The Most Surprising Eligible and Ineligible Medical Expenses

eligible and ineligible Medical Expenses

Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs) are both incredibly valuable benefits to help employees use pre-tax dollars to pay for eligible medical expenses. The IRS defines an eligible medical expense as any expense that is used to diagnose, cure, mitigate, treat, or prevent diseases, or affect any structure or function of the body. Although this seems like a straightforward definition, there are some surprising eligible and ineligible medical expenses that you should be aware of. For fun, or possibly just curiosity, we researched and wanted to highlight some of the more surprising eligible and ineligible medical expenses.

Surprising Eligible Medical Expenses

  • Broad-spectrum sunscreen with SPF 30 or above.
  • Tobacco cessation programs
  • Travel expenses to receive medical care (actual expenses or mileage rate)
  • Sleep deprivation treatment
  • Dental sealants
  • Eye glass cleaners and contact lens solution
  • Wheel chair, autoette, or wheel chair cushions
  • Telecommunication device for persons with hearing or speech disabilities
  • Medical records charges (fees associated with transferring medical records)
  • Medical alert bracelets or necklaces
  • Arthritis gloves
  • Breast pumps
  • Shoe insoles and inserts
  • Vaporizers and inhalers
  • Over-the-counter drugs & medicines

Even more surprising are some potentially qualifying expenses. Did you know the purchase of adaptive equipment, including automobile modifications and even elevator installation may be eligible? Contact your administrator, like Benefit Resource, to determine what documentation would be required and what conditions must exist for these items to be eligible.

For many participants, however, it is the items they feel should be eligible, but are not, which cause the most frustration. Here is a quick list of some of the most common items that are not automatically eligible.

Ineligible (or Potentially Ineligible) Expenses

  • Vitamins & supplements
  • Fitness programs
  • Teeth whitening, veneers
  • Cosmetic medical procedures (exceptions may exist if the procedure is medically necessary to correct a deformity resulting from birth, injury or disfiguring disease)
  • Premiums (generally premiums cannot be reimbursed from an FSA or HSA)
  • Prescription drugs & medicines obtained and imported from foreign countries

If you have questions regarding a specific expense or condition which makes an expense eligible, view our searchable list of eligible expenses or visit our resource center.