Allowable medical expenses

This is a general listing of accepted items. Please check your company’s plan documents for specific exclusions. For example, participation in a Health Savings Account would limit the reimbursable expenses listed below. To verify if a certain expense is covered if it is not listed below, please call 1-800-532-3327. This expense will qualify as long as the child qualifies as a tax dependent when the services were incurred. Maybe Must be prescribed by licensed health care provider and primarily used for treatment of medical condition and be detachable from the property. If attached to property only the amount which exceeds the value added to the property is reimbursable. Amount paid for inpatient treatment including meals and lodging at a therapeutic center for alcohol addiction. Maybe Must be primarily for treatment of a medical condition and service must be performed by a professional who is providing a legal service. Maybe Generally no, if the product is one which would be owned even without allergies (such as a pillow or vacuum) except where the difference in cost between a regular item and the allergy proof item can be established. Items such as air purifier or water Medications and devices such as inhalers and nebulizers are accepted. These expenses are reimbursable under a DCAP account. If prescribed by licensed health care provider. Maybe No for parenting or childrearing. Yes if they related to the birth Amount paid which exceeds cost of regular printed materials. Yes, if they are for the purpose of affecting a structure or func-tion of the body of the lactating woman. Maybe No, unless there is an underlying medical condition. Maybe Yes, for licensed health care provider charges if legal and pri- marily for treatment of a medical condition. Yes, if primarily for treatment of a medical condition and not for general health reasons. Yes, if legal and primarily for treatment of a medical condition. COBRA premiums are not reimbursable from the FSA. Requires Rx (non-cosmetic). Includes materials and equipment needed for contact lens care such as saline solution and enzyme cleaners. Except as required to correct congenital deformity or personal injury from an accident, trauma or disfiguring disease. Cosmetic surgery which is directed at improving the patient’s appearance and does not meaningfully promote the proper function of the body or prevent or treat illness or disease is not an allowable expense. Maybe No, for marriage counseling. Yes, for medical reasons – see Psy- Maybe No, if for general health. Yes, if prescribed by licensed health care provider for specific medical condition (such as rehabilita-tion after surgery). Must be medically necessary and non-cosmetic. Maybe No, unless prescribed by a health care provider to treat a medical condition. Must have a licensed health care pro-vider’s prescription. The costs of foods associated with a weight-loss program do not qualify. Unless medically necessary and prescribed. Maybe Generally these expenses will not qualify. Temporary storage (one year or less) will if used as a part of a treatment, diagno-sis, or prevention of a medical condition. Amount paid for inpatient treatment including meals and lodg-ing at a therapeutic center for drug addiction. Language Training will qualify if the child is disabled or has dyslexia. A licensed health care providers note is required rec-ommending the training to treat the specific medical condi-tion. If medically necessary and prescribed by licensed health care provider. Maybe Amounts paid for the egg donor fee will qualify. Fees for stor- age will qualify but only for immediate conception (one year). Maybe No, if for general health. Yes, if prescribed by licensed health care provider for specific medical condition (such as rehabilita-tion after surgery). Maybe Only to extent necessary for immediate conception. Fees for Expenses paid to or for an in vitro surrogate are not reimburs-able. Maybe No, if for general health. Yes, if prescribed by licensed health care provider for specific medical condition (such as rehabilita-tion after surgery). Maybe Generally, no, unless the food is for a specific medical condi- tion. If so, then only the cost of food, which exceeds the cost of commonly available versions of same product, is reimburs-able. A licensed health care provider’s note is needed. Maybe Yes, if performed to prevent possible defect. No, if performed Includes charges for purchase, training and care. Except as required to correct congenital deformity or personal injury from an accident, trauma or disfiguring disease. Cosmetic surgery which is directed at improving the patient’s appearance and does not meaningfully promote the proper function of the body or prevent or treat illness or disease is not an allowable expense. Maybe No, if for general health. Yes, if prescribed by licensed health care provider for specific medical condition (such as rehabilita-tion after surgery). Including batteries and maintenance charges. Maybe Yes, for professional charges if legal and primarily for treatment of a medical condition. No, if for general health. Expenses paid to or for an in vitro surrogate are not reimburs-able. Also includes test strips and testing equipment. No, unless there is an underlying medical condition. Yes, for removal of paint from surfaces in the home. Surfaces must be in poor repair and within child’s reach. Cost of repaint-ing is not a medical expense. Must be prescribed by licensed health care provider for a child who has severe learning disabilities caused by mental or physi- Maybe Up to $50 per night will qualify if these conditions are met: 1. Lodging is primarily for medical care. 2. A licensed health care provider or practitioner provides medical care. 3. Lodging is not lavish or extravagant. 4. If there is no significant element of per-sonal pleasure, recreation, or vacation in the travel. Up to $100 per night will qualify if a parent or companion is traveling with a sick child. Not even if for medical care and allowed by state law allows with licensed health care provider’s prescription. Maybe No, if for general health. Yes, if prescribed by licensed health care provider for specific medical condition (such as rehabilita-tion after surgery. Must have licensed health care provider’s prescription on file to be reimbursed. Unless prescribed by licensed health care provider and mattress possesses a uniqueness used exclusively for treatment of se-vere medical condition (i.e., hospital mattress as opposed to an extra-firm mattress). If so, then only the cost of the mattress, which exceeds the cost of a commonly available version of the same product, is reimbursable. Maybe No, unless the amount paid is part of the hospital stay. ing devices (e.g. blood pres-sure monitor, syringes, glu-cose kits, etc.) Maybe Yes, for professional charges if legal and primarily for treatment of a medical condition or for charges for remedies that are characterized as a medicine or drug. Expenses towards vitamin, supplements, or general wellness are not accepted. Yes, for wages and nursing services; No, for a healthy baby care in home. Maybe Yes, if for treatment of medical condition. No, if for general If legal and medically necessary. Cosmetic expenses are not re-imbursable. Includes amounts paid for surgical, hospital, laboratory and transportation expenses for organ donor. Maybe No, unless prescribed by a health care provider for a medical condition. Must have a licensed health care provider’s prescrip-tion. See 'Allowable FSA OTC Meds' listing at www.flores247.com for a complete listing. OTC supplies including bandages, sunscreen with SPF 30 or higher, and first aid kits are reimbursable. See the "Allowable FSA OTC Expenses" listing at www.flores247.com for a com-plete listing. Includes oxygen and breathing equipment for treatment of a medical condition. Maybe No, if for general health. Yes, if prescribed by licensed health care provider for specific medical condition (such as rehabilita-tion after surgery). Services are only reimbursable when/if they are incurred. As long as the fees are covering the purchase of a qualified medical expense. Smoking cessation medications purchased from a licensed Maybe Yes, if for medical condition and only for cost of foods which exceed cost of commonly available versions of same product. No, if for general health. Must have licensed health care pro-vider’s prescription on file to be reimbursed. Maybe This qualifies only if there is a specific medical condition it is treating. Long-term storage, in hopes of treating a future medi-cal condition, is not accepted. Maybe If supply is directly related to a specific medical condition and is gauze, batteries for hearing aids, etc.) Maybe Only prescription sunglasses are accepted. If legal and medically necessary. Cosmetic expenses are not reimbursable. Maybe No, if for general health. Yes, if prescribed by licensed health care provider for specific medical condition (such as rehabilita-tion after surgery). Maybe No, if for general health. May be reimbursable if incurred to treat a specifically diagnosable condition. Not even if prescribed to treat congenital condition. Includes amounts paid for surgical, hospital, laboratory and transportation expenses for organ donor. Lodging up to $50 per day. If a parent is traveling with a sick child, up to $100 ($50 per person) is allowed. Mileage can also be reimbursed for qualified medical expenses. Current mileage rates are listed on our website at www.flores247.com . Maybe Generally no, unless necessary due to the patient’s medical condition (e.g., nursing attendant) or a parent traveling with a sick child. Maybe Will qualify if the primary purpose is for medical care. program (e.g. reading pro-gram for dyslexia) Maybe This qualifies only if there is a specific medical condition it is treating. Long-term storage, in hopes of treating a future medi-cal condition, is not accepted. Cosmetic surgeries that are directed at improving the patient’s appearance and does not meaningfully promote the proper function of the body or prevent or treat illness or disease is not an allowable expense. To extent necessary to treat medical condition. Maybe No, unless prescribed by a health care provider to treat a medi- cal condition. Must have a licensed health care provider’s pre-scription. Maybe No, if for general health. Yes, if prescribed by licensed health care provider to treat medical condition such as diabetes. Must have licensed health care provider’s prescription on file to be reimbursed. Includes rental or purchase plus maintenance. Maybe The full cost of a wig purchased if prescribed by a licensed health care provider for the mental health of a patient who has lost all of his or her hair from disease.

Source: https://www.flores-associates.com/fsaforms/medicalguide.pdf