ELIGIBLE FLEXIBLE EXPENSES
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1 ELIGIBLE FLEXIBLE EXPENSES The following is not a comprehensive list of items, but it should cover the majority of eligible expenses that can typically be processed through flexible spending accounts. If you are not sure about an eligible expense, please contact Lisa Giesen in the Finance Department before incurring the expense. Please note that OTC drugs are listed below but they will require a prescription which is indicated on the chart by (Rx) beginning in Rx (Prescription) Co-payment (medical) Office visit (medical) Dental Over-the-counter drugs and medicines (eligible) Vision Psychotherapy Chiropractic care Lab (medical) Orthodontia Hospital Fees X-ray (medical) Over-the-counter vision products Acne treatments (over-the-counter) Acupuncture Adoption (medical expenses related to) Alcoholism treatment (Rx) (Rx)
2 Allergy & sinus medicine and products (over the counter) Allergy medication Ambulance and emergency health services Anesthesia (for non-cosmetic purposes) Antacid (over-the-counter) Antibiotic ointment (over-the-counter) Aspirin or other pain reliever (over-thecounter) Asthma medicines or treatments (overthe-counter) Athletic treatments/braces Bandages and related items (over-thecounter) Birth control devices (over-the-counter) Birth control (prescription or other) Blood pressure monitor Blood sugar test kits and test strips Body scans Canker & cold sore treatments (over-the-counter) Chest rubs (over-the-counter) Childbirth classes Chiropractic office visit or treatment Cholesterol test kits and supplies Co-Insurance (dental) (Rx) (Rx) (Rx) (Rx) (Rx) (Rx) (Rx) (Rx)
3 Co-Insurance (medical) Co-Insurance (prescription) Co-insurance (vision) Co- payment (dental) Co-payment (medical) Co-payment (other) Co-payment (vision) Cold & flu medicine (over-the-counter) Concierge medical fees (billed for actual services received) Condoms Contacts lenses, cleaning solutions, etc. Contraceptives (over-the counter) Corn and callus remover (over-the-counter) Corneal keratotomy Cough drops & sore throat lozenges (over-the-counter) Cough syrup (over-the-counter) Counseling (for treatment of a medical condition) Crutches, canes, walkers or like equipment (purchase or rental) Deductible for dental plan Deductible for medical plan Deductible for prescription plan Deductible for vision plan Dental care (for non-cosmetic purposes, including sealants) (Rx) (Rx) (Rx) (Rx) (Rx)
4 Dental co-insurance Dental co-payment Dental reconstruction (including implants) Dentures, bridges, etc. Diabetic monitors, test kits, strips and supplies Diagnostic services (other than dental or vision) Diagnostic services (dental or vision) Diaper rash ointments and creams Dietary supplements (for treatment of a medical condition) Drug addiction treatment Drugs (prescription) Dyslexia treatment Ear drops & wax removal (over-the-counter) Eye examinations Eye related equipment/materials Eye surgery or treatment to correct vision Eyeglasses (over-the-counter) Eyeglasses (prescription) Fertility monitor (over-the-counter) Fertility treatment (for employee, spouse or dependent) First aid kits (over-the-counter) Flu shots (Rx) (Rx) (Rx)
5 Gastrointestinal medication (over-the-counter) Guide dog (dog, training, care) Hearing aids and batteries Hospital services and fees Immunizations Incontinence supplies Infertility treatment (for employee, spouse or dependent) Insulin, testing materials and supplies Laboratory fees Lactose intolerance (over-the-counter) Lamaze classes Laser eye surgery Lasik Laxatives (over-the-counter) Learning disability treatments Lice treatment (over-the-counter) Listening therapy Mastectomy-related special bras Medical abortion Medical co-insurance Medical co-payment (Rx) (Rx) (Rx) Medical equipment (for treatment of medical condition) and repairs
6 Medical monitoring and testing devices Medical records charges Medical supplies (for treatment of a medical condition) Medicines (over-the-counter) Medicines (prescription) Midwife Monitors & test kits (over-the-counter) Motion & nausea Nasal sprays Nasal strips (over-the-counter) Norplant insertion or removal Nursing services (wages and taxes) OB/GYN fees Occlusal guards to prevent teeth grinding Occupational therapy (related to a medical condition or disability) Office visits (chiro) Office visits (dental) Office visits (medical) Office visits (psych/therapy) Office visits (vision) Operations (for non-cosmetic purposes) Operations (for vision and dental only) Optometrist/ophthalmologist fees Organ transplants (recipient and donor) (Rx) (Rx) (Rx) (Rx)
7 Orthotics Ortho keratotomy Orthodontia (braces and retainers) Orthopedic and surgical supports Over-the-counter acne treatments Over-the-counter allergy & sinus medicine Over-the-counter antacid Over-the-counter antibiotic ointment Over-the-counter aspirin or other pain reliever Over-the-counter asthma medicines or treatments Over-the-counter bandages and related items Over-the-counter canker & cold sore treatments Over-the-counter cold & flu medicine Over-the-counter cough drops & sore throat lozenges Over-the-counter cough syrup Over-the-counter (eligible medical) Over-the-counter health care products (eligible) Over-the-counter health care products (require a health care provider s prescription) Over-the-counter medication (including for motion sickness, sleep aids and sedatives) Over-the-counter products for dental, oral and teething pain Over-the-counter vision products Ovulation monitor (over-the-counter) (Rx) (Rx) (Rx) (Rx) (Rx) (Rx) (Rx) (Rx) (Rx) (Rx) (Rx) (Rx) (Rx) (Rx) (Rx)
8 Oxygen Pain Reliever (over-the-counter) Physical exams Physical therapy Pregnancy tests (over-the-counter) Prescription co-insurance Prescription co-payment Prescription drugs (for non-cosmetic purposes) Prosthesis Psychiatric care Psychoanalysis Psychologist fees Radial keratotomy (RK) Reading glasses (over-the-counter) Removal of benign mole, cyst or tumor Retainer fee (to physician for on-call or concierge services) Retin-A (for non-cosmetic purposes) Smoking cessation gum or patches (over-the-counter) Speech therapy Spermicidals Sterilization Student health fees for dental services (billed for actual services received) (Rx) (Rx) (Rx) (Rx)
9 Student health fees for medical services (billed for actual services received) Student health fees for prescriptions (billed for actual services received) Student health fees for vision services (billed for actual services received) Sunglasses (prescription) Sunscreen with SPF 30+, sunburn creams and ointments (over-the-counter) Supplies (for treatment of a medical condition) Surgery (for non-cosmetic purposes) Teeth grinding prevention devices Therapy (for treatment of a medical condition) Toothache and teething pain reliever (over-the-counter) Transportation, parking and related travel expenses (essential to receive eligible care) Tubal ligation Urological products Vaccinations Varicose vein removal surgery (for medical care) Vasectomy Vision co-insurance Vision co-payment Vitamins (prescription) Walking aids (canes, walkers, crutches and related supplies) Wart removal treatments (over-the-counter) Weight loss drugs (for treatment of a medical condition) (Rx) (Rx) (Rx) (Rx)
10 Wheelchair and repairs Wound care (over-the-counter) X-ray fees (dental) X-ray fees (medical) Rx: A prescription is required for this item.
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