This tool is licensed to alt Bentley Yates and All American Benefits for use by its employees. Any other use is strictly prohibited.

Each item, service, or charge in this Table is classified as a "qualifying expense" (normally qualifying for reimbursement under a health FSA or HRA or for a tax-free distribution from an HSA), a "potentially qualifying expense" (depending on the facts, sometimes qualifying and sometimes not qualifying), or "not a qualifying expense." Shaded rows with the OTC icon represent items that are generally available for retail purchase over the counter (i.e., without a prescription). Some OTC items are qualifying expenses (for example, aspirin), some are potentially qualifying expenses (for example, air purifier), and some are not qualifying expenses (for example, hand lotion).

Disclaimer: This Table is the copyrighted work of EBIA and is designed to provide accurate and authoritative information. It represents EBIA's interpretation of the Internal Revenue Code, Treasury regulations, and both formal and informal IRS guidance. Because the applicable rules are not always clear, reasonable minds may differ from some of our interpretations. The Table provides general information and its entries may be changed without notice. The Table is made available "as is," without warranty of any kind, and with the understanding that EBIA (the publisher) is not engaged in rendering legal, accounting, or other professional service. If tax or legal advice is required, the services of a competent professional should be sought. Caution: Some items in the Table might not be reimbursable under your employer's health FSA or HRA if the FSA or HRA contains exclusions, restrictions, or other limitations or requirements. Consult the summary plan description (SPD) of your employer's health FSA or HRA for guidance. If you have an HSA, you are responsible for determining whether an expense qualifies for a tax-free distribution.


Last revised: 9/14/09

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Key: = Qualifying expense; = Potentially qualifying expense; = Not a qualifying expense; = Over-the-counter item (shaded in brown)

Expense
Is expense a qualifying expense?

Learn more—see the Glossary

Comments and special rules

AA meetings, transportation to

Potentially qualifying expense

See Alcoholism treatment.

Abortion

Qualifying expense

Expenditures for operations that are illegal do not qualify.

Acne treatment

Potentially qualifying expense

Because acne is considered a disease, the cost of acne treatment qualifies (including over-the-counter (OTC) acne medications). However, the cost of regular skin care (face creams, etc.) does not qualify. And when the expense has both medical and cosmetic purposes (e.g., Retin-A, which can be used to treat both acne and wrinkles), a note from a medical practitioner recommending the item to treat a specific medical condition is normally required. See Drugs and medicines; Cosmetic procedures; Cosmetics, Retin-A, and Toiletries.

Acupuncture

Qualifying expense

Adaptive equipment

Potentially qualifying expense

Includes various items that assist individuals in performing activities of daily living (e.g., feeding, bathing, toileting, and mobility). To qualify, the item must be used to relieve or alleviate sickness or disability. To show that the expense is primarily for medical care, a note from a medical practitioner recommending the item to treat a specific medical condition (e.g., multiple sclerosis or arthritis) is normally required. Where applicable, only amounts above the cost of the regular version of the item will qualify. Depending on the nature of the item, other special rules may apply. See Capital expenses and Home improvements.

Adoption,
pre-adoption medical expenses

Qualifying expense

Medical expenses incurred before an adoption is finalized will qualify, if medical expenses the child qualifies as your tax dependent when the services/items are provided. (Adoption fees and other nonmedical expenses incurred in connection with adoption assistance may qualify for an adoption assistance credit (under Code § 23) or for reimbursement under an adoption assistance program (under Code § 137).)

Air conditioner

Potentially qualifying expense

The primary purpose must be to treat or alleviate a medical condition and expense the expense must not have been incurred "but for" the condition. To show that the expense is primarily for medical care, a note from a medical practitioner recommending the item to treat a specific medical condition is normally required. If it is attached to a home (such as central air conditioning), only the amount spent that is more than the value added to the property will qualify. See Capital expenses.

Air purifier

Potentially qualifying expense

To show that the expense is primarily for medical care, a note from a medical practitioner recommending the item to treat a specific medical condition (such as a severe allergy) is normally required. Several special rules apply. See Air conditioner and Capital expenses.

Alcoholism treatment

Qualifying expense

Amounts paid for in-patient treatment (including meals and lodging), at a therapeutic center for alcohol addiction will qualify. See Health institute fees; Lodging at a hospital or similar institution; Meals at a hospital or similar institution; and Schools and education, residential. Transportation expenses associated with attending meetings of an Alcoholics Anonymous group in the community would also qualify if attending due to a physician's advice that membership is necessary to treat alcoholism.

Allergy medicine

(Examples: Alavert, Claritin)

Qualifying expense

Allergy treatment products; household improvements to treat allergies

Potentially qualifying expense

Expenses generally won't qualify if the product would be owned even without allergies, such as a pillow or a vacuum cleaner. However, an air purifier or water filter necessary to treat a specific medical condition might qualify. To show that the expense is primarily for medical care, a note from a medical practitioner recommending the item to treat a specific medical condition is normally required. See Air purifier; Air conditioner; Capital expenses; and Drugs and medicines.

Alternative healers, dietary substitutes, and drugs and medicines

Potentially qualifying expense

Non-traditional healing treatments provided by professionals may be eligible if provided to treat a specific medical condition, but the IRS looks at these expenses very closely. The treatments must be legal. And the expenses do not qualify if the remedy is a food or substitute for food that the person would normally consume in order to meet nutritional requirements. It appears that drugs and medicines recommended by alternative healers to treat a specific medical condition also can qualify as medical care. To show that the expense is primarily for medical care, a note from a medical practitioner recommending the item to treat a specific medical condition is normally required. See Drugs and medicines; Christian Science practitioners; Special foods; and Vitamins.

Ambulance

Qualifying expense

Analgesics

(Examples: Advil, Aspirin, Tylenol)

Qualifying expense

Antacids

(Examples: Maalox, Prilosec OTC, Zantac)

Qualifying expense

Antibiotic ointments

(Examples: Bacitracin, Neosporin)

Qualifying expense

Antihistamines

(Examples: Benadryl, Claritin)

Qualifying expense

Anti-itch creams

(Examples: Benadryl, Cortaid, Ivarest)

Qualifying expense

Appearance improvements

Not a qualifying expense

See Cosmetic procedures; Cosmetics; and Toiletries.

Arthritis gloves

Qualifying expense

Artificial limbs

Qualifying expense

Artificial teeth

Qualifying expense

Aspirin

Qualifying expense

Asthma treatments

Qualifying expense

Includes asthma medications and delivery devices (e.g., inhalers and nebulizers)

Automobile modifications

Potentially qualifying expense

To show that the expense is primarily for medical care, a note from a medical practitioner recommending the item to treat a specific medical condition (e.g., a physical handicap) is normally required. But see Capital expenses. Expenses of operating a specially equipped car do not qualify (but see Transportation).

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Expense
Is expense a qualifying expense?

Learn more—see the Glossary

Comments and special rules

Babysitting and child care

Not a qualifying expense

Babysitting, child care, and nursing services for a normal, healthy baby do not qualify as medical care. But see Dependent care expenses and Disabled dependent care expenses.

Bactine

Qualifying expense

Bandages, elastic

(Example: Ace)

Qualifying expense

Bandages, for torn or injured skin

(Examples: Band-Aid, Curad)

Qualifying expense

Behavioral modification programs

Potentially qualifying expense

See Schools and education, residential and Schools and education, special.

Birth-control pills

Qualifying expense

See Contraceptives and Drugs and medicines. See also "Morning-after" contraceptive pills.

Birthing classes

Potentially qualifying expense

See Lamaze classes.

Blood-pressure monitoring devices

Qualifying expense

They are diagnostic items. See Diagnostic items/services and Screening tests.

Blood storage

Potentially qualifying expense

Fees for temporary storage may qualify under some circumstances, such expense as where the blood is collected as part of the diagnosis, treatment, or prevention of an existing or imminent medical condition (e.g., in advance of a scheduled surgery for use in a possible transfusion). Fees for indefinite storage, just in case the blood might be needed, would not be considered medical care. "Temporary" is not defined; however, one consideration might be whether the blood is stored and used within the same year. Also see Stem cell, harvesting and/or storage of and Umbilical cord, freezing and storing of.

Blood-sugar test kits and test strips

Qualifying expense

They are diagnostic items. See Diagnostic items/services and Screening tests.

Body scans

Qualifying expense

Body scans employing MRIs and similar technologies are diagnostic services. See Diagnostic items/services and Screening tests.

Braille books and magazines

Qualifying expense

Only amounts above the cost of regular printed material will qualify.

Breast pumps

Potentially qualifying expense

Will not qualify if used merely to benefit general health, or for convenience, scheduling, or other personal reasons. However, may qualify if used for medical reasons. To show that the expense is primarily for medical care, a note from a medical practitioner recommending the item to treat a specific medical condition (e.g., a breast abscess) is normally required.

Breast reconstruction surgery following mastectomy

Qualifying expense

Will qualify to the extent that surgery was done following a mastectomy for cancer. This is an exception to the general rules regarding cosmetic procedures. See Cosmetic procedures.

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Expense
Is expense a qualifying expense?

Learn more—see the Glossary

Comments and special rules

Calamine lotion

Qualifying expense

Capital expenses

Potentially qualifying expense

Improvements or special equipment added to a home (for example, an Elevator or Inclinator) or other capital expenditures (such as Automobile modifications for a physically handicapped person) may qualify if the primary purpose of the expenditure is medical care for you (or your spouse or dependent) and the expense would not be incurred "but for" this purpose. To show that the expense is primarily for medical care, a note from a medical practitioner recommending the item to treat a specific medical condition is normally required. How much of the expense would qualify depends on the extent to which the expense permanently improves the property.

Car modifications

Potentially qualifying expense

See Automobile modifications.

Carpal tunnel wrist supports

Qualifying expense

Cayenne pepper

Potentially qualifying expense

May qualify if used primarily to treat a specific medical condition. To show that the expense is primarily for medical care, a note from a medical practitioner recommending the item to treat a specific medical condition is normally required. See Alternative healers; Drugs and medicines; Special foods; and Vitamins.

Chelation therapy

Qualifying expense

Will qualify if used to treat a medical condition such as lead poisoning.

Childbirth classes

Potentially qualifying expense

See Lamaze classes.

Chinese herbal practitioners & herbal treatments

Potentially qualifying expense

See Alternative healers.

Chiropractors

Qualifying expense

Chondroitin

Potentially qualifying expense

Will qualify if used primarily for medical care (for example, to treat arthritis). Won't qualify if used just to maintain general health. To show that the expense is primarily for medical care, a note from a medical practitioner recommending the item to treat a specific medical condition (for example, arthritis) is normally required.

Christian Science practitioners

Potentially qualifying expense

Fees that you pay to Christian Science practitioners for medical care will qualify. Fees for other purposes generally do not qualify. See Alternative healers.

Circumcision

Qualifying expense

Claritin (loratadine), an allergy drug

Qualifying expense

Club dues and fees

Potentially qualifying expense

See Health club fees.

COBRA premiums

Depends on whether plan is a health FSA, HRA, or HSA; see next column for details

Health FSA: COBRA premiums are not qualifying expenses.
HRA: COBRA premiums are qualifying expenses.
HSA: COBRA premiums are qualifying expenses.
Also see Insurance premiums.

Co-insurance amounts

Qualifying expense

Will qualify if the underlying service/item qualifies.

Cold medicine

(Examples: Comtrex, Sudafed)

Qualifying expense

Cold/hot packs

Qualifying expense

Only cold/hot packs sold as medical supplies will qualify; those sold for other purposes (e.g., to keep beverages cold or hot) won't qualify.

Cologne

Not a qualifying expense

See Toiletries and Cosmetics.

Compression hose

Potentially qualifying expense

Won't qualify if used for personal or preventive reasons. If used to treat or alleviate a specific medical condition, only the excess cost of the specialized hose over the cost of regular hose will qualify. To show that the expense is primarily for medical care, a note from a medical practitioner recommending the item to treat a specific medical condition is normally required.

Condoms

Qualifying expense

See Contraceptives.

Contact lenses, materials, and equipment

Qualifying expense

Materials and equipment needed for using lenses (such as saline solution and enzyme cleaner) would qualify if the lenses are needed for medical purposes, as would distilled water used to store and clean the lenses. Contact lens insurance would not qualify, however. See Insurance premiums. Contact lenses for solely cosmetic purposes (for example, changing one's eye color) do not qualify. See Cosmetics.

Contraceptives

Qualifying expense

Includes Birth-control pills, Condoms, "Morning-after" contraceptive pills, and Spermicidal foam. Also see Sterilization procedures.

Controlled substances in violation of federal law

Not a qualifying expense

If the substance violates federal law (e.g., the Controlled Substances Act), the expense would not qualify even if a state law allows its use with a physician's prescription (for example, marijuana or laetrile prescribed to treat a specific medical condition). See Drugs and medicines and Illegal operations and treatments.

Co-payments

Qualifying expense

Will qualify if the underlying service/item qualifies.

Cosmetic procedures

Not a qualifying expense

Most cosmetic procedures do not qualify. This includes cosmetic surgery or other procedures that are directed at improving the patient's appearance and don't meaningfully promote the proper function of the body or prevent or treat illness or disease. Examples include face lifts, hair transplants, hair removal (electrolysis), teeth whitening, and liposuction. There is an exception, however, for procedures necessary to ameliorate a deformity arising from congenital abnormality, personal injury from accident or trauma, or disfiguring disease—these may qualify. See Breast reconstruction surgery. Also see Drugs and medicines.

Cosmetics

Not a qualifying expense

Cosmetics are articles used primarily for personal purposes, and are intended to be rubbed on, poured on, sprinkled on, sprayed on, introduced into, or otherwise applied to the human body for cleansing, beautifying, promoting attractiveness, or altering the appearance. Examples include skin moisturizers, perfumes, lipsticks, fingernail polish, eye and facial makeup, shampoos, permanent waves, hair colors, toothpastes, and deodorants. Also see Cosmetic procedures and Toiletries.

Cough suppressants

(Examples: Pediacare, Robitussin, cough drops)

Qualifying expense

Also see Throat lozenges.

Counseling

Potentially qualifying expense

Will qualify if for a medical reason. Marriage counseling doesn't qualify. To show that the expense is primarily for medical care, a note from a medical practitioner recommending the counseling to treat a specific medical condition is normally required. Also see Psychiatric care and Psychologist.

Crowns, dental

Potentially qualifying expense

Will not qualify if they are obtained for a cosmetic reason. See Cosmetic procedures.

Crutches

Qualifying expense

Will qualify whether purchased or rented.

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Expense
Is expense a qualifying expense?

Learn more—see the Glossary

Comments and special rules

Dancing lessons

Potentially qualifying expense

Generally the cost of dancing lessons, swimming lessons, etc., does not qualify, even if recommended by a medical practitioner, if the lessons are to improve general health. But the expenditure might qualify if recommended by a medical professional to treat a specific medical condition (such as part of a rehabilitation program after surgery) and the expense would not have been incurred "but for" the condition. To show that the lessons are primarily for medical care, a note from a medical practitioner recommending them to treat a specific medical condition is normally required.

Decongestants

(Examples: Dimetapp, Sudafed)

Qualifying expense

Deductibles

Qualifying expense

Will qualify if the underlying service/item qualifies.

Dental floss

Not a qualifying expense

Dental sealants

Qualifying expense

Dental treatment

Qualifying expense

Includes fees for X-rays, fillings, braces, extractions, dentures, etc., but not teeth whitening. When an orthodontic treatment plan is paid up front at the time of the first visit, some health FSAs will apportion the reimbursements as services are provided during the treatment plan. Also see Prepayments.

Dentures and denture adhesives

Qualifying expense

Deodorant

Not a qualifying expense

See Cosmetics and Toiletries.

Dependent care expenses

Not a qualifying expense

Such expenses won't qualify, even if you are paying for dependent care (for example, hiring a babysitter) so that you can receive medical care. But see Disabled dependent care expenses. Such expenses might be reimbursable under a DCAP if applicable rules are met (but the same expenses may not be reimbursed under a health FSA, HRA, or HSA and a DCAP—there is no "double-dipping" allowed). Also see Babysitting and child care.

Diabetic socks

Potentially qualifying expense

Won't qualify if used for personal or preventive reasons. If used to treat or alleviate a specific medical condition, only the excess cost of the specialized socks over the cost of regular socks will qualify. To show that the expense is primarily for medical care, a note from a medical practitioner recommending the item to treat a specific medical condition is normally required.

Diabetic supplies

Qualifying expense

Also see Blood-sugar test kits and test strips; Glucose-monitoring equipment; and Insulin.

Diagnostic items/services

Qualifying expense

Includes a wide variety of procedures to determine the presence of a disease or dysfunction of the body, such as tests to detect heart attack, stroke, diabetes, osteoporosis, thyroid conditions, and cancer. Also see Body scans; Blood-pressure monitoring devices; Blood-sugar test kits and test strips; Medical monitoring and testing devices; and other entries throughout.

Diaper rash ointments and creams

(Example: Desitin)

Qualifying expense

Diapers or diaper service

Not a qualifying expense

Regular diapers or diaper services for newborns do not qualify. But diapers or diaper services that are used to relieve the effects of a diagnosed medical condition do qualify. To show that the expense is primarily for medical care, a note from a medical practitioner recommending the item to treat a specific medical condition is normally required. See also Incontinence supplies.

Diarrhea medicine

(Examples: Imodium, Kaopectate)

Qualifying expense

Dietary supplements

Potentially qualifying expense

The cost of dietary supplements, nutritional supplements, vitamins, herbal supplements, and natural medicines does not qualify if they are merely beneficial for general health (e.g., one-a-day vitamins). To show that the expense is primarily for medical care, a note from a medical practitioner recommending the item to treat a specific medical condition (e.g., 1,000 mg of Vitamin B-12 daily to treat a specific vitamin deficiency) is normally required. See Special foods; Mineral supplements and Vitamins.

Diet foods

Not a qualifying expense

Costs of special foods to treat a specific disease (such as obesity) do not qualify to the extent that they satisfy ordinary nutritional requirements. Thus, the costs of food associated with a weight-loss program, such as special pre-packaged meals, would not qualify, since they just meet normal nutritional needs. See Weight-loss programs. But see Special foods.

Disabled dependent care expenses

Potentially qualifying expense

Such expenses will qualify if the expenses are for medical care of the disabled dependent. Note that some disabled dependent care expenses that qualify as medical expenses may also qualify as work-related expenses for purposes of the dependent care tax credit under Code § 21 or for reimbursement under a dependent care assistance program under Code § 129. You must not use the same expenses for more than one purpose (for example, medical expenses reimbursed under a health FSA cannot be used to claim a dependent care tax credit).

DNA collection and storage

Potentially qualifying expense

Such expenses generally won't qualify. But temporary storage may qualify under some circumstances, such as where the DNA is collected as part of the diagnosis, treatment, or prevention of an existing or imminent medical condition. "Temporary" is not defined; however, one consideration might be whether it is stored and used within the same plan year. Also see Umbilical cord, freezing and storing of.

Doula

Potentially qualifying expense

Will only qualify to the extent that the doula provides medical care for the mother or child. Services such as emotional support, parenting information, child care, and housekeeping will not qualify. See Household help; Lamaze classes; and Nursing services.

Drug addiction treatment

Qualifying expense

Amounts paid for an inpatient's treatment at a therapeutic center for drug addiction will qualify. See Alcoholism treatment.

Drug overdose, treatment of

Qualifying expense

Drugs and medicines

Potentially qualifying expense

Will qualify if primarily for medical care (and not for personal, general health, or cosmetic purposes), legally procured, and generally accepted as medicines and drugs. Also see Aspirin and other entries throughout for both prescription and OTC drugs.

Dyslexia

Potentially qualifying expense

See Language training.

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Expense
Is expense a qualifying expense?

Learn more—see the Glossary

Comments and special rules

Ear piercing

Not a qualifying expense

See Cosmetic procedures.

Ear plugs

Potentially qualifying expense

Will qualify if recommended by a medical practitioner for a specific medical condition (for example, to protect surgically implanted ear tubes). To show that the expense is primarily for medical care, a note from a medical practitioner recommending the item to treat a specific medical condition is normally required.

Ear wax removal products

(Examples: Debrox, Murine)

Qualifying expense

Eczema treatments

Qualifying expense

Egg donor fees

Potentially qualifying expense

Amounts paid for the egg donor fee, an agency fee, an egg donor's medical and psychological testing, and the legal fees for preparation of the egg donor contract will qualify, if preparatory to a procedure performed on you, your spouse, or your dependent. Also see Fertility treatments; Sperm, storage fees; and Surrogate expenses.

Eggs and embryos, storage fees

Potentially qualifying expense

Fees for temporary storage qualify, but only to the extent necessary for immediate conception. Storage fees for undefined future conception probably aren't considered medical care. "Temporary" is not defined; however, one consideration might be whether it is stored and used within the same year. Also see Fertility treatments; Sperm, storage fees; and Surrogate expenses.

Electrolysis or hair removal

Not a qualifying expense

See Cosmetic procedures.

Elevator

Potentially qualifying expense

Installing an elevator upon the advice of a physician so that a person with heart disease won't have to climb stairs may be medical care to the extent of the amount in excess of value enhancement to the property. To show that the expense is primarily for medical care, a note from a medical practitioner recommending the item to treat a specific medical condition is normally required. See Capital expenses.

Exercise equipment or programs

Potentially qualifying expense

Qualifies only if required to treat an illness (such as obesity) diagnosed by a physician. The purpose of the expense must be to treat the disease rather than to promote general health, and the expense must not have been incurred "but for" this purpose. To show that the expense is primarily for medical care, a note from a medical practitioner recommending the item or program to treat a specific medical condition is normally required. See Capital expenses; Health club fees; Prepayments; and Weight-loss programs.

Expectorants

(Examples: Comtrex, Robitussin)

Qualifying expense

Eye drops

(Example: Visine)

Qualifying expense

Eye examinations, eyeglasses, equipment, and materials

Qualifying expense

Materials and equipment needed for using the eyeglasses (such as eyeglass cleaners) also should be medical care. Also see Contact lenses and Sunglasses.

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Expense
Is expense a qualifying expense?

Learn more—see the Glossary

Comments and special rules

Face creams

Not a qualifying expense

See Cosmetics; Toiletries; and Cosmetic procedures.

Face lifts

Not a qualifying expense

See Cosmetic procedures.

Feminine hygiene products (tampons, etc.)

Not a qualifying expense

Such expenses generally won't qualify, as they are ordinarily considered as being used to maintain general health. See Toiletries and Cosmetics. There may be exceptions (e.g., if a medical practitioner recommends the product to alleviate a specific medical condition). See Incontinence supplies and Menstrual pain relievers.

Fertility treatments

Potentially qualifying expense

Will qualify to the extent that procedures are intended to overcome an expense inability to have children and are performed on you, your spouse, or your dependent. Examples are IVF (in vitro fertilization—including temporary storage of eggs or sperm), surgery (including an operation to reverse prior surgery preventing someone from having children), shots, treatments, and GIFT (gamete intrafallopian transfer). Expenses paid to or for an in vitro surrogate usually do not qualify, nor do egg donor expenses unless preparatory to a procedure performed on you, your spouse, or a dependent. See Egg donor fees; Eggs and embryos, storage fees; Legal fees in connection with fertility treatments; Prepayments, Sperm, storage fees; and Surrogate expenses.

Fever-reducing medications

(Examples: Aspirin, Motrin, Tylenol)

Qualifying expense

Fiber supplements

Potentially qualifying expense

Won't qualify if used for general health purposes or other personal reasons. May qualify if used to treat or alleviate a specific medical condition, and if the expense would not have been incurred "but for" the condition. To show that the expense is primarily for medical care, a note from a medical practitioner recommending the item to treat a specific medical condition is normally required. See Dietary supplements; Prenatal vitamins; and Special foods.

First aid cream

Qualifying expense

First aid kits

Qualifying expense

Fitness programs

Potentially qualifying expense

See Exercise equipment or programs.

Flu shots

Qualifying expense

Immunizations to prevent disease will qualify, even though no medical condition has been diagnosed.

Fluoride Rinses

Potentially qualifying expense

Won't qualify if used to maintain general health or for other personal reasons (e.g., as a toiletry). May qualify if used to treat or alleviate a specific medical condition, and if the expense would not have been incurred "but for" the condition. To show that the expense is primarily for medical care, a note from a medical practitioner recommending the item to treat a specific medical condition is normally required.

Fluoridation services

Qualifying expense

Will qualify if recommended by a dentist to prevent tooth decay. The amount that qualifies is limited to the cost allocable to the current year.

Foods

Potentially qualifying expense

See Special foods; Meals; and Alternative healers, dietary substitutes and drugs and medicines.

Food thickeners

Potentially qualifying expense

Whether food thickeners are a medical care expense is a question of fact that must be determined on a case-by-case basis.� To show that the expense is primarily for medical care, a note from a medical practitioner recommending the item to treat a specific medical condition is normally required.

Founder's fee

Not a qualifying expense

Founder's fees are amounts you pay under an agreement with a retirement home. Even if a portion is allocable to medical care, these expenses usually do not qualify.

Funeral expenses

Not a qualifying expense

These are not for medical care.

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Expense
Is expense a qualifying expense?

Learn more—see the Glossary

Comments and special rules

Gambling problem, treatment for

Potentially qualifying expense

Pathological gambling has been classified as an impulse control disorder by the American Psychiatric Association and thus, it could be argued, is a mental illness. If so, its treatment would be a qualifying expense. See Alcoholism treatment.

Gauze pads

Qualifying expense

See Bandages.

Genetic testing

Potentially qualifying expense

Would qualify to the extent that testing is done to diagnose a medical condition or to determine possible defects. However, testing done just to determine the sex of a fetus would not qualify.

Glucosamine

Potentially qualifying expense

See Chondroitin.

Glucose-monitoring equipment

Qualifying expense

Items such as blood-glucose meters and glucose test strips are diagnostic items and are primarily for medical care. Also see Blood-sugar test kits and test strips.

Guide dog; other service animal

Qualifying expense

Expenses for buying, training, and maintaining a service animal used by a physically disabled person would qualify; this includes the expenses of food and innoculations. Veterinary fees for such animals also qualify as medical care. See Veterinary fees.

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Expense
Is expense a qualifying expense?

Learn more—see the Glossary

Comments and special rules

Hair colorants

Not a qualifying expense

See Cosmetics and Toiletries.

Hair removal and transplants

Not a qualifying expense

Such expenses generally won't qualify. See Cosmetic procedures and Drugs and medicines.

Hand lotion

Not a qualifying expense

Such expenses generally won't qualify. See Cosmetics and Toiletries.

Hand sanitizer

Potentially qualifying expense

Won't qualify if used for general health purposes or other personal reasons (e.g., as a toiletry). May qualify if used to treat or alleviate a specific medical condition, and if the expense would not have been incurred "but for" the condition. Might also qualify where there is an imminent probability of contracting a specific illness (e.g., from a household member who has a contagious disease). A note from a medical practitioner recommending the item to treat a specific medical condition (or if applicable, to prevent a specific and imminent illness) is normally required.

Headache medications

(Examples: Advil, Aspirin, Tylenol)

Qualifying expense

Health club fees

Potentially qualifying expense

Only in very limited circumstances would fees paid to a health club qualify. One instance might be where fees are incurred upon the advice of a medical practitioner to treat a specific medical condition (e.g., rehabilitation after back surgery or treatment for obesity). The expense must not have been incurred "but for" the disease (for example, if you belonged to the health club before being diagnosed, then the fees would not qualify). When treatment is no longer needed, the fees would no longer qualify. To show that the expense is primarily for medical care, a note from a medical practitioner recommending it to treat a specific medical condition is normally required. See Prepayments and Weight-loss programs.

Health institute fees

Potentially qualifying expense

Qualifies only if the treatment at the health institute is prescribed by a physician who issues a written statement that the treatment is necessary to alleviate a physical or mental defect or illness of the individual receiving the treatment.

Hearing aids

Qualifying expense

The costs of the hearing aid and its batteries would qualify.

Hemorrhoid treatments

(Example: Preparation H)

Qualifying expense

Herbs

Potentially qualifying expense

See Vitamins.

HMO premiums

Depends on whether plan is a health FSA, HRA, or HSA

See Insurance premiums.

Holistic or natural healers, dietary substitutes, and drugs and medicines

Potentially qualifying expense

See Alternative healers.

Home care

Potentially qualifying expense

See Nursing services.

Home improvements (such as exit ramps, widening doorways, etc.)

Potentially qualifying expense

May qualify if done to accommodate a disability. If the improvement is permanent and increases the value of the property, the expense will qualify only to the extent that the improvement cost exceeds the increase in property value. If the improvement doesn't increase the property value at all, then the entire cost may qualify. Items that usually don't increase property value include constructing entrance or exit ramps, widening or modifying doorways or hallways, installing railings or support bars to bathrooms, lowering or modifying kitchen cabinets or equipment, moving or modifying electrical outlets and fixtures, installing porch lifts, modifying fire alarms or smoke detectors, modifying other warning systems, and modifying stairways. To show that the expense is primarily for medical care, a note from a medical practitioner recommending the item to treat a specific medical condition is normally required. See Capital expenses; Elevator; and Air conditioner.

Hormone replacement therapy (HRT)

Potentially qualifying expense

Will qualify if used primarily for medical care (for example, to treat menopausal symptoms such as hot flashes, night sweats, etc.). Won't qualify if primarily for maintaining general health. To show that the expense is primarily for medical care, a note from a medical practitioner recommending the therapy to treat a specific medical condition is normally required. See Drugs and medicines.

Hospital services

Qualifying expense

Expenses of inpatient care (plus meals and lodging) at a hospital or similar institution qualify if a principal reason for being there is to get medical care. Also see Nursing services; Meals at a hospital; and Lodging at a hospital.

Household help

Not a qualifying expense

Won't qualify, even if a medical practitioner recommends such help, unless the expenses qualify as nursing services. See Nursing services. In some cases, household services may qualify for reimbursement under a DCAP if attributable in part to care of a qualifying individual (i.e., certain children under age 13 and certain individuals who are physically or mentally incapable of self-care).

Humidifier

Potentially qualifying expense

To show that the expense is primarily for medical care, a note from a medical practitioner recommending the item to treat a specific medical condition (such as severe allergy) is normally required. Several special rules apply. See Air conditioner; Air purifier; and Capital expenses.

Hypnosis

Potentially qualifying expense

Will qualify if performed by a professional to treat a medical condition, or for other medical purposes (e.g., smoking cessation); won't qualify if for general stress relief, personal enjoyment, or other personal purposes. To show that the expense is primarily for medical care, a note from a medical practitioner recommending it to treat a specific medical condition is normally required. Also see Psychoanalysis and Therapy.

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Expense
Is expense a qualifying expense?

Learn more—see the Glossary

Comments and special rules

Illegal operations and treatments

Not a qualifying expense

Won't qualify, even if they are rendered or prescribed by licensed medical practitioners. See Controlled substances.

Immunizations

Qualifying expense

Immunizations to prevent disease (such as tetanus or well-baby shots) will qualify, even if no medical condition has been diagnosed.

Inclinator

Potentially qualifying expense

May qualify to the extent of the amount in excess of value enhancement to the property, if the primary purpose of the expenditure is medical care for you (or your spouse or dependent) and the expense would not be incurred "but for" this purpose. To show that the expense is primarily for medical care, a note from a medical practitioner recommending the item to treat a specific medical condition is normally required. See Capital expenses and Elevator.

Incontinence supplies

Qualifying expense

Adult diapers used to relieve incontinence generally will qualify as medical care expenses. But see Diapers.

Infertility treatments

Potentially qualifying expense

See Egg donor fees; Eggs and embryos, storage fees; Fertility treatments; Prepayments; Sperm, storage fees; and Surrogate expenses.

Insect-bite creams and ointments

(Examples: Benadryl, Cortaid)

Qualifying expense

Insulin

Qualifying expense

Equipment needed to inject the insulin, such as syringes or insulin pumps, also qualifies as a medical expense. Also see Glucose-monitoring equipment.

Insurance premiums

Depends on whether plan is a health FSA, HRA, or HSA; see next column for details

Health FSA: Insurance premiums are not qualifying expenses.
HRA: The following premiums are qualifying expenses: premiums for traditional health insurance (including COBRA) or qualified long-term care insurance. (Note that reimbursing premiums for individual major medical insurance policies raises concerns under HIPAA, COBRA, and ERISA.) The following insurance premiums are not qualifying expenses: premiums for employer-sponsored group health coverage that could be paid on a pre-tax basis under the employer's cafeteria plan, LTD insurance, fixed indemnity cancer insurance, hospital indemnity insurance.
HSA: Payments for health insurance premiums or contributions for self-funded health coverage generally aren't qualifying expenses. However, the following premiums will qualify for reimbursement from an HSA: COBRA coverage, a qualified long-term care insurance contract, any health plan maintained while the individual is receiving unemployment compensation under federal or state law, or, for those age 65 or older (whether or not they are entitled to Medicare), any deductible health insurance (e.g., retiree medical coverage) other than a Medicare supplemental policy. (Note: Long-term care insurance premium reimbursements that exceed certain limits will be treated as taxable and may be subject to an additional 10% excise tax.)
Also see COBRA premiums.

IVF (in vitro fertilization)

Potentially qualifying expense

See Eggs and embryos, storage fees; Fertility treatments; Prepayments; Sperm, storage fees; and Surrogate expenses.

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Expense
Is expense a qualifying expense?

Learn more—see the Glossary

Comments and special rules

Laboratory fees

Qualifying expense

Such expenses will qualify if they are part of medical care.

Lactation consultant

Potentially qualifying expense

If a woman is having lactation problems and cannot breastfeed her child, then the expense of a lactation consultant helping to overcome this dysfunction might qualify. To show that the expense is primarily for medical care, a note from a medical practitioner recommending it to treat a specific medical condition is normally required.

Lamaze classes

Potentially qualifying expense

Expenses may qualify to the extent that instruction relates to birth and not childrearing. The fee should be apportioned to exclude instruction in topics such as newborn care. Expenses for the coach or significant other do not qualify.

Language training

Potentially qualifying expense

Such expenses will qualify if for a child with dyslexia or an otherwise disabled child. But amounts paid for regular schooling normally don't qualify. To show that the expense is primarily for medical care, a note from a medical practitioner recommending it to treat a specific medical condition is normally required. Also see Learning disability, instructional fees; Prepayments and Schools and education, residential/special.

Laser eye surgery; Lasik

Qualifying expense

Will qualify because the procedure is done primarily to promote the correct function of the eye. Also see Radial keratotomy; Vision correction procedures; and Prepayments.

Late fees (e.g., for late payment of bills for medical services)

Not a qualifying expense

Such fees would not be for medical care.

Laxatives

(Example: Ex-Lax)

Qualifying expense

Lead-based paint removal

Potentially qualifying expense

The expense of removing lead-based paints from surfaces in the participant's home to prevent a child who has (or has had) lead poisoning from eating the paint would qualify. To show that the expense is primarily for medical care, a note from a medical practitioner recommending it to treat a specific medical condition is normally required. The surfaces must be in poor repair (peeling or cracking) or be within the child's reach; the cost of repainting the scraped area does not qualify. If instead of removing the paint, the area is covered with wallboard or paneling, treat these items as Capital expenses. The cost of painting the wallboard does not qualify. Also see Chelation therapy.

Learning disability, instructional fees

Potentially qualifying expense

If prescribed by a physician, tuition fees paid to a special school and tutoring fees paid to a specially trained teacher for a child who has learning disabilities caused by mental or physical impairments (such as nervous system disorders) will qualify. Also see Prepayments and Schools and education, residential/special.

Legal fees, general

Potentially qualifying expense

Legal fees may qualify as medical care if they bear a direct or proximate relationship to the provision of medical care—for example, if the medical care could not have been provided without legal assistance. Fees for legal services retained to authorize treatment for mental illness may qualify. But legal fees for management of a guardianship estate for conducting the affairs of the person being treated or other fees that aren't necessary for medical care do not qualify; neither do divorce costs. See Legal fees in connection with fertility treatments.

Legal fees in connection with fertility treatments

Potentially qualifying expense

May qualify if the legal fees are in connection with a medical procedure performed upon you (or your spouse or dependent). Legal fees for preparing a contract for you to obtain a donated egg from an egg donor may also qualify, if preparatory to a procedure performed on you, your spouse, or your dependent. In contrast, legal fees incurred in connection with a procedure performed on a surrogate mother do not constitute medical care. See Fertility treatments and Legal fees, general.

Lipsticks

Not a qualifying expense

See Cosmetics and Toiletries.

Liquid adhesive for small cuts

Qualifying expense

See Bandages.

Lodging at a hospital or similar institution

Qualifying expense

Will qualify if a principal reason for being there is to receive medical care. See Meals at a hospital or similar institution and Schools and education, residential.

Lodging not at a hospital or similar institution

Potentially qualifying expense

Up to $50 per night will qualify if these conditions are met: (1) The lodging is primarily for and essential to medical care; (2) the medical care is provided by a physician in a licensed hospital or medical care facility related to (or equivalent to) a licensed hospital; (3) the lodging isn't lavish or extravagant; and (4) there is no significant element of personal pleasure, recreation, or vacation in the travel. If a parent is traveling with a sick child, up to $100 may qualify ($50 for each person). Also see Meals not at a hospital.

Lodging of a companion

Potentially qualifying expense

Will qualify if accompanying a patient for medical reasons and all of the conditions described under Lodging not at a hospital or similar institution are also met. For example, if a parent is traveling with a sick child, up to $100 per night ($50 for each person) will qualify. See Lodging not at a hospital or similar institution.

Lodging while attending a medical conference

Not a qualifying expense

See Medical conference admission, transportation, meals, etc. and Meals while attending a medical conference.

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Expense
Is expense a qualifying expense?

Learn more—see the Glossary

Comments and special rules

Makeup

Not a qualifying expense

See Cosmetics and Toiletries.

Marijuana or other controlled substances in violation of federal law

Not a qualifying expense

See Controlled substances and Illegal operations and treatments.

Masks, disposable

Potentially qualifying expense

Won't qualify if used for general health purposes or other personal reasons. May qualify if used to treat or alleviate a specific medical condition, and if the expense would not have been incurred "but for" the condition. Might also qualify where used to prevent a specific illness that is imminent (e.g., if a household member has a contagious disease). A note from a medical practitioner recommending the item to treat a specific medical condition (or if applicable, to prevent a specific and imminent illness) is normally required.

Massage therapy

Potentially qualifying expense

The costs of a massage just to improve general health don't qualify. However, if the massage therapy was recommended by a physician to treat a specific injury or trauma, then it would qualify. To show that the expense is primarily for medical care, a note from a medical practitioner recommending it to treat a specific medical condition is normally required.

Mastectomy-related special bras

Qualifying expense

See Breast reconstructive surgery following a mastectomy.

Maternity clothes

Not a qualifying expense

Mattresses

Not a qualifying expense

In rare cases, a portion of the expenditure might qualify if a unique type of mattress is prescribed by a physician to treat a specific medical condition. Also see Capital expenses.

Meals at a hospital or similar institution

Potentially qualifying expense

Meals that are part of the cost of inpatient care at a hospital or similar institution will qualify if a principal reason for the recipient's being there is to receive medical care; the meals must be furnished as a necessary incident to the individual's continuing medical care. Meals that are not part of inpatient care generally won't qualify. It is unclear whether meals provided at a hospital or similar institution for an outpatient who must remain at the institution for continuing care for some period (e.g., following a medical procedure) would qualify. See Lodging at a hospital or similar institution; Meals of a companion; Schools and education, residential; and Schools and education, special.

Meals not at a hospital or similar institution

Not a qualifying expense

See Lodging not at a hospital or similar institution.

Meals of a companion

Not a qualifying expense

Won't qualify even if accompanying a patient for medical reasons. See Lodging of a companion.

Meals while attending a medical conference

Not a qualifying expense

See Medical conference admission, transportation, meals, etc.

Medical alert bracelet or necklace

Qualifying expense

Will qualify if recommended by a medical practitioner in connection with treating a medical condition.

Medical conference admission, transportation, meals, etc.

Potentially qualifying expense

Expenses for admission and transportation to a medical conference qualify, if they relate to a chronic disease suffered by you, your spouse, or your dependent and if the conference is primarily for and essential to the person in need of medical care. Includes transportation expenses to the city where the conference is held, plus local transportation to the conference. Most of the time at the conference must be spent attending sessions on medical information. The expenses of meals and lodging while attending the conference don't qualify.

Medical information plan charges

Qualifying expense

These are expenses paid to a plan to keep medical information so that it can be retrieved from a computer databank for your (or your spouse's or dependent's) medical care.

Medical monitoring and testing devices

Qualifying expense

Examples of such devices are blood-pressure monitors, syringes, glucose kit, etc. Also see Blood-sugar test kits and test strips; Body scans; Diagnostic items/services; Glucose monitoring equipment; Ovulation monitor; and Pregnancy test kits.

Medical newsletter

Not a qualifying expense

Although a newsletter may discuss current information about treatments for a specific medical condition, the newsletter itself does not directly treat the condition.

Medical records charges

Qualifying expense

For example, the fee associated with transferring medical records to a new medical practitioner will qualify.

Medical services

Qualifying expense

This is a very broad category, and includes expenditures for legal medical services recommended by physicians, surgeons, specialists, and other medical practitioners.

Medicines and drugs

Potentially qualifying expense

See Drugs and medicines.

Menstrual pain relievers

(Example: Midol)

Qualifying expense

Mentally handicapped, special home for

Potentially qualifying expense

The cost of keeping a mentally handicapped person in a special home (not a relative's home) on a psychiatrist's recommendation to help that person adjust from life in a mental hospital to community living may qualify. See also Schools and education, residential.

Mineral supplements

Potentially qualifying expense

Won't qualify if used to maintain general health. But under narrow circumstances, mineral supplements might qualify if recommended by a medical practitioner for a specific medical condition (for example, a prescribed dosage of iron daily to treat iron-deficiency anemia). To show that the expense is primarily for medical care, a note from a medical practitioner recommending the item to treat a specific medical condition is normally required. See Dietary supplements.

Missed appointment fees

Not a qualifying expense

Such fees would not be for medical care.

Moisturizers

Not a qualifying expense

See Cosmetics; Toiletries; and Cosmetic procedures.

"Morning-after" contraceptive pills

Qualifying expense

Also see Birth-control pills and Contraceptives.

Motion-sickness pills

(Examples: Bonine, Dramamine)

Qualifying expense

Mouthwash

Not a qualifying expense

Such expenses generally won't qualify. See Cosmetics and Toiletries. However, depending on the facts and circumstances, a special mouthwash recommended by a medical practitioner for the treatment of gingivitis might qualify.

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Expense
Is expense a qualifying expense?

Learn more—see the Glossary

Comments and special rules

Nail polish

Not a qualifying expense

See Cosmetics and Toiletries.

Nasal strips or sprays

Potentially qualifying expense

Nasal sprays or strips that are used to treat sinus problems qualify as being primarily for medical care, as would those that are used to prevent sleep apnea. However, nasal strips or sprays used to prevent run-of-the-mill snoring wouldn't qualify, nor would those used by athletes. To show that the expense is primarily for medical care, a note from a medical practitioner recommending the item to treat a specific medical condition is normally required. See Drugs and medicines.

Naturopathic healers, dietary substitutes and drugs and medicines

Potentially qualifying expense

See Alternative healers; Drugs and medicines; Special foods; and Vitamins.

Nicotine gum or patches

(Examples: Nicoderm, Nicorette)

Qualifying expense

Such items are primarily for medical care when used for stop-smoking purposes. See Drugs and medicines.

Non-prescription drugs and medicines

Potentially qualifying expense

See Drugs and medicines.

Norplant insertion or removal

Qualifying expense

Also see Contraceptives; Birth-control pills; Vasectomy; and Spermicidal foam.

Nursing services provided by a nurse or other attendant

Potentially qualifying expense

Wages, employment taxes, and other amounts you pay for nursing services (including extra costs for nurses' room and board) generally will qualify, whether provided in the participant's home or another facility. The attendant doesn't have to be a nurse, so long as the services are of a kind generally performed by a nurse. These include services connected with caring for the patient's condition, such as giving medication or changing dressings, as well as bathing and grooming. But if the person providing nursing services also provides household and personal services, the amounts must be accounted for separately—only those for nursing services qualify.

Nursing services for a baby

Not a qualifying expense

Won't qualify if the baby is normal and healthy.

Nutritionist's professional expenses

Potentially qualifying expense

May qualify if the treatment relates to a specifically diagnosed medical condition. Won't qualify if the expense is for general health. To show that the expense is primarily for medical care, a note from a medical practitioner recommending the item to treat a specific medical condition is normally required. Also see Special foods.

Nutritional supplements

Potentially qualifying expense

See Dietary supplements.

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Expense
Is expense a qualifying expense?

Learn more—see the Glossary

Comments and special rules

Obstetrical expenses

Qualifying expense

Occlusal guards to prevent teeth grinding

Qualifying expense

One-a-day vitamins

Not a qualifying expense

See Vitamins.

Operations

Qualifying expense

Will qualify if the operations are legal (and aren't cosmetic procedures). See Cosmetic procedures.

Optometrist

Qualifying expense

Also see Eye examinations, eyeglasses, etc.

Organ donors

Qualifying expense

See Transplants.

Orthodontia

Qualifying expense

Such expenses generally will qualify. When an orthodontic treatment plan is paid up front at the time of the first visit, some health FSAs will apportion the reimbursements as services are provided during the treatment plan. Also see Dental treatment and Prepayments.

Orthopedic shoe inserts

Qualifying expense

Will qualify if used to treat injured or weakened body parts.

Orthopedic shoes

Potentially qualifying expense

Won't qualify if used for personal or preventive reasons. If used to treat or alleviate a specific medical condition, only the excess cost of the specialized orthopedic shoe over the cost of a regular shoe will qualify. To show that the expense is primarily for medical care, a note from a medical practitioner recommending the item to treat a specific medical condition is normally required.

Osteopath fees

Qualifying expense

Over-the-counter (OTC) medicines

Potentially qualifying expense

Some OTC medicines qualify (for example, aspirin). See Drugs and medicines.

Ovulation monitor

Qualifying expense

Also see Medical monitoring and testing devices.

Oxygen

Qualifying expense

This includes the expenses of oxygen and oxygen equipment for breathing problems caused by a medical condition.

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Expense
Is expense a qualifying expense?

Learn more—see the Glossary

Comments and special rules

Pain relievers

(Examples: Advil, Aspirin, Tylenol)

Qualifying expense

Perfume

Not a qualifying expense

See Cosmetics and Toiletries.

Permanent waves

Not a qualifying expense

See Cosmetics and Toiletries.

Personal trainer fees

 

Potentially qualifying expense

Will qualify if a medical practitioner has recommended a supervised exercise regimen in order to treat a disease or injury (e.g., rehabilitation after surgery or the treatment of obesity) and if incurred for a limited duration. The expense must not have been incurred "but for" the disease (e.g., if you were working with a personal trainer before being diagnosed, the expense would not qualify). To show that the expense is primarily for medical care, a note from a medical practitioner recommending it to treat a specific medical condition is normally required. See Weight-loss programs.

Petroleum jelly

Potentially qualifying expense

Won't qualify if used to maintain general health or for other personal reasons (e.g., as a toiletry or a cosmetic). May qualify if used to treat or alleviate a specific medical condition, and if the expense would not have been incurred "but for" the condition. To show that the expense is primarily for medical care, a note from a medical practitioner recommending the item to treat a specific medical condition is normally required.

Physical exams

Qualifying expense

Physical therapy

Qualifying expense

Pregnancy test kits

Qualifying expense

Also see Medical monitoring and testing devices and Ovulation monitor.

Prenatal vitamins

Potentially qualifying expense

Obstetricians routinely recommend prenatal vitamins for the health of unborn children. If taken during pregnancy (a medical condition), prenatal vitamins would be considered primarily for medical care. Vitamins taken at other times generally do not qualify. See Vitamins.

Prepayments

Not a qualifying expense

Generally, prepayments for services/items that have not yet been incurred/obtained are not reimbursable under a health FSA. See Dental treatment; Fertility treatments; and Orthodontia.

Prescription drugs

Potentially qualifying expense

See Drugs and medicines.

Prescription drugs and medicines obtained from other countries

Not a qualifying expense

Importing prescription drugs from other countries generally will violate federal law. However, a drug or medicine may qualify for reimbursement if (1) it is purchased and consumed in the other country and is legal in both that country and the U.S. or (2) the FDA announces that it can be legally imported by individuals. See Drugs and medicines.

Prescription drug discount programs

Not a qualifying expense

If an individual pays a fee for a card that provides for a 20% discount on all drugs, the fee would not qualify. In contrast, the cost of a prescribed drug generally will qualify. See Drugs and medicines.

Preventive care screenings

Qualifying expense

Will qualify if the tests are used for medical diagnoses. Examples include hearing, vision, and cholesterol screenings. Also see Body scans and Diagnostic items/services.

Probiotics

Potentially qualifying expense

Won't qualify if used to maintain general health or for other personal reasons. May qualify if used to treat or alleviate a specific medical condition, and if the expense would not have been incurred "but for" the condition. To show that the expense is primarily for medical care, a note from a medical practitioner recommending the item to treat a specific medical condition is normally required.

Propecia

Potentially qualifying expense

Generally won't qualify if purchased for cosmetic purposes (for example, to treat male pattern baldness), even if recommended by a medical practitioner. But the expense may qualify if it is to ameliorate a deformity arising from congenital abnormality, personal injury from accident or trauma, or disfiguring disease. See Cosmetic procedures and Drugs and medicines.

Prosthesis

Qualifying expense

See Artificial limbs and teeth.

Psychiatric care

Qualifying expense

Includes the cost of supporting mentally ill dependent at a special center that provides medical care.

Psychoanalysis

Potentially qualifying expense

Will qualify if provided for medical care, and not just for the general improvement of mental health, relief of stress, or personal enjoyment, nor if the expense stems from training to be a psychoanalyst. To show that the expense is primarily for medical care, a note from a medical practitioner recommending it to treat a specific medical condition is normally required. Also see Psychologist and Therapy.

Psychologist

Potentially qualifying expense

Will qualify if the expense is for medical care, and not just for the general improvement of mental health, relief of stress, or personal enjoyment. To show that the expense is primarily for medical care, a note from a medical practitioner recommending it to treat a specific medical condition is normally required. Also see Therapy.

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Expense
Is expense a qualifying expense?

Learn more—see the Glossary

Comments and special rules

Radial keratotomy

Qualifying expense

Corneal ring segments (removable plastic half-rings that correct vision) would also qualify. See Laser eye surgery and Vision correction procedures.

Reading glasses

Qualifying expense

See Eye examinations, eyeglasses, etc.

Recliner chairs

Not a qualifying expense

Generally won't qualify, unless used exclusively to treat a specific medical condition, as diagnosed and prescribed by a medical practitioner. See Mattresses.

Rehydration solution

(Example: Pedialyte)

Qualifying expense

Retin-A

Potentially qualifying expense

Generally won't qualify if purchased for cosmetic purposes (for example, to reduce wrinkles), even if recommended by a medical practitioner. But may qualify if recommended by a medical practitioner for a specific medical condition (e.g., acne vulgaris) and not for cosmetic purposes. To show that the expense is primarily for medical care, a note from a medical practitioner recommending it to treat a specific medical condition is normally required. See Acne treatment; Cosmetic procedures and Drugs and medicines.

Rogaine

Potentially qualifying expense

Generally won't qualify if purchased for cosmetic purposes. But may qualify if it is recommended by a medical practitioner for a specific medical condition. To show that the expense is primarily for medical care, a note from a medical practitioner recommending it to treat a specific medical condition is normally required. See Propecia and Drugs and medicines.

Rubbing alcohol

Qualifying expense

Will qualify when purchased for first-aid purposes (e.g., when purchased in first-aid quantities in a pharmacy or first-aid section of a retail store).

Rubdowns

Potentially qualifying expense

Generally won't qualify, unless a medical practitioner determines that the procedure is necessary to treat a specific medical condition. To show that the expense is primarily for medical care, a note from a medical practitioner recommending it to treat a specific medical condition is normally required. See Massage therapy.

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Expense
Is expense a qualifying expense?

Learn more—see the Glossary

Comments and special rules

Safety glasses

Not a qualifying expense

Probably won't qualify unless prescribed. See Eye examinations, eyeglasses, etc.

Schools and education, residential

Potentially qualifying expense

Payments made to a residential school or program to treat an individual for behavioral, emotional, or addictive conditions (tuition, meals, and lodging) will qualify if a principal reason for attending the program is to receive medical care. (Ordinary education must be an incidental component.) Whether someone is attending to receive medical care is a question of fact that must be determined for each individual—just because a school or program provides medical care to some individuals does not mean that it provides medical care to all individuals. If a child is at a school because the courses and disciplinary methods have a beneficial effect on the child's attitude, the expenses won't qualify. See Schools and education, special and Prepayments.

Schools and education, special

Potentially qualifying expense

Payments made for a mentally impaired or physically disabled person to attend a special school (tuition, meals, and lodging) will qualify if a principal reason for attending the school is to overcome or alleviate the disability. (Ordinary education must be an incidental component.) This includes teaching Braille to a visually impaired person, teaching lip reading to a hearing-impaired person, and remedial language training to correct a condition caused by a birth defect. If a child is at a school because the courses and disciplinary methods have a beneficial effect on the child's attitude, the expenses won't qualify. Also see Schools and education, residential and Prepayments.

Screening tests

Qualifying expense

Will qualify if the tests are used for medical diagnoses. Examples include hearing, vision, and cholesterol screenings. Also see Body scans and Diagnostic items/services.

Seeing-eye dog

Qualifying expense

See Guide dog.

Shampoos

Not a qualifying expense

Generally won't qualify. See Cosmetics and Toiletries.

Shaving cream or lotion

Not a qualifying expense

See Cosmetics and Toiletries.

Shipping and handling fees

Qualifying expense

Shipping and handling fees incurred to obtain an item that constitutes medical care (e.g., drugs or medicine) are inextricably linked to the cost of the medical care and therefore qualify.

Sinus medications

(Example: Sudafed)

Qualifying expense

See Drugs and medicines and Nasal strips or sprays.

Skin moisturizers

Not a qualifying expense

See Cosmetics and Toiletries.

Sleep-deprivation treatment

Qualifying expense

Probably qualifies if the person is under the care of a medical practitioner.

Smoking-cessation medications

Qualifying expense

Amounts paid for prescribed and OTC drugs used to stop smoking would qualify. See Drugs and medicines and Nicotine gum or patches.

Smoking-cessation programs

Qualifying expense

Amounts paid for a smoking-cessation (stop-smoking) program would qualify. Also see Smoking-cessation medications.

Soaps

Not a qualifying expense

Generally won't qualify. See Cosmetics and Toiletries.

Special foods (such as foods needed for a gluten-free or salt-free diet)

Potentially qualifying expense

Will qualify if prescribed by a medical practitioner to treat a specific illness or ailment and if the foods do not substitute for normal nutritional requirements. But the amount that may qualify is limited to the amount by which the cost of the special food exceeds the cost of commonly available versions of the same product. To show that the expense is primarily for medical care, a note from a medical practitioner recommending it to treat a specific medical condition is normally required. See Drugs and medicines and Vitamins.

Speech therapy

Qualifying expense

Spermicidal foam

Qualifying expense

See Contraceptives.

Sperm, storage fees

Potentially qualifying expense

Fees for temporary storage might qualify, but only to the extent necessary for immediate conception. Storage fees for undefined future conception probably aren't considered to be for medical care. "Temporary" is not defined; however, one consideration might be whether it is stored and used within the same year. Also see Fertility treatments; Eggs and embryos, storage fees; Surrogate expenses; and Prepayments.

St. John's Wort

Potentially qualifying expense

Will qualify if used primarily for medical care (for example, to treat a diagnosed medical condition such as depression); won't qualify if used to maintain general health. To show that the expense is primarily for medical care, a note from a medical practitioner recommending the item to treat a specific medical condition is normally required.

Stem cell, harvesting and/or storage of

Potentially qualifying expense

Might qualify if there is a specific and imminent medical condition that the stem cells are intended to treat. For example, the cost of harvesting and storing stem cells because a newborn has a birth defect and the stem cells would be needed in the near future might be allowable. But collection and storage indefinitely, just in case an item might be needed, is not medical care. See DNA collection and storage; Prepayments and Umbilical cord, freezing and storing of.

Sterilization procedures

Qualifying expense

Sterilization means the cost of a legally performed operation to make a person unable to have children. Also see Vasectomy.

Stop-smoking program

Qualifying expense

See Smoking-cessation programs.

Student health fee

Potentially qualifying expense

A fee that is simply the cost of belonging to the program won't qualify. Expenses for specific medical services might qualify.

Sunglasses

Potentially qualifying expense

Prescription sunglasses would qualify. Allowable amounts include the expenses of eye examinations and eyeglasses and lenses needed for medical reasons. It is unclear whether non-prescription sunglasses or clip-on sunglasses recommended by a physician to alleviate an eye condition would qualify.

Sunburn creams and ointments

(Example: Solarcaine)

Qualifying expense

Will qualify if used to treat a sunburn (and not as regular skin moisturizers). See Drugs and medicines and Sunscreen.

Sunscreen

Potentially qualifying expense

Won't qualify if to maintain general health or for other personal reasons (e.g., as a toiletry or a cosmetic). May qualify if used to treat or alleviate a specific medical condition, and if the expense would not have been incurred "but for" the condition. A personal history of skin cancer might qualify, but family history or other genetic propensity would not be sufficiently imminent for the expense to qualify as medical care. To show that the expense is primarily for medical care, a note from a medical practitioner recommending the item to treat a specific medical condition is normally required.

Supplies to treat medical condition

Qualifying expense

Will qualify if the medical supply is used to diagnose or treat a specific medical condition and isn't a personal comfort item. Also see Bandages and Crutches.

Support braces

Qualifying expense

Will qualify if used for injured or weakened body parts.

Surgery

Qualifying expense

Generally will qualify. See Operations.

Surrogate or gestational carrier expenses

Not a qualifying expense

Such expenses generally won't qualify, even if they are for medical care of the surrogate/gestational carrier or her unborn child. The procedure must be performed upon you, your spouse, or your dependent in order to be medical care. Also see Fertility treatments; Egg donor fees; Eggs and embryos, storage fees; Legal fees in connection with fertility treatments; and Sperm, storage fees.

Swimming lessons

Potentially qualifying expense

Such expenses generally won't qualify, but there are some exceptions. See Dancing lessons.

Swimming pool maintenance

Potentially qualifying expense

Such expenses generally won't qualify if the swimming pool is used for recreation. However, if the swimming pool is used primarily for medical care by someone who has been diagnosed with a medical condition and a medical practitioner has substantiated that the pool is part of the medical treatment, then the cost of maintaining the pool might qualify. Also see Capital expenses.

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Expense
Is expense a qualifying expense?

Learn more—see the Glossary

Comments and special rules

Tanning salons and equipment

Not a qualifying expense

See Cosmetic procedures. In rare cases, they might qualify if recommended for a specific medical condition (such as a skin disorder), so long as there is no personal element or use of the equipment by other family members.

Taxes on medical services and products

Qualifying expense

Such expenses generally will qualify to the extent that the tax is imposed on qualified medical care services/items. This includes local, sales, service, and other taxes.

Teeth whitening

Not a qualifying expense

Won't qualify if tooth discoloration is simply the result of aging and the whitening is done for cosmetic purposes. But if tooth discoloration (rising to the level of a deformity) was caused by disease, birth defect, or injury, expenses for teeth whitening might qualify. See Cosmetic procedures.

Telephone for hearing-impaired persons

Qualifying expense

The expenses of buying and repairing special telephone equipment for a hearing-impaired person will qualify. This includes teletypewriter (TTY) and telecommunications device for the deaf (TDD) equipment. See Capital expenses.

Television for hearing-impaired persons

Qualifying expense

Equipment that displays the audio part of television programs as subtitles for hearing-impaired persons will qualify. But the amount that qualifies is limited to the excess of the cost over the cost of the regular item. For example, the cost of a specially equipped television qualifies only to the extent that it exceeds the cost of a regular model. See Capital expenses.

Therapy

Qualifying expense

Will qualify if provided for medical care (and not just for the general improvement of mental health, relief of stress, or personal enjoyment). Also see Psychoanalysis; Psychologist; and Schools and education, residential/special.

Thermometers

Qualifying expense

Will qualify if for medical uses. See Supplies to treat medical condition.

Throat lozenges

(Examples: Cepacol, Chloraseptic)

Qualifying expense

Also see Cough suppressants.

Toiletries

Not a qualifying expense

A toiletry is an article or preparation that is used in the process of dressing and grooming oneself. Examples include toothpaste, shaving cream or lotion, and cologne. Also see Cosmetics.

Toothache and teething pain relievers

(Example: Orajel)

Qualifying expense

Toothbrushes

Not a qualifying expense

Won't qualify even if a dentist recommends special ones (such as electric or battery-powered ones) to treat a medical condition like gingivitis. Toothbrushes are items that are used primarily to maintain general health—a person would still use one even without the medical condition. Thus, they are not primarily for medical care. See Toiletries and Cosmetics.

Toothpaste

Not a qualifying expense

Won't qualify even if a dentist recommends a special one to treat a medical condition like gingivitis. Toothpaste is an item that is primarily used to maintain general health—a person would still use it even without the medical condition. Thus, it is not primarily for medical care. But topical creams or other drugs (e.g., fluoride treatment) used to treat a dental condition would qualify, so long as they are primarily for medical care. See Cosmetics; Drugs and medicines; and Toiletries.

Transplants

Qualifying expense

Includes surgical, hospital, and laboratory services, and transportation expenses for organ donors.

Transportation costs of disabled individual commuting to and from work

Not a qualifying expense

A disabled individual's commuting costs to and from work are personal expenses and not expenses for medical care. However, the costs incurred for transportation to and from work may be medical expenses if the employment itself is explicitly prescribed as therapy to treat a medical condition.

Transportation to and from a medical conference

Potentially qualifying expense

See Medical conference admission, transportation, meals, etc.

Transportation expenses for person to receive medical care

Qualifying expense

Will qualify if the expenses are primarily for and essential to medical care. Includes car expenses; bus, taxi, train, plane, and ferry fares; and ambulance services. Instead of actual car expenses, a standard mileage rate (24 cents per mile for 2009; 19 cents per mile for Jan.–June 2008; 27 cents per mile for July–Dec. 2008) for use of a car to obtain medical care is allowed. Parking fees and tolls can also qualify.

Transportation of someone other than the person receiving medical care

Potentially qualifying expense

Will qualify in some cases. Transportation expenses of the following persons will qualify: (1) a parent who must go with a child who needs medical care; (2) a nurse or other person who gives injections, medications, or other treatment required by a patient who is traveling to get medical care and is unable to travel alone; and (3) an individual who travels to visit a mentally ill dependent, if such visits are recommended as part of treatment. See Transportation expenses for person to receive medical care and Lodging not at a hospital or similar institution.

Treadmill

Potentially qualifying expense

See Exercise equipment and Capital expenses.

Tuition for special-needs program

Potentially qualifying expense

Will qualify if the primary purpose is for medical care. Includes reading program for dyslexia. See Learning disability, instructional fees; Schools and education, residential/special and Prepayments.

Tuition evidencing separate breakdown for medical expenses

Qualifying expense

Will qualify to the extent that charges for medical expenses are separately broken down in a bill for tuition for a college or private school and are for specific qualified medical services/items that have been incurred/obtained (and are not premiums for medical care generally). See Student health fee and Insurance premiums.

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Expense
Is expense a qualifying expense?

Learn more—see the Glossary

Comments and special rules

Ultrasound, prenatal

Potentially qualifying expense

Will qualify if used as a diagnostic tool to determine fetal health and development. Won't qualify if for other purposes (e.g., to obtain prenatal snapshots).

Umbilical cord, freezing and storing of

Potentially qualifying expense

Might qualify if there is a specific medical condition that the umbilical cord is intended to treat. Collection and storage indefinitely, just in case it is needed, is not medical care. "Temporary" is not defined—one consideration might be whether it is stored and used within the same year. The cost of storing cord blood where a newborn has a birth defect and where the cord blood would be needed in the near future might qualify. See Prepayments.

Usual and customary charges, excess

Qualifying expense

Medical expenses in excess of an insurance plan's usual, customary, and reasonable charges qualify if the underlying expense is for medical care.

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Expense
Is expense a qualifying expense?

Learn more—see the Glossary

Comments and special rules

Vaccines

Qualifying expense

See Immunizations.

Varicose veins, treatment of

Potentially qualifying expense

Such expenses generally won't qualify if the procedure merely improves appearance and doesn't meaningfully promote the proper function of the body or prevent or treat illness or disease. May qualify if the procedure promotes the proper function of the body or prevents or treats an illness or disease. To show that the expense is primarily for medical care, a note from a medical practitioner recommending it to treat a specific medical condition is normally required. See Cosmetic procedures.

Vasectomy

Qualifying expense

See Sterilization procedures.

Vasectomy reversal

Qualifying expense

Veneers

Not a qualifying expense

Such expenses generally won't qualify, as veneers are used primarily for cosmetic purposes. See Cosmetic procedures and Teeth whitening.

Veterinary fees

Potentially qualifying expense

Will qualify if the veterinary fees are incurred for the care of a guide dog or other animal used by a disabled person. Otherwise, no.

Viagra

Qualifying expense

Will qualify if prescribed by a physician to treat a medical condition.

Vision correction procedures

Qualifying expense

Medical procedures that correct vision, including laser procedures such as Lasik and radial keratotomy, qualify. Also see Laser eye surgery and Radial keratotomy.

Vision discount programs

Not a qualifying expense

Such expenses generally won't qualify. See Insurance premiums. But will qualify to the extent that an expense is for actual medical treatment (such as an eye exam).

Vitamins

Potentially qualifying expense

Won't qualify if used to maintain general health (e.g., one-a-day vitamins). But under narrow circumstances, vitamins might qualify if recommended by a medical practitioner for a specific medical condition (for example, a prescribed dosage of Vitamin B-12 daily to treat a specific vitamin deficiency). To show that the expense is primarily for medical care, a note from a medical practitioner recommending the item to treat a specific medical condition is normally required. See Prenatal vitamins; Dietary supplements; and Special foods.

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Expense
Is expense a qualifying expense?

Learn more—see the Glossary

Comments and special rules

Walkers

Qualifying expense

Will qualify if used to relieve sickness or disability.

Wart remover treatments

(Example: Compound W)

Qualifying expense

Although not addressed in IRS guidance, we believe such products are for the treatment of a disease and thus would qualify as medical care. See Drugs and medicines.

Weight-loss programs and/or drugs prescribed to induce weight loss

Potentially qualifying expense

Will qualify if the weight-loss program is recommended by a physician to treat a specific medical condition (such as obesity, heart disease, or diabetes) and is not simply to improve general health. However, the costs of food associated with a weight-loss program (such as special pre-packaged meals) would not qualify, since it just meets normal nutritional needs. To show that the expense is primarily for medical care, a note from a medical practitioner recommending it to treat a specific medical condition is normally required. See Exercise programs; Health club fees; Prepayments; and Special Foods.

Wheelchair

Qualifying expense

If used to relieve sickness or disability, amounts you pay for a wheelchair or autoette and the upkeep costs will qualify. Wheelchair cushions will also qualify as a necessary accessory to the wheelchair.

Wigs

Potentially qualifying expense

Might qualify if the wig is prescribed by a physician for the mental health of a patient who has lost all of his or her hair from disease or treatment (e.g., chemotherapy or radiation).

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Expense
Is expense a qualifying expense?

Learn more—see the Glossary

Comments and special rules

X-ray fees

Qualifying expense

Will qualify if the X-rays are performed for medical reasons.

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Expense
Is expense a qualifying expense?

Learn more—see the Glossary

Comments and special rules

Yeast infection medications

(Example: Monistat)

Qualifying expense

YMCA day camp

Not a qualifying expense

Such expenses generally won't qualify. However, if a camp is a special program that is therapeutic and treats a specific disability, then the expense might qualify. To the extent attributable to a qualifying individual under a dependent care assistance program (DCAP), such expenses might be reimbursable under a DCAP if applicable rules are met (but the same expenses may not be reimbursed under a health FSA, HRA, or HSA and a DCAP—there is no "double-dipping" allowed).

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Glossary

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Term
Definition

Qualifying Expense

These are services/items that are generally known to be incurred/obtained primarily for medical care; in other words, they are services/items that practically no one would incur or obtain unless they had a medical condition that prompted the expenditure. These "primarily medical" services/items are the types of expenses that normally qualify for reimbursement under a health FSA or HRA or for a tax-free distribution from an HSA if other health FSA, HRA, or HSA requirements are met. We identify these primarily medical services/items with a green icon to show that they are normally given the "green light"; they normally qualify.

Potentially qualifying expense

These are services/items that are generally known to be used for both a medical purpose and a personal, cosmetic, or general health purpose. These dual-purpose services/items qualify for reimbursement under a health FSA or HRA or a tax-free distribution from an HSA only if there is appropriate proof that the service/item was incurred/obtained primarily for medical care; in most cases, participants are required to show that the service/item is recommended by a medical practitioner to treat a specific medical condition. We identify dual purpose expenses with a yellow caution icon, showing that one must proceed with caution in determining whether the service/item qualifies.

Not a qualifying expense

These are services/items in one of the following two categories:
• Services/items that are generally known to be incurred/obtained primarily for personal, cosmetic, or general health purposes and not primarily for medical care. These "primarily personal" services/items almost never qualify for reimbursement from a health FSA or HRA or for a tax-free distribution from an HSA. Services/items in this category theoretically could qualify in the extremely rare case where an individual can overcome a strong presumption of nonqualification and prove that, based on all the facts and circumstances and taking into account the prevailing IRS guidance, the service/item was incurred/obtained primarily to treat an existing medical condition diagnosed by a medical practitioner.
• Services/items for which reimbursement is not allowed under statutory or regulatory provisions, even if they might seem to be for medical care, (for example, insurance premiums cannot be reimbursed by a health FSA). In this Table, we identify services/items in these two categories with a red X, showing that the services/items normally do not qualify.

OTC

Item is generally available for retail purchase over the counter (i.e., without a prescription). Depending on the nature of the OTC item, it might be a qualifying expense, a potentially qualifying expense, or not a qualifying expense. See the OTC entries throughout this table.

Health FSA

A health flexible spending arrangement (health FSA) is an employer-sponsored plan under which participants may obtain reimbursement for medical expenses that are not reimbursed through insurance or any other arrangement. Health FSAs are typically funded with employee pre-tax salary reductions and/or employer flex credits. For more information about Health FSAs, see IRS Publication 969 ("Health Savings Accounts and Other Tax-Favored Health Plans").

HRA

A health reimbursement arrangement (HRA) is an employer-funded arrangement under which participants can be reimbursed for certain medical expenses up to a specified maximum amount per year.For more information about HRAs, see IRS Publication 969 ("Health Savings Accounts and Other Tax-Favored Health Plans").

HSA

A health savings account (HSA) is an account established by an eligible individual covered by a high-deductible health plan that meets the requirements of Internal Revenue Code § 223 and enables the account-holder to pay for qualified medical expenses on a tax-favored basis. For more information about HSAs, see IRS Publication 969 ("Health Savings Accounts and Other Tax-Favored Health Plans").