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 76–90 of 107
Eligible expenses. Each row shows whether the expense is eligible and any documentation needed.
Expense Eligible? Documentation Needed
Sales tax, shipping and handling fees (for any eligible expense) Eligible with detailed receipt
Service Animals (for blindness or vision impairment) (with Certificate of Registration) Eligible with detailed receipt Requires prescription from your doctor, plus detailed receipt
Service Animals (services not related to blindness or vision impairment) (with Certificate of Registration) Not eligible
Smoking cessation drugs (prescription) Not eligible
Sunglasses (over-the-counter) Not eligible
Sunglasses (prescription) Eligible with detailed receipt
Sunscreen with SPF <15 or suntan lotion (over-the-counter) Not eligible
Teeth bleaching or whitening Not eligible
Teeth grinding prevention devices Eligible with detailed receipt
Toothache and teething pain reliever (over-the-counter) Eligible with detailed receipt
Toothpaste, medicated (Only cost difference between medicated and regular toothpaste, plus documentation of cost difference required) Eligible with detailed receipt Requires prescription from your doctor, plus detailed receipt
Toothpaste, toothbrush, floss, etc. Not eligible
Transportation: Bus, Train, Taxi, Parking expenses (for eligible care/expenses) Eligible with detailed receipt
Transportation: Bus, Train, Taxi, Parking expenses (for non-eligible care/expenses) Not eligible
Tuition or educational classes 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