical FSA and HSA Expense Eligibility List
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). Diet foods
Disabled dependent care of
Such expenses will qualify if they are for medical care of the disabled 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 for temporary storage qualify, but only to the extent necessary for immediate conception. Storage fees for undefined future conception are not 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. Epsom salt
Exercise equipment
Exercise Programs
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
Medical FSA and HSA Expense Eligibility List
Flu shots
Funeral expenses
Gauze pads
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. Hand sanitizer
Health club fees
Prepayments are not eligible until services have been rendered. 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 does not 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. Homeopathic products
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
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
Medical FSA and HSA Expense Eligibility List
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
Such expenses will qualify for a child with dyslexia or an otherwise Laser eye surgery; Lasik
Late fees
Example: For late payment of bills for medical services Latex gloves
Laxatives
Learning disability,
If prescribed by a physician, tuition fees paid to a special school and instructional fees
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
Will qualify if the principal reason for being there is to receive medical institution
Lodging not at a hospital or
Up to $50 per night will qualify if the lodging is primarily for and similar institution
essential to medical care 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
See also Controlled substances in violation of federal law.
substances in violation of
federal law
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
Meals that are part of the cost of inpatient care at a hospital or similar institution
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

Will not qualify even if accompanying a patient for medical reasons. Medical FSA and HSA Expense Eligibility List
Must contain SPF 30 or higher to be considered eligible. The SPF must be specified on the receipt, or a copy of the box/bottle displaying the price must be included. Medical alert bracelet or
necklace
Medical records charges

Example: The fee associated with transferring medical records to a new medical practitioner will qualify. Mentally handicapped, special
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. Midwives
Mineral supplements
Missed appointment fees
“Morning-after” contraceptive
pills
Motion sickness patches or

wristband
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
Dietary supplements; Mineral supplements.
Obstetrical birthing expenses
Prepayments towards the delivery cannot be reimbursed until the birth.
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
Osteopath fees
Ovulation monitor
Oxygen and equipment
Pain relievers
Examples: Advil, Aspirin, Tylenol, Aleve, Midol Pedialyte
Pedometer
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
Physical exams
Physical therapy
Pregnancy test kits
Prescription drugs and
Importing prescription drugs from other countries violate federal law. Medical FSA and HSA Expense Eligibility List
medicines obtained from other
However, a drug or medicine may qualify for reimbursement if: (1) it is countries
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
Fees for discounts on drugs are not considered medical care. programs
Probiotics

Prosthesis
Psychiatric care
Includes the costs associated at a special center that provides medical care. Psychoanalysis testing
Psychological care
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
May be eligible, 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
Will not qualify unless lenses are prescription. Schools and education,
Payments made to a residential school or program to treat an residential
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 is a 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 will not 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 will not qualify. Screening tests
Will qualify if the tests are used for medical diagnoses. Examples include hearing, vision, and cholesterol screenings. Seeing-eye dog
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
also Nasal strips or sprays.
Sleep aids
Smoking-cessation
Amounts paid for prescribed and OTC drugs used to stop smoking will medications
Smoking-cessation programs
Amounts paid for a stop-smoking program will 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 Medical FSA and HSA Expense Eligibility List
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
Might qualify if there is a specific and imminent medical condition that storage of
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. Sterilization procedures
Sunburn creams and ointments
Sunglasses
Sunglasses, clip-on
Will qualify if prescribed by a physician to treat a specific medical condition. Sunscreen
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. 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
This includes local, sales, service, and other taxes. products
Teeth whitening

Telephone for hearing-impaired
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
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

Will not 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. Medical FSA and HSA Expense Eligibility List
Toothpaste
Will not 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. Transportation expenses for
Will qualify if the transportation is primarily for and essential to medical person to receive medical care
care. Includes car 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
Will qualify if the primary purpose is for medical care. Umbilical cord, freezing and
Can qualify if there is a specific medical condition that the umbilical storing of
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

Water Pik
Weight loss drugs
Weight-loss programs
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.gpc.edu/humanresources/sites/www.gpc.edu.humanresources/files/files/FSAandHSAExpense.pdf

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