![]() Late fees (e.g., for late payment of bills for medical services)Įligibility rules for OTC items may change.Controlled substances in violation of federal law.Rehydration solution (Example: Pedialyte).Holistic or natural healers, dietary substitutes, and drugs and medicines.Allergy treatment products household improvements to treat allergies.Items in this category require a Certification of Medical Necessity form completed by your physician. Home improvements (such as exit ramps, widening doorways, elevator, etc.).AA meetings, transportation to and from.Potentially Qualifying Health Care ExpensesĪ Certification of Medical Necessity Form must be completed by your physician. ![]() Personal Protective Equipment (PPE), such as masks, hand sanitizer, and sanitizing wipes, for the primary purpose of preventing the spread of COVID-19, are eligible expenses. Qualifying Personal Protective Equipment (PPE) Other similar products used by individuals with respect to menstruation.Toothache and teething pain relievers (Example: Orajel).Throat lozenges (Examples: Cepacol, Chloraseptic).Pain relievers (Examples: Advil, Aspirin, Tylenol).Motion sickness pills (Examples: Bonine, Dramamine).Insect bite creams and ointments (Examples: Benadryl, Cortaid).Hemorrhoid treatments (Example: Preparation H).Expectorants (Examples: Comtrex, Robitussin).Diarrhea medicine (Examples: Imodium, Kaopectate).Diaper rash ointments and creams (Example: Desitin).Decongestants (Examples: Dimetapp, Sudafed).Cough suppressants (Examples: Pediacare, Robitussin, cough drops).Contact lenses, materials and equipment.Cold medicine (Examples: Comtrex, Sudafed).Bandages (Examples: Band- Aid, Curad, Ace).Anti-itch creams (Examples: Benadryl, Cortaid, Ivarest).Antibiotic ointments (Examples: Bacitracin, Neosporin).Antacids (Examples: Maalox, Prilosec OTC, Zantac).Vision Care (including eyeglasses, contact lenses, Lasik surgery).Transportation expenses for person to receive medical care.Television for hearing impaired persons.Occlusal guards to prevent teeth grinding.Lodging at a hospital or similar institution.Breast reconstruction surgery following mastectomy.Requires letter of Medical Necessity signed by your doctor, plus detailed receipt Requires letter of Medical Necessity signed by your doctor, plus detailed receiptĪllergy & sinus medicine (over-the counter)Īllergy treatments products (HEPA filters, Air purifier, etc. Encircled icon of a desktop computer monitor Encircled hand hold a mobile device on which the screen shows a check mark Arrow pointing left Arrow pointing right At symbol indicating an email address Institution Icon Menu Icon Go to first page symbol Closed book icon Bookmark with tabs Encircled image of a handheld calculator Calculator Icon Encircled monthly calendar Calendar shaped box with checkmark Month view of a Calendar Caret Down Caret Left Caret Right Checkmark on a circlular background Check mark in a square box Child Icon Circle Clock face Close or Cancel symbol Three cogs enmeshed Comment bubble Comment bubble Two comment bubbles addressing each other in conversation Icon indicating a database as a stack of circles Encircled image of a small hand laid atop a larger hand Dependent Care FSA Icon Desktop computer monitor over a circle with a shadow Desktop computer icon Encicled open document folder Money Icon Encircled dollar sign US Dollar symbol Dotted Arrow Icon Edit Icon Go to last page symbol Pen with checked checkbox within a circle Envelope Icon Exclamation Mark within a Triangular Sign Encircled hand holding dollar bills American Flag Encircled compass Eye Icon Facebook Logo Edit Icon Star Icon Fax Icon Encircled hand holding a dollar sign Adobe Acrobat PDF icon Single, blank file icon Two files in a stack Lightning bolt symbol Encircled file icon A group of people Encircled white cross Health Care Flexible Spending Account Icon Heartbeat Icon Encircled "i" character Text file icon symbolizing a paper letter Encircled image of two files, one laid above the other Encircled icons of a tooth and an eye Limited Expense Healthcase FSA Icon Encircled lightbulb List Icon Lock Icon Encircled megaphone Medkit Icon Encircled chat bubble Mobile phone over a circle with a shadow Pause Icon Encircled stack of coins Phone Icon Play Icon Mouse Pointer Icon Prescription Symbol Printer Icon Question Mark Icon Encircled question mark Encircled cloud with download symbol Search Icon Secure Email Sign In Icon Sign out of this site Spinning circle indicating a process is active Encircled star Star Icon Wrench within a circle Twitter Logo User Icon with Plus Symbol Download on the App Store FSAFEDS Logo Get it on Google Play United States Office of Personnel Managementĭisplaying expenses 1-15 of 316 Eligible?Įligible with a detailed receipt Eligible with a detailed receiptĮligible with appropriate documentation Eligible with appropriate documentation
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