Various Eligible Expenses
You can use your Limited Expense Health Care FSA (LEX HCFSA) funds to pay for a variety of dental and vision 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 LEX HCFSA 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 |
|---|---|---|
| Adoption fees | Not eligible | |
| Birth control (prescription) | Not eligible | |
| Child or newborn care instruction | Not eligible | |
| Contact lenses and solutions | Eligible with detailed receipt | |
| Cord blood storage (for unidentified future use) | Not eligible | |
| Corneal keratotomy | Not eligible | |
| Cosmetic procedures or surgery | Not eligible | |
| Counseling (marriage) | Not eligible | |
| CPR classes (adult or child) | Not eligible | |
| Dental | Eligible with detailed receipt | |
| Dental Sealants | Eligible with detailed receipt | |
| Dental (Co-insurance, Co-Payment and Deductible) | Eligible with detailed receipt | |
| Dental (for non-cosmetic purposes) | Eligible with detailed receipt | |
| Dental Bridge | Eligible with detailed receipt | |
| Dental Denture | Eligible with detailed receipt |
- Eligible with detailed receipt
- Not eligible
- Requires prescription from your doctor, plus detailed receipt
- Requires Letter of Medical Necessity signed by your doctor, plus detailed receipt