Eligible/Ineligible Health Care Expenses

The following is a partial list of expenses that may be reimbursed under your Health Care Flexible Spending Account. Please note that this is not meant to be an all inclusive list, and if there are expenses not specifically listed the University reserves the right to amend the list. However, It is important to note that under the university’s plan, you cannot receive reimbursement for oral contraceptives, contraceptive devices or contraceptive implants, except when specifically requested by a physician based on medical necessity and for purposes other than contraception. Additionally, we will only reimburse for those oral and injectable fertility drugs and other fertility related treatment that would be covered under a University health plan. If you have questions about eligible expenses please contact the Human Resource Department.

Medical Expenses (Not covered by medical insurance)*

  • Cosmetic surgery (only if required to treat an illness, injury, or disfiguring disease)
  • Expenses for eligible medical services or supplies not covered by medical insurance plan
  • Experimental surgery (only if it is a legal operation)
  • Hospital private room charges
  • Laboratory fees
  • Medical charges over the usual and customary limits
  • Medical deductibles, co-payments and coinsurance
  • Prescription drugs (exclusions include oral contraceptives, devices, and prescriptions purchased outside of the U.S.)
  • Vaccinations and immunizations
    *Weight management and exercise programs as long as prescribed by physician for a medical condition (contact Meritain for prior approval)
  • Well-baby care not covered by a medical insurance plan
  • X-ray fees

Dental Expenses (Not covered by dental insurance)

  • Artificial teeth
  • Cosmetic surgery (only if required to treat an illness, injury, or disfiguring disease)
  • Orthodontia expenses not covered by a dental insurance plan
  • Routine examinations not covered by a dental insurance plan

Vision Care (Not covered by vision insurance)

  • Contact lenses
  • Contact lens solutions and cleaners
  • Eye examinations
  • Frames
  • Lenses
  • Laser eye surgery
  • Optometrist charges
  • Prescription eyeglasses

Hearing Care *

  • Ear examinations
  • Hearing aids
  • Special telephone for the hearing impaired

Other Miscellaneous Eligible Expenses (Not covered by insurance)

  • Alcoholism or drug dependency payments to treatment centers
  • Analysis fees (for psychotherapy by a licensed practitioner)
  • Chiropractic charges (within the scope of license)
  • Guide dog
  • Halfway house fees (care for helping an individual adjust from life in a mental hospital to community living)
  • Up to $50 per day for lodging while away from home for medical treatment or for the relief of specific health conditions
  • Physician-directed weight loss & smoking cessation programs
  • Sales tax related to eligible expenses (includes over-the-counter expenses)
  • Syringes, needles, and injections
  • Therapy (speech, physical, or occupational)
  • Thermometers

*Limited Purpose FSA accounts associated with the Anthem HSA plan are not eligible to receive reimbursment for these medical expenses.

Ineligible Health Care Expenses

Starting January 1st 2018, IRS guidelines as outlined in Pub 502 (https://www.irs.gov/pub/irs-pdf/p502.pdf) will be used to dictate what is a qualified medical or dental expense for flex reimbursement, except for abortion services, which will be excluded.

The following is a partial list of medically related expenses, which do not qualify for reimbursement through the Health Care Flexible Spending Account

  • Abortion
  • Any expenses incurred in connection with an illegal operation or treatment
  • Automobile insurance premiums, including the segment of premiums providing medical coverage for persons injured by accident in an employee’s car
  • Bottled water
  • Cosmetic surgery (whether surgical or dental, unless required to treat an illness, injury, or disfiguring disease)
  • Cosmetics, toiletries, toothpaste, etc.
  • Costs for sending a problem child to a special school for benefits the child may receive from the course of study and disciplinary methods
  • Custodial care in an institution
  • Electrolysis (hair removal)
  • Funeral and burial expenses
  • Hair transplant or hair replacement topical solutions (such as Rogaine)
  • Health care aids that can be purchased without a prescription such as toothbrushes
  • Health club dues, YWCA and YMCA dues, steam bath, etc.
  • Household and domestic help (even if recommended by a qualified physician due to an employee’s or dependent’s inability to perform physical housework)
  • Infertility treatment
  • Maternity clothes, diaper services, etc.
  • Meals and lodging over $50 per day while away from home for medical treatment or for the relief of specific health conditions
  • Membership fees or costs associated with weight-loss or smoking cessation programs for general health and well-being purposes
  • Non-prescription vitamins (and vitamin supplements) taken for general health purposes
  • Over-the-counter (OTC) drugs without a prescription (includes allergy and sinus, cough, cold, flu and pain relief medicines)
  • Premiums paid for life insurance policies providing repayment for loss of earnings or for accidental loss of life, limb, sight, or for other specific health issues
  • Premiums paid for other medical plans (whether they are paid on before-tax or after-tax basis)
  • Salary expense of licensed practical nurse (LPN) incurred in connection with the care of a normal and healthy newborn (even if required due to the death of the mother in childbirth)
  • Finance charges or interest paid
  • Social activities, such as dance lessons or classes (even if recommended by a qualified physician for general health improvement)
  • Therapy not for medical treatment
  • Transportation expenses to and from work, even though a physical condition may require special means of transportation related to a particular disease or physical defect
  • Uniforms
  • Vacation time taken to travel for general health purposes, a change in environment, improvement of morale, etc., or taken to relieve physical or mental discomfort

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