Various Eligible Expenses
You can use your Health Care FSA (HC FSA) funds to pay for a wide variety of health care products and services for you, your spouse, and your dependents. The IRS determines which expenses can be reimbursed by an FSA.
Keep Your Receipts
Please save your receipts and other supporting documentation related to your HC FSA expenses and claims. The IRS may request itemized receipts to verify the eligibility of your expenses. Credit card receipts, canceled checks, and balance forward statements do not meet the requirements for acceptable documentation.
Eligible expenses search and results
| Expense | Eligible? | Documentation Needed |
|---|---|---|
| Mileage (for travel to / from anything other than eligible care) | Not eligible | |
| Mileage (for travel to/from eligible dental care) | Eligible with detailed receipt | |
| Mileage (for travel to/from eligible health care) | Eligible with detailed receipt | |
| Mileage (for travel to/from eligible vision care) | Eligible with detailed receipt | |
| Misc. Personal Use Items | Not eligible | |
| Missed Appointment Fee | Not eligible | |
| Modified equipment (Only cost difference between special and regular equipment, plus documentation of cost difference required) | Requires Letter of Medical Necessity signed by your doctor, plus detailed receipt | Requires prescription from your doctor, plus detailed receipt |
| Monitors & test kits (over-the-counter) | Eligible with detailed receipt | |
| Motion & nausea (Over-the-Counter) | Eligible with detailed receipt | |
| Nasal Spray (Medicated) (Over-the-Counter) | Eligible with detailed receipt | |
| Nasal Spray (Saline Solution) (Over-the-Counter) | Eligible with detailed receipt | |
| Nasal strips (over-the-counter) | Eligible with detailed receipt | |
| Neti Pot | Eligible with detailed receipt | |
| Non-prescription drugs and medicines (for non-cosmetic purposes) | Eligible with detailed receipt | |
| Norplant insertion or removal | Eligible with detailed receipt |
- Eligible with detailed receipt
- Eligible with additional documentation and a detailed receipt
- Not eligible
- Requires Letter of Medical Necessity signed by your doctor, plus detailed receipt
- Requires prescription from your doctor, plus detailed receipt