Flexible Spending Accounts

Qualifying and Non-Qualifying Expenses

FSA Health Care Plan

Sample Qualifying Expenses

• Deductibles
• Co-pays
• Doctor's fees
• Dental expenses
• Vision care expenses
• Prescription glasses/sunglasses
• Contact lenses and solutions
• Corrective eye surgery
• Drugs & medicines
• Insulin
• Orthodontics (braces)
• Routine physicals
• Medical equipment (necessary for an existing medical condition)
• Hearing aids, including batteries
• Transportation expenses related to illness
• Chiropractor's fees

Sample Non-Qualifying Expenses

• Cosmetic procedures; e.g. face-lifts, skin peeling, teeth whitening, veneers, hair replacement, removal of spider veins. There do not generally qualify. For a medically necessary cosmetic procedure, enclose a note with the claim stating the existing medical condition and why the treatment is required.
• Sunglasses, non-prescription or clip-on
• Toiletries
• Expenses that are merely beneficial to your general health (e.g., vacations and vitamins)
• Herbs, vitamins & nutritional supplements not used to treat an existing diagnosed medical condition
• The cost of a weight-loss program if the purpose of the weight control is to maintain your general good health
• Health club dues

FSA Dependent Care Plan

Sample Qualifying Expenses

Expenses necessary for you to be gainfully employed:

• Expenses paid to a dependent care center
• Expenses paid to a "babysitter"
• Expenses paid for care of a dependent under age 13
• Expenses paid for care of a dependent who is physically or mentally incapable of caring for herself or himself

Sample Non-Qualifying Expenses

• Care while you are not working or looking for work
• Care for child for whom you have 50% or less physical custody
• Care for child age 13 or older who is not disabled
• Overnight care or camps
• Instructional or sport specific camps; e.g. Ballet camp, soccer camp, summer school

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