Qualifying Health Care Expenses

Under the plan, you will be reimbursed only for those types of medical expenses generally deductible on your federal income tax return (without regard to the 7.5% of adjusted gross income limitation). They must be defined as eligible under Code Section 213(d) of the IRS Code. They include, for example, expenses you have incurred for:

• Medicine, drugs, and vaccines that your doctor prescribed.
• Over-the-counter drugs. See explanation and examples of the next two pages.
• Medical doctors, dentists, eye doctors, chiropractors, osteopaths, podiatrists, psychiatrists, psychologists, physical therapists, acupuncturists, and psychoanalysts (medical care only).
• Medical examination, X-ray and laboratory service, insulin treatments the doctor prescribed.
• Nursing help. If you pay someone to do both nursing and housework, you can be reimbursed only for the cost of the nursing help.
• Hospital care (including meals and lodging), clinic costs, and lab fees.
• Medical treatment at a center for drug addicts or alcoholics.
• Medical aids such as hearing aids (and batteries), false teeth, eyeglasses, contact lenses, braces, orthopedic shoes, crutches, wheelchairs, guide dogs and the cost of maintaining them. May require additional documentation.
• Ambulance service and other travel costs to get medical care.

You cannot obtain reimbursement for:

• Premiums incurred by a spouses for accident and health insurance policies.
• The basic cost of Medicare insurance (Medicare A).
• Life insurance or income protection policies.
• The 1.45% hospital insurance benefits tax withheld from your pay as part of the Social Security tax or paid as part of Social Security self-employment tax.
• Nursing care for a healthy baby.
• Illegal operations or drugs.
• Travel your doctor told you to take for rest or change.
• Cosmetic Surgery

Qualifying medical expenses include only those expenses incurred for: 

• Yourself.
• Your spouse.
• All dependents you list on your federal tax return.
• Any person that you could have listed as a dependent on your return if that person had not received $2,000 or more of gross income or had not filed a joint return. 
  

This list is not all-inclusive and may be subject to change based on IRS codes for eligible expenses.

This list compiled from CCH Federal Tax Guide Reports.

Health Care FSA- NOT ALLOWED:

• Arch supports, knee & wrist braces (unless prescribed and medically necessary)
• Breast Pumps
• Blood Pressure machines (unless prescribed by a physician as medically necessary for constant monitoring of blood pressure due to a medical condition)
• Cosmetic Surgery
• Dental bleaching or any other teeth whitening
• Electrolysis or Hair Removal
• First Aid Supplies – Including Bandages, Hot/Cold Packs, or non-prescribed braces or splints.
• Hair transplant
• Health Club dues
• Herbs
• Humidifiers
• Insurance premiums of any kind (Please contact Pinnacle w/ questions)
• Laetrile, even if prescribed by a doctor, is not reimbursable.
• Marijuana, even if prescribed for medicinal purposes, is not reimbursable.
• Massage therapy (Unless prescribed by a physician to treat an injury or trauma, or for rehabilitative purposes)
• Neck support pillows
• Smoking Cessation Programs & Over the Counter Smoking Cessation Drugs
• Electric (Sonicare) toothbrushes, replacement brushes or toothpaste. Even when prescribed by a Dentist.
• Supplements (Only those prescribed by a physician and are not available over the counter are allowed)
• Tuition for Special Schools (unless it is a special school to treat a specific condition like blindness, speech, etc.)
• Vitamins that are available over the counter, even if prescribed.
• Weight loss programs & machines even with Doctor’s Prescription

Dependent Care FSA - NOT ALLOWED:

• Daycare for a child aged 13 or older
• Expenses paid to your older child who is under the age of 19
• Kindergarten or school tuition (pre-school and before and after care is okay) for age 5 & older

Premium Reimbursement FSA - NOT ALLOWED:

• Life Insurance
• Long Term Care
• Group insurance premiums through your employer, or your spouse's employer.
• Contact lens insurance.

In addition, the following are not acceptable receipts:

• Bankcard statements
• Canceled checks for Health Care or Dependent Care FSA
• Charges submitted that are illegible
• Estimates of expenses. A statement is required showing date of service and type of medical expense (or daycare, if applicable).
• Statement Balances and/or Balance Forwards are never acceptable.