Common FSA eligible/ ineligible expenses - Optum

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Common FSA eligible/ ineligible expenses - Optum
Common FSA eligible/
ineligible expenses
Common FSA eligible/ ineligible expenses - Optum
Using a flexible spending account (FSA) is a great way to pay for
eligible expenses with income tax-free dollars.

The following lists are not all-inclusive but will highlight some common
eligible expenses for your health care FSA, limited purpose FSA or
dependent care FSA. The Internal revenue service (IRS) decides which
expenses can be paid from an FSA and they can modify the list at any
time. Be sure to review your benefit plan documents to learn what
expenses are qualified for reimbursement under your specific plan.          Managing your FSA is simple
                                                                            It’s easy to manage your account
If you are currently participating in a high-deductible health plan
                                                                            online. Simply register at
(HDHP) and are contributing to a health savings account (HSA), you
                                                                            optumbank.com to:
may also participate in a limited purpose FSA (LPFSA). Eligible LPFSA
expenses are limited to dental and vision.                                  • Sign up to receive email
                                                                              notifications
Common eligible health care expenses
                                                                            • Sign up for direct deposit
• Acupuncture                          • Laboratory fees
                                                                            • Check your account balance
• Ambulance                            • Laser eye surgery*
                                                                            • Submit claims and receipts for
• Artificial limbs                     • Medical alert bracelet
                                                                              reimbursement
• Artificial teeth*                    • Medical records charges
                                                                            • View your recent transactions
• Birth control treatment              • Midwife
                                                                            With an Optum Financial FSA,
• Blood sugar test kits for            • Occlusal guards to prevent
                                                                            you have the tools and resources
  diabetics                              teeth grinding
                                                                            to make the most of your health
• Breast pumps and lactation           • Orthodontics*
                                                                            care dollars.
  supplies                             • Orthotic Inserts (custom or off
• Chiropractor                           the shelf)
                                                                            We’re everywhere you go
• Contact lenses and solutions*        • (Certain) over-the-counter drugs
                                         and medications                    The Optum Bank mobile app
• Crutches
                                                                            is the most convenient way
• Dental treatments including          • Physical therapy
                                                                            to check your balance, submit
  X-rays, cleanings, fillings,         • Special education services         and review claims, and receive
  sealants, braces and tooth             for learning disabilities          messages — even when you’re
  removals*                              (recommended by a doctor)          in line at the pharmacy. You can
• Doctor’s office visits and co-pays   • Speech therapy                     snap a photo of a receipt using
• Drug addiction treatment             • Stop-smoking programs              your device’s camera and upload
• Drug prescriptions                     (including nicotine gum or         it to your account to document
                                         patches, if prescribed)            your claim.
• Eyeglasses (Rx and reading)*
                                       • Surgery, excluding
• Fluoride treatments*
                                         cosmetic surgery
• Flu shots
                                       • Vaccines
• Guide dogs
                                       • Vasectomy
• Hearing aids and batteries
                                       • Vision exam*
• Infertility treatment
                                       • Walker, cane
• Inpatient alcoholism treatment
                                       • Wheelchair
• Insulin

*LPFSA-eligible expense
Common FSA eligible/ ineligible expenses - Optum
Common over-the-counter (OTC) medicines
Many over-the-counter medicines and drugs as well as medical supplies
may be qualified for reimbursement with a health care FSA. Examples
include but are not limited to:

• Acid controllers                   • Elastic bandages and wraps
                                                                          • The IRS publishes information
• Acne medicine                      • Eye care*
                                                                            on FSAs and qualified medical
• Anti-gas products                  • Feminine antifungal
                                                                            expenses. Visit irs.gov and
• Allergy and sinus medicine           or anti-itch products
                                                                            search for Publication 502 or 969
• Anti-diarrheal medicine            • First-aid supplies                   to learn more.
• Baby rash ointments/creams         • Hemorrhoid treatments              • View your account information
• Bandages, adhesive or elastic      • Laxatives or stool softeners         at optumbank.com
• Braces and supports                • Menstrual care products
• Breast pumps                       • Motion sickness medicines
• Blood pressure monitors            • Nasal sprays or drops
• Catheters                          • Ointments for cuts, burns
                                       or rashes
• Cold and flu medicine
                                     • Ostomy products
• Cold packs/hot packs
                                     • Pain relievers, such as
• Contact lens solution
                                       aspirin or ibuprofen
  and supplies*
                                     • Pregnancy test kits
• Contraceptives
                                     • Sleep aids
• Crutches
                                     • Stomach remedies
• Denture adhesives*
                                     • Sunscreen
• Diagnostic tests and monitors
  (such as blood glucose monitors)   • Thermometers
                                     • Walkers, wheelchairs and canes     You do the shopping;
                                                                          we make it easy.
Services that may be eligible with a letter of medical necessity          Make the most of your FSA
form completed                                                            dollars at the Optum Store
This list is not all-inclusive:
                                                                          Shop store.optum.com for a wide
• Weight-loss program, only if it is a treatment for a specific disease   selection of all your health and
  diagnosed by a physician (e.g., obesity, hypertension, heart disease)   wellness essentials from the brands
                                                                          you trust. Plus, when you use your
• Compression hosiery/socks, anti-embolism socks or hose
                                                                          Optum Financial payment card
• Massage treatment for specific ailment or diagnosis
                                                                          — purchases are automatically
• CPR classes for adult or child                                          approved, hassle-free.
• Improvements or special equipment added to a home or other capital
                                                                          Use code OPTFSA7 to save 7%
  expenditures for a physically handicapped person
                                                                          storewide, plus free shipping.**
• Toothbrushes (including electric) and toothpaste

*LPFSA eligible expense
Common FSA eligible/ ineligible expenses - Optum
Ineligible expenses
Listed below are some services and expenses that are not qualified for FSA
reimbursement. This list is not all-inclusive:

 • Aromatherapy                               • Hair re-growth supplies
 • Baby bottles and cups                        and/or services
 • Baby oil                                   • Health club membership
                                                dues
 • Baby wipes
                                              • Humidifier
 • Breast enhancement
                                              • Lotion
 • Cosmetics and skin care
                                              • Low-calorie foods
 • Cotton swabs
                                              • Mouthwash
 • Dental floss
                                              • Petroleum jelly
 • Deodorants
                                              • Shampoo and conditioner
                                              • Spa salts

Qualified dependent care expenses

 • Au pair services                           • Nursery school
 • Babysitting services                       • Pre-kindergarten
 • Before- and after-school                   • Summer day camp (not
   programs                                     educational in nature)
 • Custodial or eldercare
   expenses, in-home or
   daycare center (not medical
   care)

Ineligible dependent care expenses
 • Clothing                                   • Kindergarten and higher
 • Food/meals                                   education/tuition expenses
                                              • Overnight camp

                                      optumbank.com

**The promotional code OPTFSA7 cannot be applied to previously placed orders, and cannot be combined with
other promotional codes. Promotional codes are not transferable or redeemable for cash or credit. To apply a
promotional code you must enter it prior to completing the order. Failure to adhere to these terms of use may
result in the transaction being voided. Free and expedited shipping offers do not apply to shipping outside of
the contiguous United States.
Additional shipping restrictions may apply.
The Optum Store is an affiliate of the UnitedHealth Group family of companies.
We are now Optum Financial, which includes Optum Bank.
Health savings accounts (HSAs) are individual accounts offered or administered by Optum Bank® Member FDIC,
a subsidiary of Optum Financial, Inc., and are subject to eligibility requirements and restrictions on deposits and
withdrawals to avoid IRS penalties. State taxes may apply. Fees may reduce earnings on account. Flexible spending
accounts/arrangements (FSAs) are administered by OptumHealth Financial Services and are subject to eligibility and
restrictions. This communication is not intended as legal or tax advice. Federal and state laws and regulations are
subject to change.
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