FSA and HSA Eligibility List

Acne Treatment

If to treat acne, it is eligible. However, the cost of regular skin care does not qualify.

Acne treatment - Prescription

If the expense can be used for both cosmetic and medical (such as Retin-A, which can be used to treat both acne and wrinkles), a physician's recommendation* with the medical condition is required.

Acupuncture

If treating a medical condition.

Adoption - Medical Expenses Incurred Before Adoption is Finalized

If the child is your tax dependent when the service is provided. 

Advanced Reimbursements

See special requirements under Orthodontia expenses.

Alcoholism Treatment

Amounts paid for inpatient treatment at a therapeutic center for alcohol addiction will qualify.

Allergy Medicine

See Over the Counter - Drugs and Medicines.

Allergy Treatments

Allergy treatment and products

Alternate Diet

Alternative dietary supplements

Alternative Healers

While expenses may be eligible, the treatments must be legal and may not be a food or substitute for a food the person would normally consume in order to meet nutritional requirements.

While treatment costs do not require a prescription to be eligible, any Prescriptions - Drugs and Medicines prescribed must be prescribed by an individual legally authorized to issue prescriptions in the applicable state.

Ambulance

Analgesics

See Over the Counter - Drugs and Medicines.

Antacid

See Over the Counter - Drugs and Medicines.

Anti-Itch Creams

See Over the Counter - Drugs and Medicines.

Antibiotic Sprays or Ointments for First Aid

See Over the Counter - Drugs and Medicines.

Antihistamine

See Over the Counter - Drugs and Medicines.

Artificial Limbs and Teeth

Aspirin

See Over the Counter - Drugs and Medicines.

Asthma Treatments

Autopsy

Babysitting/Child Care

See Dependent Care Account Expenses.

Bandages

Behavioral Modification Programs

See Schools and Education.

Birth Control Pills

Eligible with a prescription. See Prescriptions - Drugs and Medicines.

Birthing Classes/Childbirth Classes/Lamaze

Expenses for a coach or significant other are not eligible. Expenses for a doula may be eligible if expenses are related to medical care. See Lamaze classes.

Blood Pressure Monitoring Devices

Blood Sugar Test Kit and Test Strips

See Diabetic Supplies.

Body Scan

Body scans employing MRIs and similar technologies are diagnostic services. See diagnostic items/services.

Botox

May qualify if recommended to treat a specific medical condition (e.g., migraines); does not qualify if used for cosmetic purposes.

Breast Pumps and Lactation Supplies, Excluding Breastfeeding Bras

Breast Reconstruction Surgery Following Mastectomy

Eligible if surgery was done following a mastectomy for cancer.

Calamine Lotion

See Over the Counter - Drugs and Medicines.

Carpal Tunnel Wrist Supports

Chelation Therapy

Eligible expense if used to treat a medical condition such as lead poisoning.

Chiropractors

Chondroitin

Eligible if used primarily for medical care. Will not qualify if used to maintain general health. A medical practitioner's recommendation* is required stating the item is to treat a specific medical condition.

Christian Science Practitioners

Eligible if expense is for medical care.

Circumcision

Co-Insurance Amounts, Co-Payments and Deductibles

Eligible if the underlying service/item qualifies.

COBRA Premiums (HCFSA, HRA)

Healthcare FSA – Not eligible
Health Reimbursement Arrangement – Not Eligible

COBRA Premiums (HSA)

HSA – Eligible expense

Cold Medicine 

See Over the Counter - Drugs and Medicines.

Cold/Hot Packs

Only cold/hot packs sold as medical supplies will qualify; those sold for other purposes (e.g., to keep beverages cold or hot) won’t qualify.

Condoms

Contact Lenses, Materials, and Equipment

If contacts are needed for medical purposes. Supplies needed for using lenses will qualify if the lenses are needed for medical purposes.

Contraceptives

See birth control pills; condoms; Spermicidal foam.

Cosmetic Procedures or Surgery

Exception for amounts paid for surgery necessary to improve a deformity arising from a congenital abnormality, personal injury from an accident or trauma, or a disfiguring disease.

Cosmetics

Cough Suppressants

See Over the Counter - Drugs and Medicines.

Counseling

Eligible if primarily for medical care. Must submit a medical practitioner's recommendation* with the medical condition, an EOB, or a practitioner's receipt listing the diagnosis code.

COVID-19 Personal Protective Equipment (PPE)

Face masks, hand sanitizer, and hand sanitizer wipes are eligible when used to prevent the spread of the Coronavirus Disease 2019 (COVID-19). Use of these items for other purposes will require a Letter of Medical Necessity.

Crutches

Decongestants

See Over the Counter - Drugs and Medicines.

Deductibles

Dental Aligners

See orthodontia.

Dental Services

Eligible for expenses incurred for the prevention and alleviation of dental disease. Teeth whitening is not eligible.

Dentures and Denture Adhesives

Dependent Care Expenses

Dependent care expenses are not eligible medical expenses but may be eligible for reimbursement from a Dependent Care Account.

Diabetic Supplies

Includes Blood-sugar test kits and test strips; Glucose-monitoring equipment; and Insulin.

Diagnostic Items/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, and cancer.

Diaper Rash Ointment/Cream

See Over the Counter - Drugs and Medicines.

Diapers or Diaper Service

Eligible if expenses incurred to relieve the effects of a diagnosed medical condition, such as urinary incontinence in adults. A medical practitioner's recommendation* with the medical condition is required.

Diarrhea Medicine

See Over the Counter - Drugs and Medicines.

Dietary Supplements - Over the Counter

Eligible if used primarily for medical care. Will not qualify if used to maintain general health. A medical practitioner's recommendation* is required stating the item is to treat a specific medical condition.

DNA Collection and Storage

Temporary storage may be eligible if collected as part of a diagnosis, treatment or prevention of existing or imminent medical condition. A medical practitioner's recommendation* with the medical condition is required.

Drug Addiction Treatment

Drug Overdose Treatment

Ear Plugs - Over the Counter

Eligible if treating a specific medical condition. A medical practitioner's recommendation* with the medical condition is required.

Egg Donor Fees

Eggs and Embryos Storage Fees

Eligible if expense is for temporary storage, but only to the extent necessary for immediate conception.

Electrolysis or Hair Removal

Eye Examinations, Eyeglasses and Related Equipment and Materials/Cleaners

Face Creams, Moisturizers - Over the Counter

Face Lifts

Face Masks

See COVID-19 PPE.

Feminine Hygiene Products

See Menstrual Care Products. Does not include hygienic sprays, powders, washes, vaginal suppositories, douches, feminine deodorant, chaffing powder, or other products not used to control the flow of menstruation or other genital secretions. 

Fertility Treatments (e.g., surgery, in vitro fertilization (IVF), gamete intrafallopian transfer (GIFT) and shots)

Eligible to the extent procedure is intended to overcome an inability to have children. Expenses for IVF surrogate not eligible unless the surrogate is a tax dependent.

Fever Reducing Medications

See Over the Counter - Drugs and Medicines.

Fiber Supplements- Over the Counter

Eligible if used primarily for medical care. Will not qualify if used to maintain general health. A medical practitioner's recommendation* is required stating the item is to treat a specific medical condition.

First Aid Cream

Fitness Programs

See Health Club Dues.

Flu Shots

Funeral Expenses

Gambling Addiction Treatment

Expense eligible for inpatient treatment at a therapeutic center for gambling addiction.

Gauze Pads

Genetic Testing

Eligible if testing is done to diagnose a medical condition or to determine possible defects. However, testing done just to determine the sex of a fetus would not qualify.

Glucosamine- Over the Counter

Eligible if used primarily for medical care. Will not qualify if used to maintain general health. A medical practitioner's recommendation* is required stating the item is to treat a specific medical condition.

Glucose Monitoring Equipment

See Diabetic Supplies.

Guide Dog or Other Animal Aide

Eligible if expense is to assist a physically disabled person; expense of buying, training, and maintaining a guide dog includes the expenses of food and inoculations. Veterinary fees for such animals also qualify as medical care.

Hair Removal/Transplant

Hand Sanitizer

See COVID-19 PPE.

Health Club Dues and Fees

Only in very limited circumstances would fees paid to a health club qualify. Expense is eligible if a physician recommends to treat a specific medical condition (e.g., rehabilitation after back surgery or treatment for obesity). The expense must not have been incurred "but for" the disease (e.g., if you belonged to the health club before being diagnosed, then the fees would not qualify). When treatment is no longer needed, the fees would no longer qualify. A medical practitioner's recommendation* is required stating the expense is to treat a specific medical condition.

Hearing Aids

Includes the cost of batteries.

Hemorrhoid Treatment

See Over the Counter - Drugs and Medicines.

Hemp or Cannabidiol (CBD) Products

Federal and state law in this area is in flux; until the law is settled, plan sponsors and administrators may exclude hemp or CBD products.

Herbal Supplements - Over the Counter

See Dietary Supplements.

Home Care

See Nursing Services.

Hormone Replacement Therapy

Eligible with a prescription if expense is primarily for medical care. Will not qualify if used to maintain general health. A medical practitioner's recommendation* is required stating the item is to treat a specific medical condition. See Prescriptions - Drugs and Medicines.

Hospital Services

Illegal Operations and Treatments

Immunizations

Incontinence Supplies

Adult diapers used to relieve incontinence generally will qualify. See Diapers.

Infertility Treatments

See Fertility Treatments.

Insect Bite Creams and Ointments

See Over the Counter - Drugs and Medicines.

Insulin

Includes equipment necessary to inject the insulin, such as syringes or insulin pumps.

Insurance Premiums

FSA – no.

HRA - depending on plan design, insurance premiums may be eligible.

HSAs - can reimburse insurance premiums in limited circumstances. See information at www.irs.gov for more details.

Laboratory Fees

If part of medical care or diagnosis.

Lamaze Class

To the extent instruction relates to birth and not child rearing. Expenses for the coach or significant other do not qualify.

Language Training for Dyslexic/Disabled Child

Eligible if the expense is for a child with dyslexia or an otherwise disabled child. Amounts paid for regular schooling do not qualify. A medical practitioner's recommendation* is required stating the expense is to treat a specific medical condition.

Laser Eye Surgery/Lasik/Radial Keratotomy

Late Fees on Medical Bills

Laxatives

See Over the Counter - Drugs and Medicines.

Learning Disability, Instructional Fees

Eligible if expense is prescribed by a physician. Includes expenses for special school or specially trained teacher for a child who has severe learning disability caused by mental or physical impairment.

Liquid Bandage

Lodging at Hospital or Similar Institution

Eligible if principal reason for being there is to receive medical care.

Lodging Not at Hospital or Similar Institution

Up to $50/night, provided: (1) lodging is primarily for and essential to medical care; (2) medical care is provided in a hospital or medical facility related to or equivalent to licensed hospital; (3) lodging is not lavish; and (4) no 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 of a Companion

If accompanying a patient for medical reasons and all of the conditions described under Lodging not at a hospital, are also met.

Lodging While Attending a Medical Conference

Long-Term Care Services (HCFSA or HRA)

HCFSA – No
HRA – No

Long-Term Care Services (HSA)

HSA - Yes

Marijuana or Other Controlled Substances

Massage Therapy

Eligible if expense is to treat a specific injury or trauma. Will not qualify if to improve general health or to relieve stress. A medical practitioner's recommendation* is required stating the expense is to treat a specific medical condition.

Mastectomy-Related Bras

Medic-Alert Bracelet/Necklace - Over the Counter

Eligible if expense is recommended by a medical practitioner in connection with treating a medical condition. A medical practitioner's recommendation* is required stating the expense is to treat a specific medical condition.

Medical Conference Admission/Transportation

Eligible if expense relates to a chronic disease suffered by you, your spouse, or your dependent and if the conference is primarily for and essential to the person in need of medical care.

Medical Monitoring and Testing Devices

These items include blood-pressure monitors, syringes, glucose kit, etc.

Medical Records Charges

For the expense associated with transferring medical records to a new medical practitioner.

Menstrual Pain Relievers

See Over the Counter - Drugs and Medicines.

Menstrual Care Products

The term ‘menstrual care product’ means a tampon, pad, liner, cup, sponge, or similar product used by individuals with respect to menstruation or other genital-tract secretions. Does not include hygienic sprays, powders, washes, vaginal suppositories, douches, feminine deodorant, chaffing powder, or other products not used to control the flow of menstruation or other genital secretions.  

Mentally Handicapped, Special Home For

The cost of keeping a mentally handicapped person in a special home (not a relative's home) on a psychiatrist's recommendation* to help that person adjust from life in a mental hospital to community living may apply.

Missed Appointment Fee

Motion Sickness Pills

See Over the Counter - Drugs and Medicines.

Nasal Sprays

 See Over the Counter - Drugs and Medicines.

Nasal Strips - Over the Counter

Eligible if expense is incurred to treat medical condition. Will not qualify if used for run of the mill snoring. A medical practitioner's recommendation* is required stating the expense is to treat a specific medical condition.

Naturopathic Healers

See Alternative Healers

Nicotine Gum or Patches

See Over the Counter - Drugs and Medicines.

Norplant Insertion or Removal

Nursing Services for a Baby

Does not qualify if baby is healthy and normal. 

Nursing Services Provided by a Nurse or Other Attendant

Expenses incurred, such as wages, employment taxes, and other amounts you pay for nursing services (including extra costs for nurses' room and board) generally will qualify, whether provided in the participant's home or another facility. The attendant doesn't have to be a nurse, as long as the services are those generally performed by a nurse. These include services connected with caring for the patient's condition, such as giving medication or changing dressings, as well as bathing and grooming. But if the person providing nursing services also provides household and personal services only those expenses for nursing services qualify.

Nutritionist's Professional Expenses

Eligible if expense relates to a specifically diagnosed medical condition. Will not qualify if the expense is for general health. A medical practitioner's recommendation* is required stating the expense is to treat a specific medical condition.

Obstetrical Expenses

Occlusal Guards to Prevent Teeth Grinding

Optometrist

Organ Donor

Including surgical, hospital and laboratory services as well as transportation expense for donor.

Orthodontia Expenses

Orthodontia expenses and supplies are eligible. However, when an orthodontic treatment plan is paid up-front at the time of the first visit, the plan may apportion the reimbursements as services are provided during the treatment plan.

Over the Counter - Drugs and Medicines (OTC)

Must be primarily for medical care (and not for personal, general health, or cosmetic purposes), legally procured, and generally accepted as medicines and drugs.

Ovulation Monitor

Pain Relievers

See Over the Counter - Drugs and Medicines.

Patterning Exercises

Eligible if expense is for exercises for a mentally handicapped child. A medical practitioner's recommendation* is required stating the expense is to treat a specific medical condition.

Physical Exams

Physical Therapy

Physician Access Retainer

Prenatal Expenses

Prenatal Vitamins

If taken during pregnancy (a medical condition). Vitamins taken at other times generally do not qualify.

Prescription Drug Discount Programs

A fee paid to get a drug discount card will not qualify; the cost of the prescription may qualify.

Prescriptions - Drugs and Medicines

Must be primarily for medical care (and not for personal, general health, or cosmetic purposes), legally procured, and generally accepted as medicines and drugs. A prescription for this purpose is one written by an individual legally licensed to issue prescriptions, meeting the legal requirements as required for a drug or medicine that is available by prescription only. 

Prescriptions - Drugs and Medicines Obtained from Other Countries

Propecia

Eligible if used to treat a medical condition such as alopecia. When used for cosmetic purposes (e.g., to treat male pattern baldness) it is not an eligible expense. Must be prescribed. See Prescriptions - Drugs and Medicines.

Prosthesis

Psychiatric Care

Eligible if treating a medical condition. Must submit a medical practitioner's recommendation* stating the expense is to treat a specific medical condition, an EOB, or a practitioner's receipt listing the diagnosis code.

Psychoanalysis or Psychologist

Eligible if expense is treating a medical condition. Will not qualify if for the general improvement of mental health, to relieve stress, or personal enjoyment. Must submit a medical practitioner's recommendation* stating the expense is to treat a specific medical condition, an EOB, or a practitioner's receipt listing the diagnosis code.

Radial Keratotomy

Retin-A

Eligible with a prescription if expense is treating a medical condition. Will not qualify if purchased for cosmetic purposes (e.g., to reduce wrinkles), even if recommended by a medical practitioner. See Acne Treatment; Cosmetic Procedures and Drugs and Medicines.

Rogaine

Eligible with a prescription if expense is treating a medical condition. Will not qualify if purchased for cosmetic purposes even if recommended by a medical practitioner. See Propecia and Drugs and Medicines.

Safety Glasses

Eligible if prescription lenses.

Sanitizing Wipes

See COVID-19 PPE.

Schools and Education, Residential

Eligible if expense is to treat an individual for behavioral, emotional, or addictive conditions (tuition, meals, and lodging) and the principal reason for attending the program is to receive medical care. 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. A medical practitioner's recommendation* is required stating the expense is to treat a specific medical condition.

Schools and Education, Special

Eligible if expense is to treat an individual who is mentally impaired or physically disabled to attend a special school (tuition, meals, and lodging) and the principal reason for attending the school is to overcome or alleviate the disability. 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. A medical practitioner's recommendation* is required stating the expense is to treat a specific medical condition.

Screening Tests

Must be used for medical diagnosis.

Seeing-Eye Dog

See Guide Dog.

Sinus Medication

See Over the Counter - Drugs and Medicines.

Sleep Deprivation Treatment

Eligible expense if the person is under the care of a medical practitioner. A medical practitioner's recommendation* is required stating the expense is to treat a specific medical condition.

Smoking Cessation (Stop-Smoking) Programs

Sperm, Storage Fees

Eligible if expense is for temporary storage, but only to the extent necessary for immediate conception.

Spermicidal Foam

 See Over the Counter - Drugs and Medicines.

St. John's Wort - Over the Counter

Eligible if used primarily for medical care. Will not qualify if used to maintain general health. A medical practitioner's recommendation* is required stating the item is to treat a specific medical condition.

Stem Cell, Harvesting and/or Storage of

Eligible if there is a specific and imminent medical condition that the stem cells are intended to treat. But collection and storage indefinitely, just in case an item might be needed, is not medical care. A medical practitioner's recommendation* is required stating the item is to treat a specific medical condition.

Sterilization Procedures

Sunglasses

Prescription sunglasses would qualify. For non-prescription sunglasses, a medical practitioner's recommendation* is required stating the item is to treat a specific medical condition.

Sunscreen with 15 SPF or higher

Eligible if SPF is 15 or higher. Does not include tanning lotions, make-up or moisturizers, etc.

Suntan Lotion without Sunscreen

Sun-Protective Clothing

Supplies to Treat Medical Condition- Over the Counter

Eligible if the medical supply is used to diagnose or treat a specific medical condition and is not a personal comfort item.

Surrogate Expenses

Taxes on Medical Services and Products

Eligible expense to the extent imposed on reimbursable medical care or products.

Teeth Whitening/Bleaching

Cosmetic procedures are not eligible for reimbursement.

Telephone Equipment for Hearing-Impaired Person

Expense of buying and repairing special telephone equipment for hearing-impaired person.

Television Equipment for Hearing-Impaired Person

Eligible expense for the equipment that displays the audio part of television programs as subtitles for hearing-impaired individuals. Eligible reimbursement is limited to the cost that exceeds cost of regular item.

Thermometers - Over the Counter

Throat Lozenges

See Over the Counter - Drugs and Medicines.

Toothache and Teething Pain Relievers

See Over the Counter - Drugs and Medicines.

Transplants

Eligible expenses include surgical, hospital, and laboratory services and transportation expenses for donors.

Transportation Expenses for Person to Receive Medical Care

Eligible expense if travel is primarily for, and essential to, medical care. Includes car and rental car expenses; bus, taxi, train, plane, and ferry fares; parking and tolls; and ambulance services. The standard medical travel mileage rate is $0.20 per mile in 2019, $0.17 per mile in 2020, $0.16 per mile in 2021 and $0.22 per mile on or after July 1, 2022.

Transportation Expenses for Someone Other than the Person Receiving Medical Care

Transportation costs of an individual (such as a family member) traveling with the individual receiving medical care will qualify as eligible expenses if the presence of the family member on the trip was indispensable to enable the individual to obtain care, such as a parent traveling with a child or a nurse or other person who gives injections, medication, or other treatment required by a patient who is traveling to get medical care and is unable to travel alone. In addition, an individual who travels to visit a mentally ill dependent, if such visits are recommended as part of treatment.

Transportation to and from Medical Conference

See Medical conference admission, transportation, etc.

Umbilical Cord Blood Storage

Eligible expense if there is an existing or imminently probable disease that the umbilical cord blood is intended to treat, such a newborn who has a birth defect and the cord blood would be needed in the near future. Collection and storage as a precaution to treat a disease or condition that might possibly develop in the future is not medical care.

Vasectomy/Vasectomy Reversal

Viagra

Eligible expense if prescribed by a physician to treat a medical condition. See Prescription - Drugs and Medicines.

Vitamins - Over the Counter

Eligible if used primarily for medical care. Will not qualify if used to maintain general health. A medical practitioner's recommendation* is required stating the item is to treat a specific medical condition.

Walkers

Weight-Loss Programs and/or Drugs Prescribed to Induce Weight Loss

Eligible expense with a prescription to treat a specific medical condition (such as obesity, heart disease, or diabetes). Will not qualify if only to improve general health. The costs of food associated with a weight-loss program would not qualify. See Prescriptions - Drugs and Medicines.

Wheelchair

X-Ray Fee

Eligible if incurred for medical reasons.