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

Displaying expenses 106–107 of 107
Eligible expenses. Each row shows whether the expense is eligible and any documentation needed.
Expense Eligible? Documentation Needed
Weight loss foods Not eligible
Weight loss program (to improve or maintain general health) Not eligible
  • 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