FSA and HSA Eligibility List
Search for eligible Flexible Spending Account and Health Savings Account expenses.
NOTE: On March 27, 2020, the CARES Act allowed HSA, FSA, and HRA participants to be reimbursed for the purchase of over-the-counter drugs and medicines without a prescription from a physician. It also includes a reimbursement provision for menstrual products. This change will go into effect for American Fidelity Section 125 Plans April 15, 2020, subject to employers executing plan amendments. The change can be applied to amounts paid or incurred starting January 1, 2020, where permitted by the employer’s plan. We are currently amending Section 125 Plan Documents to include this change. All employers must sign this document by April 15, 2020 to be compliant. Learn More
Expense | Eligibility |
---|---|
Expense | Eligibility |
If to treat acne, it is eligible. However, the cost of regular skin care does not qualify. |
Eligible |
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. |
Eligible with Letter* |
Acupuncture If treating a medical condition. |
Eligible |
Adoption - Medical Expenses Incurred Before Adoption is Finalized If the child is your tax dependent when the service is provided. |
Eligible |
Advanced Reimbursements See special requirements under Orthodontia expenses. |
Not Eligible |
Alcoholism Treatment Amounts paid for inpatient treatment at a therapeutic center for alcohol addiction will qualify. |
Eligible |
Allergy Medicine |
Eligible |
Allergy Treatments Allergy treatment and products |
Eligible with Letter* |
Alternate Diet Alternative dietary supplements |
Eligible with Letter* |
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. |
Eligible with Rx |
Ambulance |
Eligible |
Analgesics |
Eligible |
Antacid |
Eligible |
Anti-Itch Creams |
Eligible |
Antibiotic Sprays or Ointments for First Aid |
Eligible |
Antihistamine |
Eligible |
Artificial Limbs and Teeth |
Eligible |
Aspirin |
Eligible |
Asthma Treatments |
Eligible |
Autopsy |
Not Eligible |
Babysitting/Child Care |
Not Eligible |
Bandages |
Eligible |
Behavioral Modification Programs |
Not Eligible |
Eligible with a prescription. See Prescriptions - Drugs and Medicines. |
Eligible with Rx |
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. |
Not Eligible |
Blood Pressure Monitoring Devices |
Eligible |
Blood Sugar Test Kit and Test Strips |
Eligible |
Body Scan Body scans employing MRIs and similar technologies are diagnostic services. See diagnostic items/services. |
Eligible |
Breast Pumps and Lactation Supplies, Excluding Breastfeeding Bras |
Eligible |
Breast Reconstruction Surgery Following Mastectomy Eligible if surgery was done following a mastectomy for cancer. |
Eligible |
Calamine Lotion |
Eligible |
Carpal Tunnel Wrist Supports |
Eligible |
Chelation Therapy Eligible expense if used to treat a medical condition such as lead poisoning. |
Eligible |
Chiropractors |
Eligible |
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. |
Eligible with Letter* |
Christian Science Practitioners Eligible if expense is for medical care. |
Eligible |
Circumcision |
Eligible |
Co-Insurance Amounts, Co-Payments and Deductibles Eligible if the underlying service/item qualifies. |
Eligible |
COBRA Premiums (HCFSA, HRA) Healthcare FSA – Not eligible |
Not Eligible |
COBRA Premiums (HSA) HSA – Eligible expense |
Eligible |
Cold Medicine |
Eligible |
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. |
Eligible |
Condoms |
Eligible |
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. |
Eligible |
Contraceptives |
Eligible |
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. |
Not Eligible |
Cosmetics |
Not Eligible |
Cough Suppressants |
Eligible |
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. |
Eligible with Letter* |
Crutches |
Eligible |
Decongestants |
Eligible |
Deductibles |
Eligible |
Dental Services Eligible for expenses incurred for the prevention and alleviation of dental disease. Teeth whitening is not eligible. |
Eligible |
Dentures and Denture Adhesives |
Eligible |
Dependent Care Expenses Dependent care expenses are not eligible medical expenses but may be eligible for reimbursement from a Dependent Care Account. |
Not Eligible |
Includes Blood-sugar test kits and test strips; Glucose-monitoring equipment; and Insulin. |
Eligible |
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. |
Eligible |
Diaper Rash Ointment/Cream |
Eligible |
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. |
Eligible with Letter* |
Diarrhea Medicine |
Eligible |
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. |
Eligible with Letter* |
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. |
Eligible with Letter* |
Drug Addiction Treatment |
Eligible |
Drug Overdose Treatment |
Eligible |
Ear Plugs - Over the Counter Eligible if treating a specific medical condition. A medical practitioner's recommendation* with the medical condition is required. |
Eligible with Letter* |
Egg Donor Fees |
Eligible |
Eggs and Embryos Storage Fees Eligible if expense is for temporary storage, but only to the extent necessary for immediate conception. |
Eligible |
Electrolysis or Hair Removal |
Not Eligible |
Eye Examinations, Eyeglasses and Related Equipment and Materials/Cleaners |
Eligible |
Face Creams, Moisturizers - Over the Counter |
Not Eligible |
Face Lifts |
Not Eligible |
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. |
Eligible |
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. |
Eligible |
Fever Reducing Medications |
Eligible with Rx |
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. |
Eligible with Letter* |
First Aid Cream |
Eligible |
Fitness Programs |
Not Eligible |
Flu Shots |
Eligible |
Funeral Expenses |
Not Eligible |
Gambling Addiction Treatment Expense eligible for inpatient treatment at a therapeutic center for gambling addiction. |
Eligible |
Gauze Pads |
Eligible |
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. |
Eligible |
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. |
Eligible with Letter* |
Glucose Monitoring Equipment |
Eligible |
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. |
Eligible |
Hair Removal/Transplant |
Not Eligible |
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. |
Eligible with Letter* |
Hearing Aids Includes the cost of batteries. |
Eligible |
Hemorrhoid Treatment |
Eligible |
Herbal Supplements - Over the Counter |
Eligible with Letter* |
Home Care |
Eligible |
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. |
Eligible with Letter* |
Hospital Services |
Eligible |
Illegal Operations and Treatments |
Not Eligible |
Immunizations |
Eligible |
Incontinence Supplies Adult diapers used to relieve incontinence generally will qualify. See Diapers. |
Eligible |
Infertility Treatments |
Eligible |
Insect Bite Creams and Ointments |
Eligible |
Insulin Includes equipment necessary to inject the insulin, such as syringes or insulin pumps. |
Eligible |
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. |
Not Eligible |
Laboratory Fees If part of medical care or diagnosis. |
Eligible |
To the extent instruction relates to birth and not child rearing. Expenses for the coach or significant other do not qualify. |
Eligible |
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. |
Eligible with Letter* |
Laser Eye Surgery/Lasik/Radial Keratotomy |
Eligible |
Late Fees on Medical Bills |
Not Eligible |
Laxatives |
Eligible |
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. |
Eligible with Rx |
Liquid Bandage |
Eligible |
Lodging at Hospital or Similar Institution Eligible if principal reason for being there is to receive medical care. |
Eligible |
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). |
Eligible |
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. |
Eligible |
Lodging While Attending a Medical Conference |
Not Eligible |
Long-Term Care Services (HCFSA or HRA) HCFSA – No |
Not Eligible |
Long-Term Care Services (HSA) HSA - Yes |
Eligible |
Marijuana or Other Controlled Substances |
Not Eligible |
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. |
Eligible with Letter* |
Mastectomy-Related Bras |
Eligible |
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. |
Eligible with Letter* |
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. |
Eligible |
Medical Monitoring and Testing Devices These items include blood-pressure monitors, syringes, glucose kit, etc. |
Eligible |
Medical Records Charges For the expense associated with transferring medical records to a new medical practitioner. |
Eligible |
Menstrual Pain Relievers |
Eligible |
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. |
Eligible |
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. |
Eligible with Letter* |
Missed Appointment Fee |
Not Eligible |
Motion Sickness Pills |
Eligible |
Nasal Sprays |
Eligible |
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. |
Eligible with Letter* |
Naturopathic Healers |
Eligible with Rx |
Nicotine Gum or Patches |
Eligible |
Norplant Insertion or Removal |
Eligible |
Nursing Services for a Baby Does not qualify if baby is healthy and normal. |
Not Eligible |
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. |
Eligible |
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. |
Eligible with Letter* |
Obstetrical Expenses |
Eligible |
Occlusal Guards to Prevent Teeth Grinding |
Eligible |
Optometrist |
Eligible |
Organ Donor Including surgical, hospital and laboratory services as well as transportation expense for donor. |
Eligible |
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. |
Eligible |
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. |
Eligible |
Ovulation Monitor |
Eligible |
Pain Relievers |
Eligible |
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. |
Eligible with Letter* |
Physical Exams |
Eligible |
Physical Therapy |
Eligible |
Physician Access Retainer |
Not Eligible |
Prenatal Expenses |
Eligible |
Prenatal Vitamins If taken during pregnancy (a medical condition). Vitamins taken at other times generally do not qualify. |
Eligible |
Prescription Drug Discount Programs A fee paid to get a drug discount card will not qualify; the cost of the prescription may qualify. |
Not Eligible |
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. |
Eligible with Rx |
Prescriptions - Drugs and Medicines Obtained from Other Countries |
Not Eligible |
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. |
Eligible with Rx |
Prosthesis |
Eligible |
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. |
Eligible with Letter* |
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. |
Eligible with Letter* |
Radial Keratotomy |
Eligible |
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. |
Eligible with Rx |
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. |
Eligible with Rx |
Safety Glasses Eligible if prescription lenses. |
Eligible with Rx |
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. |
Eligible with Letter* |
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. |
Eligible with Letter* |
Screening Tests Must be used for medical diagnosis. |
Eligible |
Seeing-Eye Dog |
Eligible |
Sinus Medication |
Eligible |
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. |
Eligible with Letter* |
Smoking Cessation (Stop-Smoking) Programs |
Eligible |
Sperm, Storage Fees Eligible if expense is for temporary storage, but only to the extent necessary for immediate conception. |
Eligible |
Eligible |
|
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. |
Eligible with Letter* |
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. |
Eligible with Letter* |
Sterilization Procedures |
Eligible |
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. |
Eligible with Rx |
Sunscreen with 15 SPF or higher Eligible if SPF is 15 or higher. Does not include tanning lotions, make-up or moisturizers, etc. |
Eligible |
Suntan Lotion without Sunscreen |
Not Eligible |
Sun-Protective Clothing |
Eligible with Letter* |
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. |
Eligible |
Surrogate Expenses |
Not Eligible |
Taxes on Medical Services and Products Eligible expense to the extent imposed on reimbursable medical care or products. |
Eligible |
Teeth Whitening/Bleaching Cosmetic procedures are not eligible for reimbursement. |
Not Eligible |
Telephone Equipment for Hearing-Impaired Person Expense of buying and repairing special telephone equipment for hearing-impaired person. |
Eligible |
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. |
Eligible |
Thermometers - Over the Counter |
Eligible |
Throat Lozenges |
Eligible |
Toothache and Teething Pain Relievers |
Eligible |
Transplants Eligible expenses include surgical, hospital, and laboratory services and transportation expenses for donors. |
Eligible |
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 $0.18 per mile in 2018, $0.20 per mile in 2019, and $0.17 per mile in 2020. |
Eligible |
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. |
Eligible |
Transportation to and from Medical Conference |
Eligible |
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. |
Eligible |
Vasectomy/Vasectomy Reversal |
Eligible |
Viagra Eligible expense if prescribed by a physician to treat a medical condition. See Prescription - Drugs and Medicines. |
Eligible with Rx |
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. |
Eligible with Letter* |
Walkers |
Eligible |
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. |
Eligible with Rx |
Wheelchair |
Eligible |
X-Ray Fee Eligible if incurred for medical reasons. |
Eligible |
Legend | |
---|---|
Eligible for reimbursement |
|
Eligible for reimbursement with a prescription from your doctor |
|
Eligible for reimbursement with a Letter of Medical Necessity signed by your doctor* |
|
Not eligible for reimbursement |