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 |
|---|---|---|
| Office visits (vision) | Eligible with detailed receipt | |
| Optometrist / ophthalmologist fees | Eligible with detailed receipt | |
| Oral care (over-the-counter) | Not eligible | |
| Ortho keratotomy | Eligible with detailed receipt | |
| Orthodontia | Eligible with detailed receipt | |
| Orthodontia (braces and retainers) | Eligible with detailed receipt | |
| Over-the-Counter medication (2019 Requires Prescription from your doctor) | Not eligible | |
| Payment Processing Fees | Eligible with detailed receipt | |
| Physician retainer fee (for on-call or concierge services) | Not eligible | |
| Prescription Eyeglasses/ contact lenses | Eligible with detailed receipt | |
| Prescription(Co-insurance, Co-Payment, Deductible) | Not eligible | |
| Provider discount/coupon | Not eligible | |
| Radial keratotomy (RK) | Eligible with detailed receipt | |
| Reading glasses (over-the-counter) | Eligible with detailed receipt | |
| Rx (prescription) | 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