P.O. Box 70168 Springfield, OR 97475
Examples of Eligible and Ineligible Expenses
The following expenses are commonly requested for reimbursement from Flexible Spending Accounts (FSAs). This list is not comprehensive and is subject to change. In order for any expense to be eligible under your FSA, supporting documentation from your healthcare provider is required. Documentation must include:
• the date the service was incurred (not necessarily equal to the date of payment),
• a brief description of the service or product, and
• the name of the provider or place of purchase.
All expenses must be incurred for medical care, and not cosmetic or general health purposes. To be considered an eligible expense, any items listed as "Potentially eligible" will require a Letter of Medical Necessity or prescription from your healthcare provider. The letter or prescription must include the item prescribed, condition being treated, and duration of treatment. For your convenience,form is available at ManleyPlan.com under Forms.
Please note: Healthcare reform places restrictions on over-the-counter (OTC) medicines. Effective January 1, 2011, most OTC medicines and drugs (excluding insulin) will require a Letter of Medical Necessity or prescription from your healthcare provider. Please note this ruling does not affect all OTC items, only those considered medicines or biologicals. Expense Type Eligibility Comments and Special Rules (if applicable) AA meetings/
Transportation expenses associated with outpatient care or attending meetings of
Alcoholism
an AA group qualify. Expenses for inpatient treatment (including meals and
treatment
lodging), at a center for alcohol addiction will also qualify.
Acne treatment
Because acne is considered a disease, the cost of acne treatment will generally
qualify, although over-the-counter (OTC) acne medications must be prescribed if incurred after December 31, 2010. 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; Toiletries.
Acupuncture Adaptive
To show that the expense is primarily for medical care, a Letter of Medical
equipment
Necessity is 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.
Adoption, pre-
Medical expenses incurred before an adoption is finalized will qualify, if the child
adoption
qualifies as your tax dependent when the services/items are provided. Adoption
fees and other nonmedical expenses incurred in connection with adoption
expenses
assistance are not eligible under the Healthcare FSA.
The primary purpose must be to treat or alleviate a medical condition and the
conditioners
expense must not have been incurred “but for” the condition. To show that the
and purifiers
expense is primarily for medical care, a Letter of Medical Necessity is 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.
Examples: Alavert, Claritin, Zyrtec. Requires Letter of Medical Necessity or
medicine
prescription from your healthcare provider if incurred after December 31, 2010.
Page 1 of 17
Expenses generally won't qualify if the product would be owned even without
treatment
allergies, such as a pillow or a vacuum cleaner. However, an item necessary to
products;
treat a severe allergy will qualify. The excess cost of a special version of an
household
otherwise personal item (e.g., a vacuum cleaner with a HEPA filter) over the normal cost of the item will qualify if a special version of the item is necessary for
improvements
treatment. To show that the expense is primarily for medical care, a Letter of
allergies Alternative
Drugs and medicines recommended by alternative healers to treat a specific
healers, dietary
medical condition also can qualify as medical care. To show that the expense is
substitutes,
primarily for medical care, a Letter of Medical Necessity is required. Expenses for
and drugs and
food or a substitute for food that the person would normally consume in order to
medicines
meet nutritional requirements are not eligible.
Ambulance Analgesics
Examples: Advil, Aspirin, Motrin, Tylenol. Requires Letter of Medical Necessity or
Prescription from your healthcare provider if incurred after December 31, 2010.
Antacids
Examples: Maalox, Prilosec OTC, Zantac. Requires Letter of Medical Necessity or
Prescription from your health care provider if incurred after December 31, 2010.
Antibiotic
Examples: Bacitracin, Neosporin. Requires Letter of Medical Necessity or
ointments
prescription from your healthcare provider if incurred after December 31, 2010.
Antihistamines
Examples: Benadryl, Claritin. Requires Letter of Medical Necessity or prescription
from your healthcare provider if incurred after December 31, 2010.
Anti-itch
Examples: Benadryl, Cortaid, Ivarest. Requires Letter of Medical Necessity or
prescription from your healthcare provider if incurred after December 31, 2010.
Arthritis gloves Eligible Artificial limbs Artificial teeth
Requires Letter of Medical Necessity or prescription from your healthcare provider
Includes asthma medications and delivery devices (e.g., inhalers and nebulizers).
treatments Automobile
To show that the expense is primarily for medical care, a Letter of Medical
modifications
Necessity is required. Expenses of operating a specially equipped car do not qualify.
Babysitting and Ineligible
Babysitting, child care, and nursing services for a normal, healthy baby do not
child care
Requires Letter of Medical Necessity or prescription from your healthcare provider
Bandages, Bandages, for torn or injured skin Birth-control
Prescription birth-control pills are eligible. See also Contraceptives. Birthing
Expenses for instruction that relates to birth, and not child rearing/care, are eligible
for reimbursement. The fee may need to be apportioned to exclude instruction in these topics. Expenses for the coach or significant other do not qualify.
Page 2 of 17 Blood storage
Fees for temporary storage (12 month max) for use during a scheduled surgery are
eligible. Fees for indefinite storage, just in case the blood might be needed, would not be eligible.
Blood-pressure monitors Blood-sugar test kits and test strips Body scans Books, health-
Will qualify if recommended to treat an illness (such as asthma or diabetes)
diagnosed by a physician. The purpose of the expense must be to treat the disease, not to promote general health. To show that the expense is primarily for medical care, a Letter of Medical Necessity is required.
Braille books
Only amounts above the cost of regular printed material will qualify.
and magazines Breast pumps
Will qualify to the extent that surgery was done following a mastectomy for cancer.
reconstruction
This is an exception to the rules regarding cosmetic procedures.
following mastectomy Calamine lotion Potentially
Requires Letter of Medical Necessity or prescription from your healthcare provider
Improvements or special equipment added to a home or other capital expenditures
expenses
may qualify if the primary purpose of the expenditure is medical care and the expense would not be incurred “but for” this purpose. To show that the expense is primarily for medical care, a Letter of Medical Necessity is required. The amount of the expense that would qualify depends on the extent to which the expense permanently improves the property.
Carpal tunnel wrist supports
May qualify if used primarily to treat a specific medical condition. To show that the
expense is primarily for medical care, a Letter of Medical Necessity is required.
Chelation
Will qualify if used to treat a medical condition such as lead poisoning.
Chiropractors Chondroitin
Will qualify if used for arthritis treatment, not simply prevention.
Christian practitioners Circumcision Classes, health-
Will qualify only if recommended to treat an illness diagnosed by a physician. The
purpose of the expense must be to treat the disease rather than to promote general health. To show that the expense is primarily for medical care, a Letter of Medical Necessity is required.
Page 3 of 17
COBRA premiums are not qualifying expenses for the Healthcare FSA
premiums Coinsurance
Will qualify unless reimbursed by another source, such as secondary insurance.
Cold medicine
Requires Letter of Medical Necessity or prescription from your healthcare provider
Cold/hot packs Eligible
Only cold/hot packs sold as medical supplies will qualify; those sold for other purposes won't qualify.
Compression
Qualifies when used to treat circulatory conditions. Won't qualify if used for
Contact lenses,
Materials and equipment needed for using lenses (saline solution and enzyme
materials, and
cleaner) qualify if the lenses are needed for medical purposes. Contact lenses for
equipment
cosmetic purposes (for example, to change one's eye color) do not qualify. Contact lens insurance would not qualify.
Contraceptives
Examples: Spermicidal foam, Morning-after pill. Requires Letter of Medical
Necessity or prescription from your healthcare provider if incurred after December 31, 2010.
Controlled
Any substance that violates federal law (e.g., the Controlled Substances Act) would
substances in
not qualify even if a state law allows its use with a physician's prescription (for
violation of
example, marijuana prescribed to treat a specific medical condition).
federal law Copayments
Will qualify unless reimbursed by another source, such as secondary insurance.
Cosmetic
Most cosmetic procedures do not qualify as they are directed at improving the
procedures
patient's appearance. Examples include face lifts, hair transplants, hair removal, 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.
Cosmetics
Cosmetics are used primarily for personal purposes, and are intended for cleansing, beautifying, promoting attractiveness, or altering the appearance. These types of expenses are not eligible for reimbursement. Examples include skin moisturizers, perfumes, lipsticks, fingernail polish, eye and facial makeup, shampoos, permanent waves, hair colors, toothpastes, and deodorants.
Requires Letter of Medical Necessity or prescription from your healthcare provider
suppressants Counseling
Will qualify if for a medical reason. Couples, marriage, or family counseling does not qualify.
Crowns, dental
Will not qualify if they are obtained for a cosmetic reason. See Cosmetic
Crutches
Will qualify whether purchased or rented.
Generally the cost of dancing lessons does not qualify, even if recommended by a
medical practitioner, if the lessons are to improve general health. But the expense might qualify if recommended by a medical professional to treat a specific medical condition (such as part of a rehabilitation program after surgery). To show that the expense is primarily for medical care, a Letter of Medical Necessity is required.
Page 4 of 17 Decongestants
Requires Letter of Medical Necessity or prescription from your healthcare provider
Deductibles
Will qualify unless reimbursed by another source, such as secondary insurance.
Dental floss Dental sealants
Includes services for such procedures as teeth cleaning, application of sealants,
treatment
and fluoride treatments to prevent tooth decay, X-rays, fillings, braces, extractions, dentures, and treatment of other dental ailments. Reimbursements for orthodontia will require an ortho contract. Teeth whitening/bleaching, veneers, and other cosmetic dental treatments are not eligible. Dentures and denture adhesives Deodorant Dependent care Ineligible
Such expenses won't qualify, even if they are incurred so that you can receive
expenses Diabetic socks
Qualifies when used to treat diabetic conditions. Won’t qualify if used for personal
Diabetic supplies Diagnostic
Includes a wide variety of procedures to determine the presence of a disease or
items/services
dysfunction of the body, such as tests to detect stroke, diabetes, osteoporosis, thyroid conditions, and cancer.
Diaper rash
Requires Letter of Medical Necessity or prescription from your healthcare provider
ointments Diapers or
Regular diapers or diaper services for newborns do not qualify. Diapers or diaper
diaper service
services used to alleviate a diagnosed medical condition may qualify. To show that the expense is primarily for medical care, a Letter of Medical Necessity is required.
Diarrhea
Requires Letter of Medical Necessity or prescription from your healthcare provider
medicine Diet foods
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, do not qualify.
The cost of dietary, nutritional, or herbal supplements, as well as vitamins and
supplements
natural medicines do not qualify if they are merely beneficial for general health. To show that the expense is primarily for medical care, a Letter of Medical Necessity is required.
Disabled
Such expenses will qualify if the expenses are for medical care of the disabled
dependent care
dependent. Note that some disabled dependent care expenses that qualify as
expenses
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 Code §129. You must not use the same expenses for more than one purpose. To show that the expense is primarily for medical care, a Letter of Medical Necessity is required.
Page 5 of 17 DNA collection
Generally will not qualify. Temporary storage may qualify under some
and storage
circumstances, such as where the DNA is collected as part of the diagnosis, treatment, or prevention of an existing or imminent medical condition.
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.
Drug addiction
Amounts paid for both inpatient and outpatient treatment at a center for drug
treatment Drug overdose, treatment of Drug testing
Kits that test for the presence of controlled substances won't qualify, as they do not
kits for home
treat a medical condition. However, if the drug testing kit is used in the course of
treating a medical condition or addiction, it may qualify. To show that the expense is primarily for medical care, a Letter of Medical Necessity is required.
Drugs and
Must be primarily for medical care, legally procured, and generally accepted as
medicines
medicines and drugs. In addition, expenses incurred after December 31, 2010 will qualify only if the medicine or drug is prescribed or is Insulin. For OTC medicines to be allowed, a prescription from your healthcare provider or letter of medical necessity is required.
Dyslexia
To show that the expense is primarily for medical care, a Letter of Medical
Ear piercing Ear plugs
Will qualify if recommended by a medical practitioner for a specific medical
condition. To show that the expense is primarily for medical care, a Letter of Medical Necessity is required.
Requires Letter of Medical Necessity or prescription from your healthcare provider
products Eczema
Requires Letter of Medical Necessity or prescription from your healthcare provider
treatment Egg donor fees
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.
Fees for temporary storage qualify, but only to the extent necessary for immediate
embryo storage eligible
conception. To show that the expense is primarily for medical care, a Letter of
Electrolysis Elevator
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 Letter of Medical Necessity is required.
Exercise
Qualifies only if required to treat an illness (such as obesity) diagnosed by a
equipment or
physician. The purpose of the expense must be to treat a disease (not to promote
programs
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 Letter of Medical Necessity is required.
Expectorants
Requires Letter of Medical Necessity or prescription from your healthcare provider
Page 6 of 17 Eye drops
Requires Letter of Medical Necessity or prescription from your healthcare provider
Eye exams,
Materials and equipment needed for using and cleaning the eyeglasses, and
eyeglasses,
reading glasses purchased over-the-counter are also eligible.
and equipment Face creams Face lifts Feminine
Such expenses generally won't qualify, as they are ordinarily considered as being
products Fertility
Will qualify to the extent that procedures are intended to overcome an inability to
treatments
have children and are performed on you, your spouse, or your dependent. 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.
Fever-reducing
Requires Letter of Medical Necessity or prescription from your healthcare provider
medications
Requires Letter of Medical Necessity or prescription from your healthcare provider
supplements First aid cream
Requires Letter of Medical Necessity or prescription from your healthcare provider
First aid kits
Qualifies only if required to treat an illness (such as obesity) diagnosed by a
programs
physician. The purpose of the expense must be to treat a disease (not to promote general health), and the expense must not have been incurred “but for” this purpose. Health clubs memberships effective prior to being diagnosed with a qualifying medical condition will not qualify. To show that the expense is primarily for medical care, a Letter of Medical Necessity is required. Dates of visits to the health club will need to be obtained from a health club employee.
Flu shots Fluoridation services Fluoride rinses
Requires Letter of Medical Necessity or prescription from your healthcare provider
To show that the expense is primarily for medical care, a Letter of Medical
thickeners
Special foods to treat a specific disease, such as obesity, will not qualify if they are
used as a substitute for regular nutritional requirements. Food prescribed by a medical practitioner to treat a specific disease that does not substitute for normal nutritional requirements may be eligible for reimbursement of the amount in which the food exceeds the cost of regular versions of the item. To show that the expense is primarily for medical care, a Letter of Medical Necessity is required.
Founder's fee
Founder's fees paid under an agreement with a retirement home do not qualify for reimbursement.
expenses
Page 7 of 17 Gambling
To show that the expense is primarily for medical care, a Letter of Medical
problem, treatment for Gauze pads Genetic testing
To the extent that testing is done to diagnose a medical condition or to determine
possible defects this will qualify. However, testing done to determine the sex of a fetus would not qualify. To show that the expense is primarily for medical care, a Letter of Medical Necessity is required.
Glucosamine
Will qualify if used for arthritis treatment, not simply prevention.
Glucose-
Blood-glucose meters and glucose test strips are diagnostic items and are
monitoring equipment Hair colorants Hair removal Hand lotion Hand sanitizer
Won’t qualify if used for general health purposes or other personal reasons (e.g.,
as a toiletry). Requires Letter of Medical Necessity or prescription from your healthcare provider if incurred after December 31, 2010.
Headache
Examples: Advil, Aspirin, Tylenol. Requires Letter of Medical Necessity or
medications
prescription from your healthcare provider if incurred after December 31, 2010.
Health club
Fees incurred upon the advice of a medical practitioner to treat a specific medical
condition (e.g., rehabilitation after back surgery or treatment for obesity) may qualify. 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 Letter of Medical Necessity is required.
Health institute
Qualifies only if the treatment at the health institute is prescribed by a physician. To
show that the expense is primarily for medical care, a Letter of Medical Necessity is required.
Hearing aids Hemorrhoid
Example: Preparation H. Requires Letter of Medical Necessity or prescription from
treatments
your healthcare provider if incurred after December 31, 2010.
To show that the expense is primarily for medical care, a Letter of Medical
Improvements or special equipment added to a home (for example, an Elevator or
improvements
Inclinator) or other capital expenditures may qualify if the primary purpose of the
(such as exit
expenditure is medical care for you (or your dependent) and the expense would not
be incurred “but for” this purpose. To show that the expense is primarily for medical
widening
care, a Letter of Medical Necessity is required. The amount of the expense that would qualify depends on the extent to which the expense permanently improves
doorways, etc.)
Will qualify if used primarily for medical care (for example, to treat menopausal
replacement
symptoms such as hot flashes, night sweats, etc.). Won't qualify if primarily for
therapy (HRT)
maintaining general health. To show that the expense is primarily for medical care, a Letter of Medical Necessity is required.
Hospital
Expenses of inpatient care (plus meals and lodging) at a hospital or similar
services
institution qualify if a principal reason for being there is to get medical care.
Household help Ineligible
Page 8 of 17 Humidifier
To show that the expense is primarily for medical care, a Letter of Medical
Hypnosis
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, enjoyment, or other personal purposes. To show that the expense is primarily for medical care, a Letter of Medical Necessity is required.
Won't qualify, even if they are rendered or prescribed by licensed medical
operations and treatments Immunizations Inclinator
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 Letter of Medical Necessity is required.
Incontinence
Items used to relieve adult incontinence will qualify.
supplies Insect-bite
Examples: Benadryl, Cortaid. Requires Letter of Medical Necessity or prescription
creams and
from your healthcare provider if incurred after December 31, 2010.
ointments
Equipment needed to inject the insulin, such as syringes or insulin pumps, also qualify.
Insurance premiums IVF (in vitro
Will qualify to the extent that procedures are intended to overcome an inability to
fertilization)
have children and are performed on you, your spouse, or your dependent. 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.
Laboratory fees Eligible Lactation
To show that the expense is primarily for medical care, a Letter of Medical
consultant
Example: Lactaid. Requires Letter of Medical Necessity or prescription from your
intolerance
healthcare provider if incurred after December 31, 2010.
Lamaze classes Eligible Language
Such expenses will qualify for a child with dyslexia or an otherwise disabled child.
training
But amounts paid for regular schooling normally don't qualify. To show that the expense is primarily for medical care, a Letter of Medical Necessity is required.
Laser eye surgery; Lasik Late fees
Fees or finance charges for late payment of a medical bill are not eligible for reimbursement.
Laxatives
Example: Ex-Lax. Requires Letter of Medical Necessity or prescription from your
healthcare provider if incurred after December 31, 2010.
Page 9 of 17 Lead-based
The expense of removing lead-based paints from surfaces in the participant's
paint removal
home to prevent a child who has (or has had) lead poisoning from eating the paint would qualify. 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, these items will be treated as capital expenses. To show that the expense is primarily for medical care, a Letter of Medical Necessity is required.
Learning
If prescribed by a physician, tuition fees paid to a special school and tutoring fees
disability,
paid to a specially trained teacher for a child who has learning disabilities caused
instructional
by mental or physical impairments will qualify. To show that the expense is
primarily for medical care, a Letter of Medical Necessity is required.
Legal fees in
May qualify if the legal fees are in connection with a medical procedure performed
connection with eligible fertility treatments Legal fees,
May qualify if the legal fees are in connection with a medical procedure performed
upon you (or your spouse or dependent), or to authorize treatment of a mental illness. 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. To show that the expense is primarily for medical care, a Letter of Medical Necessity is required.
Lipsticks Liquid adhesive Eligible for small cuts Lodging not at
Up to $50 per night will qualify if these conditions are met: The lodging is primarily
a hospital or
for and essential to medical care; the medical care is provided by a physician in a
licensed hospital or medical care facility related to a licensed hospital; the lodging
institution
isn't lavish or extravagant; and there is no significant element of personal pleasure, recreation, or vacation in the travel. To show that the expense is primarily for medical care, a Letter of Medical Necessity is required.
Lodging of a
Will qualify if accompanying a patient for medical reasons and all of the conditions
companion
listed above 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. To show that the expense is primarily for medical care, a Letter of Medical Necessity is required.
Long-term care
Long-term care services, even those that a chronically ill individual requires and
services
that are prescribed by a licensed healthcare practitioner under a plan of care, cannot be reimbursed on a tax-free basis, even if they otherwise qualify as medical care expenses.
Marijuana or other controlled substances in violation of federal law
Qualifies when used as a first aid item. Won’t qualify if used for general health
disposable
The costs of a massage to improve general health or stress don't qualify. 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 Letter of Medical Necessity is required.
Page 10 of 17 Mastectomy- related special bras Maternity clothes Mattresses
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. To show that the expense is primarily for medical care, a Letter of Medical Necessity is required.
Medical alert bracelet or necklace Medical
Expenses for admission and transportation to a medical conference qualify, if they
conference
relate to a chronic disease suffered by you, your spouse, or your dependent and if
admission,
the conference is primarily for and essential to the person in need of medical care.
transportation,
The expenses of meals and lodging while attending the conference don't qualify. To show that the expense is primarily for medical care, a Letter of Medical
meals, etc.
Expenses paid to a plan to keep medical information electronically for you, your
information
spouse, or your dependents are eligible.
plan charges
Examples of such devices are blood-pressure monitors, syringes, glucose kit,
monitoring and testing devices Medical records Eligible
Fees associated with transferring medical records to a new medical practitioner will
Menstrual pain
Example: Midol, Pamprin. Requires Letter of Medical Necessity or prescription
relievers
from your healthcare provider if incurred after December 31, 2010.
Mentally
The cost of keeping a mentally handicapped person in a special home (not a
handicapped,
relative's home) on a psychiatrist's recommendation to help that person adjust from
special home
life in a mental hospital to community living may qualify. To show that the expense
is primarily for medical care, a Letter of Medical Necessity is required.
To show that the expense is primarily for medical care, a Letter of Medical
supplements appointment fees Moisturizers
Examples: Bonine, Dramamine. Requires Letter of Medical Necessity or
sickness pills
prescription from your healthcare provider if incurred after December 31, 2010.
Mouthwash Nail polish Nasal strips or
Nasal sprays or strips used to treat sinus problems qualify as being primarily for
medical care, as would those that are used to prevent sleep apnea. Requires Letter of Medical Necessity or prescription from your healthcare provider if incurred after December 31, 2010.
Nicotine gum or Potentially
Examples: Nicoderm, Nicorette. Requires Letter of Medical Necessity or
prescription from your healthcare provider if incurred after December 31, 2010.
Page 11 of 17
Won't qualify if the baby is normal and healthy.
services for a baby Nursing
These expenses generally will qualify, whether provided in the participant's home
services
or another facility. The attendant doesn't have to be a nurse, so long as the
provided by a
services are of a kind generally performed by a nurse. These include services
nurse or other
connected with caring for the patient's condition, such as giving medication or
attendant
changing dressings, as well as bathing and grooming. 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. To show that the expense is primarily for medical care, a Letter of Medical Necessity is required.
Nutritional
These will not qualify if they are used merely to benefit general health. To show
supplements
that the expense is primarily for medical care, a Letter of Medical Necessity is required.
Nutritionist's
May qualify if the treatment relates to a specifically diagnosed medical condition
professional
and not for general health. To show that the expense is primarily for medical care,
expenses
a Letter of Medical Necessity is required.
Obstetrical expenses Occlusal guards to prevent teeth grinding Occupational One-a-day vitamins Operations
Qualifies if the operations are legal and not cosmetic.
Optometrist Organ donors Orthodontia
Please see Guidelines for Orthodontia Reimbursements located in the Forms section.
Orthopedic
Will qualify if used to treat injured or weakened body parts.
Orthopedic
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 Letter of Medical Necessity is required.
Osteopath fees Ovulation
This includes the expenses of oxygen and oxygen equipment for breathing problems caused by a medical condition.
Pain relievers
Examples: Advil, Aspirin, Tylenol. Requires Letter of Medical Necessity or
prescription from your healthcare provider if incurred after December 31, 2010.
Personal trainer Potentially
Will qualify if a medical practitioner has recommended a supervised exercise
regimen in order to treat a disease or injury and if incurred for a limited duration. To show that the expense is primarily for medical care, a Letter of Medical Necessity is required.
Page 12 of 17 Petroleum jelly
Example: Vaseline. May qualify if used to treat or alleviate a specific medical
condition. Won't qualify if used to maintain general health or for other personal reasons (e.g., as a toiletry or a cosmetic). Requires Letter of Medical Necessity or prescription from your healthcare provider if incurred after December 31, 2010.
Physical exams Eligible Physical therapy Pregnancy tests Prenatal
Obstetricians routinely recommend prenatal vitamins for the health of unborn
vitamins
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.
Prepayments
Payments for services/items that have not yet been incurred/obtained are not reimbursable.
Prescription
Fees paid for a card that provides a discount on drugs are not eligible. The actual
drug discount programs Prescription
Will not qualify if used for primarily cosmetic purposes.
Prescription
Importing prescription drugs from other countries generally will violate federal law.
drugs and
A drug or medicine may qualify for reimbursement if it is purchased and consumed
medicines
in the other country and is legal in both that country and the U.S., or the FDA
obtained from
announces it can be legally imported by individuals.
other countries Preventive care
Will qualify if the tests are used for medical diagnoses. Examples include hearing,
screenings Probiotics
Requires Letter of Medical Necessity or prescription from your healthcare provider
Propecia
Will not qualify if purchased for cosmetic purposes or for baldness associated with
normal aging. To show that the expense is primarily for medical care, a Letter of Medical Necessity is required.
Prosthetics Psychiatric care Psychoanalysis Eligible Psychologist
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 Letter of Medical Necessity is required.
glasses Rehydration solution
Won't qualify if purchased for cosmetic purposes (for example, to reduce wrinkles).
May qualify if recommended by a medical practitioner for a specific medical condition (e.g., acne vulgaris). To show that the expense is primarily for medical care, a Letter of Medical Necessity is required.
Page 13 of 17
Will not qualify if purchased for cosmetic purposes or for baldness associated with
normal aging. To show that the expense is primarily for medical care, a Letter of Medical Necessity is required.
Wil qualify when purchased for first-aid purposes.
Rubdowns
To show that the expense is primarily for medical care, a Letter of Medical
Safety glasses
Will qualify only if prescription lenses.
Schools and
Some payments made to a residential school or program to treat an individual for
education,
behavioral, emotional, or addictive conditions will qualify if a principal reason for
residential
attending the program is to receive medical care. To show that the expense is primarily for medical care, a Letter of Medical Necessity is required.
Schools and
Payments for a mentally or physically disabled person to attend a special school
education,
will qualify if a principal reason for attending the school is to alleviate the disability.
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 or disciplinary methods have a beneficial effect on the child's attitude, the expenses won't qualify. To show that the expense is primarily for medical care, a Letter of Medical Necessity is required.
Screening tests Eligible
Will qualify if the tests are for medical diagnoses.
Expenses for buying, training, and maintaining a service animal used by a
physically disabled person would qualify; including the expenses of food, medications, dental care, and veterinary fees for such animals.
Shampoos Shaving cream or lotion Shipping and
Shipping and handling fees incurred to obtain an item that constitutes medical care
handling fees
Example: Sudafed. Requires Letter of Medical Necessity or prescription from your
medications
healthcare provider if incurred after December 31, 2010.
Sleep treatment Eligible Smoking-
Requires Letter of Medical Necessity or prescription from your healthcare provider
cessation
if incurred after December 31, 2010. See also Drugs and medicines; Nicotine medications gum or patches. Smoking-
Amounts paid for a smoking-cessation (stop-smoking) program would qualify. See
cessation Smoking-cessation medications. programs Speech therapy Eligible Sperm, storage
Fees for temporary storage qualify, but only to the extent necessary for immediate
conception. Storage fees for undefined future conception aren't considered to be for medical care. To show that the expense is primarily for medical care, a Letter of Medical Necessity is required.
St. John's Wort Potentially
Will qualify if used primarily for medical care and not to maintain general health. To
show that the expense is primarily for medical care, a Letter of Medical Necessity is required.
Page 14 of 17 Stem cell,
Qualifies if there is a specific, imminent medical condition that the stem cells are
harvesting
intended to treat. Collection and storage indefinitely, just in case an item might be
and/or storage
needed, is not eligible. To show that the expense is primarily for medical care, a
Letter of Medical Necessity is required.
Sterilization procedures Student health
A fee for the cost of belonging to the program won't qualify. Expenses for specific
creams and
Will qualify if used to treat a sunburn (and not as regular skin moisturizers), but
ointments
must be prescribed if incurred after December 31, 2010.
Sunglasses Sun-protective
Won’t qualify if used to maintain general health or for other personal reasons.
(SPF) clothing
Qualifies if used to treat or alleviate a specific medical condition, but only the excess cost of the specialized garment over the cost of ordinary clothing will qualify. To show that the expense is primarily for medical care, a Letter of Medical Necessity is required.
Sunscreen
Requires Letter of Medical Necessity or prescription from your healthcare provider
Support braces Eligible
Will qualify if used for injured/weakened body parts.
Surgery for cosmetic reasons are not eligible.
Surrogate or
Such expenses won't qualify, even if they are for medical care of the
gestational
surrogate/gestational carrier or her unborn child.
carrier expenses Swimming
Generally the cost of swimming lessons does not qualify, even if recommended by
a medical practitioner, if the lessons are to improve general health. But the expense might qualify if recommended by a medical professional to treat a specific medical condition (such as part of a rehabilitation program after surgery). To show that the expense is primarily for medical care, a Letter of Medical Necessity is required.
Tanning salons
These will qualify if recommended for a specific medical condition, such as a skin
and equipment
disorder. To show that the expense is primarily for medical care, a Letter of Medical Necessity is required.
Local, state, service, or other taxes on medical services and products are eligible.
medical care Teeth whitening Potentially
Won't qualify if tooth discoloration is simply the result of aging and the whitening is
done for cosmetic purposes. But if tooth discoloration was caused by disease, birth defect, or injury, expenses for teeth whitening might qualify. To show that the expense is primarily for medical care, a Letter of Medical Necessity is required.
Telephone for
The expenses of buying and repairing special telephone equipment for a hearing-
hearing- impaired persons Television for
Equipment that displays the audio part of television programs as subtitles for
hearing-
hearing-impaired persons will qualify. The amount that qualifies is limited to the
impaired
excess of the cost over the cost of the regular item.
Page 15 of 17
Will qualify if provided for medical care (and not for the general improvement of mental health, relief of stress, or personal enjoyment). To show that the expense is primarily for medical care, a Letter of Medical Necessity is required. See also Counseling for additional information. Thermometers
Requires Letter of Medical Necessity or prescription from your healthcare provider
lozenges Toiletries
A toiletry is used in the process of dressing and grooming oneself and therefore is not medical care.
Toothache and
Requires Letter of Medical Necessity or prescription from your healthcare provider
teething pain relievers Toothbrushes
Won't qualify even if a dentist recommends special types to treat a medical
and toothpaste
condition. These items are used primarily for general health and would still be used without a medical condition. Thus, they are not primarily for medical care.
Transplants Transportation
A disabled individual's commuting costs to and from work are personal expenses
costs to and from work Transportation
Will qualify if the transportation is primarily for and essential to medical care.
expenses for
Includes car and rental car expenses; bus, taxi, train, plane, and ferry fares; and
person to
ambulance services. Instead of actual car expenses, the standard mileage rate for
receive medical
use of a car to obtain medical care is allowed. (Contact Customer Service for
current rate.) Parking fees and tolls also qualify.
Transportation
Will qualify in some cases. Transportation expenses of the following persons will
of someone
qualify: (1) a parent who must go with a child who needs medical care; (2) a nurse
other than the
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
receiving
individual who travels to visit a mentally ill dependent, if such visits are recommended as part of treatment.
medical care Ultrasound, prenatal Umbilical cord,
Might qualify if there is a specific medical condition that the umbilical cord is
freezing and
intended to treat. Collection and storage indefinitely, just in case it is needed, is not
storing of
medical care. To show that the expense is primarily for medical care, a Letter of Medical Necessity is required.
Vaccines Varicose veins,
Such expenses won't qualify if the procedure merely improves appearance. May
treatment of
qualify if the procedure promotes the proper function of the body or prevents/treats an illness or disease. To show that the expense is primarily for medical care, a Letter of Medical Necessity is required.
Vasectomy
Such expenses are generally for cosmetic purposes.
correction procedures Vision discount Ineligible
Fees paid for access to a vision network or discounted rate are not eligible.
programs
Page 16 of 17 Vitamins
Won't qualify if used to maintain general health (e.g., one-a-day vitamins). May
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 Letter of Medical Necessity is required.
Wart remover
Example: Compound W. Requires Letter of Medical Necessity or prescription from
treatments
your healthcare provider if incurred after December 31, 2010.
Weight-loss
Will qualify if the weight-loss program is recommended by a physician to treat a
programs
specific medical condition and is not simply to improve general health. The costs of
and/or drugs
food associated with a weight-loss program (such as special pre-packaged meals)
prescribed to
would not qualify, since it just meets normal nutritional needs. To show that the
induce weight
expense is primarily for medical care, a note from a medical practitioner recommending it to treat a specific medical condition is required. To expedite
reimbursement for weight-loss programs, please also provide proof of participation/dates of attendance from a representative of the program facility.
Wheelchair
A 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 will qualify. To show that the expense is primarily for medical care, a Letter of Medical Necessity is required.
X-ray fees Yeast infection
Examples: Monistat. Requires Letter of Medical Necessity or prescription from your
medications
healthcare provider if incurred after December 31, 2010.
Such expenses generally won't qualify. However, if a camp is a special therapeutic
program and treats a specific disability, then the expense might qualify. To show that the expense is primarily for medical care, a Letter of Medical Necessity is required.
Page 17 of 17
Fonterra Co-operative Group Limited Private Bag 92032 Auckland Fonterra Centre 9 Princes Street Auckland, New Zealand Telephone: +64 9 374 9000 All Fonterra manufacturing specifications are developed to meet New Zealand Government, importing country Government regulations and, when requested, customer specific requirements. The New Zealand Food Safety Authority (NZFSA) regulations require
GSK, Wal-Mart sell $9 rescue inhaler Devices use new propellant that replaces ozone-damaging CFC versions Sabine Vollmer, Staff Writer Comment on this story – the www.newsobserver.com GlaxoSmithKline has teamed with Wal-Mart, the largest retailer in the world, to tap the market for "green" asthma inhalers. The inhalers contain albuterol, a drug that provides asthma and emphysema