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Know Your FSA/HRA Eligible and Ineligible Expenses

Use Your Health Care FSA or HRA Wisely

The Flexible Spending Account (FSA) is an IRS sanctioned benefit that al ows you to use pretax dol ars to cover eligible
expenses. A Health Reimbursement Arrangement (HRA) is an employer program that reimburses employees for certain eligible expenses on a nontaxable basis. The IRS defines eligible health care expenses as amounts paid for the diagnosis, cure, mitigation or treatment of a disease, and for treatments affecting any part or function of the body. The expenses must be primarily to al eviate a physical or mental defect or il ness. Take a look at the fol owing lists for a better understanding of what is and isn’t eligible. Other expenses not specifical y mentioned may also qualify (for additional information, please contact Insurance Coordinators of Montana). Eligible Expenses
BABY/CHILD TO AGE 13
MEDICAL EQUIPMENT/SUPPLIES
MEDICATION
OBSTETRICS
PRACTITIONERS
MEDICAL PROCEDURES/SERVICES
LAB EXAMS/TESTS
 Sterilization/Sterilization Reversal Note: This list is not meant to be al -inclusive. Also, expenses marked with an asterisk (*) are “potential y eligible expenses” that require a Note of Medical Necessity from your health care provider to qualify for reimbursement.
Over-the-Counter Items Now through 12/31/2010

The IRS al ows certain over-the-counter (OTC) medicines to be reimbursed using your FSA/HRA dol ars.
Here is a brief listing of some of those items:
Eligible Over-the-Counter Items
 Acne Treatment Products
Medications, First Aid Kits, Gauze, Gloves,  Toothache and Teething Pain Relievers  Weight Loss Drugs (to treat a specific Blood Test Strips, Glucose Food, Glucose Check your plan document or
Plan Administrator’s website for
more information.
 Homeopathic Medicines*  Incontinence Supplies
Over-the-Counter Items Effective 1/1/2011
Employees with an FSA, HRA, or HSA can no longer use their account funds to purchase OTC drugs and medicines (e.g. Advil, ibuprofen, and cough syrup) unless they have a Note of Medical Necessity (NMN) or a prescription from their doctor. If an employee has an NMN or a prescription for an OTC drug or medicine, they must pay at the point of service and submit a manual claim for reimbursement.
Employees can continue to use their FSA, HRA and HSA funds to purchase OTC items that are not considered a
drug or a medicine (e.g. bandages, wound care, contact lens solution). Benefits cards can continue to be
used for these purchases.
Ineligible Expenses

The IRS does not al ow the fol owing expenses to be reimbursed under a Health Flexible Spending Account or
HRA, as they are not prescribed by a physician for a specific ailment.
Note: This list is not meant to be al -inclusive. Also, expenses marked with an asterisk (*) are “potential y eligible expenses” that require a Note of Medical Necessity from your health care provider to qualify for reimbursement. Child Care expenses could run through a Dependent Care Assistance Program (DCAP) if al owed in your ful flex plan. Ineligible Expenses
 Baby-sitting and Child Care*
 Vitamins or Nutritional Supplements*
For additional information, please contact your human resources department or ICMI at 406-442-3539.

Source: http://dawson.cc.mt.us/sites/default/files/files/FSA-HRA%20Eligible%20Ineligible%20info%20sheet-1.pdf