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FSA Eligibility List


This list does not include prescription drugs or brand name items; please use generic search terms.

Eligibility for various goods and services may change at any time. Please search to ensure eligibility prior to each purchase.

For more information on Dependent Care FSA, please click here for plan guidelines.

- Eligible with a detailed receipt      - Eligible with appropriate documentation      - Not eligible

A "detailed receipt" includes ALL of the following: date of service, patient name, provider name, amount, and service or expense.

Expense Eligible? Documentation Needed
72-hour kits
ABA therapy Detailed receipt
ADD/ADHD Testing Letter of Medical Necessity
Abdominoplasty Letter of Medical Necessity
Acne treatments Detailed receipt
Acupressure Detailed receipt
Acupressure mat Detailed receipt
Acupuncture Detailed receipt
Adaptive seat Letter of Medical Necessity
Adoption fees
Adoption medical expenses Detailed receipt
Air filter for humidifier Letter of Medical Necessity
Air purification systems
Air respirator system Letter of Medical Necessity
Alarm systems
Alcoholism treatment Detailed receipt
Allergy medications Detailed receipt
Allergy testing Detailed receipt
Allergy treatments and products Letter of Medical Necessity
Alopecia treatments
Alternative healer Letter of Medical Necessity
Ambulance services Detailed receipt
Amputee rings (car modification) Letter of Medical Necessity
Anesthesia (medical/dental) Detailed receipt
Antacids Detailed receipt
Anti-Distraction monitors Letter of Medical Necessity
Antibiotic ointment Detailed receipt
Antifungal treatments Detailed receipt
Antiseptic skin cleansers Detailed receipt
Apnea monitors Detailed receipt
Aquatic therapy Letter of Medical Necessity
Arthritis gloves Detailed receipt
Artificial eyes Detailed receipt
Artificial limbs Detailed receipt
Artificial teeth Detailed receipt
Assisted living facility
Asthma medications or treatments Prescription
Athletic mouth guards
Athletic shoes
Automated external defibrillators (AED) Detailed receipt
Automatic locks (car modification) Letter of Medical Necessity
Automobile modifications Letter of Medical Necessity
Baby formula
Baby monitor Letter of Medical Necessity
Balance boards Letter of Medical Necessity
Bandages Detailed receipt
Bariatric surgery Detailed receipt
Bathtubs
Batteries (for medical equipment and devices) Detailed receipt
Bed-wetting alarms Letter of Medical Necessity
Belly bands Detailed receipt
BioScan Letter of Medical Necessity
Biofeedback therapy Detailed receipt
Bioidentical hormone replacement therapy (BHRT) Letter of Medical Necessity
Bioptic telescopes (car modification) Letter of Medical Necessity
Birth control pills Prescription
Birthing classes Detailed receipt
Bladder control device Detailed receipt
Blood donor fees Letter of Medical Necessity
Blood pressure monitoring devices Detailed receipt
Blood storage Letter of Medical Necessity
Blood sugar test kits and strips Detailed receipt
Body Restoration Technique (BRT) Letter of Medical Necessity
Botulinum toxin injections (BOTOX) Letter of Medical Necessity
Braces Detailed receipt
Braille books Detailed receipt
Braille magazines Detailed receipt
Breast feeding classes Detailed receipt
Breast implant removal Letter of Medical Necessity
Breast implants Letter of Medical Necessity
Breast pump bustier Detailed receipt
Breast pump supplies Detailed receipt
Breast pumps Detailed receipt
Breast reconstruction surgery Letter of Medical Necessity
Breast reduction surgery Letter of Medical Necessity
Breath testing Letter of Medical Necessity
Breathalyzer Letter of Medical Necessity
Bug repellant sprays
COBRA premiums
COVID 19 antibody IV therapy
COVID 19 testing Detailed receipt
CPAP cleaners Detailed receipt
CPAP cleaning machines Detailed receipt
CPAP converters Detailed receipt
CPAP supplies Detailed receipt
CPR classes
CT heart calcium scan Letter of Medical Necessity
Cabinet lowering
Calamine lotions Detailed receipt
Cancer insurance premiums
Cane Detailed receipt
Car Modifications Letter of Medical Necessity
Carpet removal
Cervical pillows Letter of Medical Necessity
Chelation therapy Letter of Medical Necessity
Child diapers
Childcare instruction
Chinese herbal practitioner Letter of Medical Necessity
Chiropody Detailed receipt
Chiropractic care Detailed receipt
Cholesterol test kits and supplies Detailed receipt
Chondroitin supplements Detailed receipt
Christian Science practitioner Detailed receipt
Circulating cold water therapy device
Circumcision Detailed receipt
Clear aligners Detailed receipt
Cochlear implants Detailed receipt
Cognitive Behavioral Therapy (CBT) Letter of Medical Necessity
Coinsurance Detailed receipt
Cold laser therapy Letter of Medical Necessity
Cold medications Detailed receipt
Cold packs Detailed receipt
Cold sore medications Detailed receipt
Cold water therapy Letter of Medical Necessity
Collagen injections Letter of Medical Necessity
Colon cancer screening test Detailed receipt
Colonoscopy preparation kits Detailed receipt
Compound medication Detailed receipt
Compression therapy Letter of Medical Necessity
Computer glasses (non-prescription) Detailed receipt
Computer programs for visually impaired Letter of Medical Necessity
Condoms Detailed receipt
Conference for a medical condition Letter of Medical Necessity
Contact lens service agreements and warranties
Contact lenses and supplies Detailed receipt
Continuous glucose monitors Detailed receipt
Continuous positive airway pressure (CPAP) Detailed receipt
Contraceptives (over-the-counter) Detailed receipt
Contraceptives (prescription) Prescription
Contributions to state disability funds
Controlled substances (prescribed) Prescription
Convaid wheelchair Letter of Medical Necessity
Convalescent homes Letter of Medical Necessity
Copayments Detailed receipt
Cord blood storage Letter of Medical Necessity
Corn cushions Detailed receipt
Corn removal Detailed receipt
Corn trimmers Detailed receipt
Corneal keratotomy Detailed receipt
Corneal ring segments Detailed receipt
Cosmetic procedures or surgeries (in relation to birth defect, accident, or disease) Letter of Medical Necessity
Cosmetics
Cotton balls
Cotton swabs
Cough suppressants Detailed receipt
Counseling Detailed receipt
Cranial electrotherapy stimulation device Detailed receipt
Cranial-sacral therapy Letter of Medical Necessity
Credit card processing fees (related to FSA eligible expenses only) Detailed receipt
Crutch substitute Detailed receipt
Crutches Detailed receipt
Crystalens Detailed receipt
Custodial care Letter of Medical Necessity
Customized seats (car modification) Letter of Medical Necessity
Cutar Emulsion lotions Detailed receipt
Cyst removal Detailed receipt
DNA collection Letter of Medical Necessity
DNA storage Letter of Medical Necessity
Dance lessons
Decongestants Detailed receipt
Deductibles Detailed receipt
Dehumidifier
Dehydration treatments Detailed receipt
Dental bridges Detailed receipt
Dental crowns Detailed receipt
Dental emergency kits Detailed receipt
Dental fillings Detailed receipt
Dental floss
Dental implants Detailed receipt
Dental reconstructions Detailed receipt
Dental sealants Detailed receipt
Dental treatments Detailed receipt
Dental veneers Letter of Medical Necessity
Denture adhesives Detailed receipt
Denture cleansers Detailed receipt
Dentures Detailed receipt
Denturist Detailed receipt
Dermabrasion Letter of Medical Necessity
Diabetic bracelets Detailed receipt
Diabetic equipment Detailed receipt
Diabetic supplies Detailed receipt
Diagnostic services Detailed receipt
Diaper rash ointments Detailed receipt
Diaper services
Diarrhea medications Detailed receipt
Diathermy Detailed receipt
Dietary supplements
Dietician expenses Letter of Medical Necessity
Digestive aids Detailed receipt
Disodium phosphate Detailed receipt
Disposable medical masks Detailed receipt
Door hardware modifications
Doula services Letter of Medical Necessity
Dropped floors (car modification) Letter of Medical Necessity
Drug addiction treatments Detailed receipt
Drug overdose treatments Detailed receipt
Drug testing Detailed receipt
Durable medical equipment (DME) Detailed receipt
Dyslexia testing and treatment Letter of Medical Necessity
Ear molds Detailed receipt
Ear plugs Letter of Medical Necessity
Ear wax removal drops Detailed receipt
Educational classes for a medical condition or disease management Letter of Medical Necessity
Egg crate mattresses Letter of Medical Necessity
Egg storage fees Detailed receipt
Elbow switches (car modification) Letter of Medical Necessity
Electrical outlets
Electronic cigarettes
Elevator
Enemas Detailed receipt
Enteral formula Detailed receipt
Epsom salts Detailed receipt
Erectile dysfunction aids Letter of Medical Necessity
Erectile dysfunction medication Detailed receipt
Essential oils
Exercise equipment Letter of Medical Necessity
Expanded doorways
Expectorant Detailed receipt
Expenses not incurred during the FSA coverage period
Expenses that have already been reimbursed or that could be reimbursed by another medical plan
Experimental drugs Prescription
Experimental medical services Letter of Medical Necessity
Experimental surgery Letter of Medical Necessity
Exploratory surgery Letter of Medical Necessity
Eye drops Detailed receipt
Eye examinations Detailed receipt
Eye patches Detailed receipt
Eye surgery Detailed receipt
Eye wash and supplies Detailed receipt
Eyeglass cases
Eyeglass express fee (expedited shipping) Detailed receipt
Eyeglass lanyards
Eyeglass repair Detailed receipt
Eyeglasses Detailed receipt
FMLA records charges
Face masks Detailed receipt
Fertility enhancements Detailed receipt
Fertility treatments (for participant, spouse, or dependent) Detailed receipt
Fertility treatments (for surrogate)
Fetal monitors Detailed receipt
Fever reducing medications Detailed receipt
Finance charges
First aid creams Detailed receipt
First aid kits Detailed receipt
First aid liquids Detailed receipt
First aid tape Detailed receipt
Fitness trackers
Fixture relocation
Floor-mounted steering (car modification) Letter of Medical Necessity
Flooring replacement
Flu medications Detailed receipt
Flu shots Detailed receipt
Fluoridation devices Letter of Medical Necessity
Fluoride Detailed receipt
Fluoride pills Detailed receipt
Fluoride rinse Detailed receipt
Foam Wedge supply Letter of Medical Necessity
Foam roller therapy Letter of Medical Necessity
Food scales Letter of Medical Necessity
Foot Zoning Letter of Medical Necessity
Foot arch bandages Detailed receipt
Foot arch supports Detailed receipt
Foot care (general hygiene and cosmetic)
Foot care (medical nail clipping) Letter of Medical Necessity
Foot care medications Detailed receipt
Foot care supplies Detailed receipt
Foot creams Detailed receipt
Foot powders Detailed receipt
Foot sprays Detailed receipt
Form completion fees
Fracture fork (tuning fork to find fractures)
Full body scan Letter of Medical Necessity
Funeral expenses
Gambling addiction treatment Letter of Medical Necessity
Gas medication Detailed receipt
Gastric bypass Detailed receipt
Gastric bypass with excess skin removal Letter of Medical Necessity
Gastric sleeve Detailed receipt
Gauze pads Detailed receipt
Genetic testing Letter of Medical Necessity
Gestational carrier
Glucosamine supplements Detailed receipt
Glucose gels Detailed receipt
Glucose monitoring equipment Detailed receipt
Glucose tablets Detailed receipt
Gluten sensor Letter of Medical Necessity
Gluten-free products
Grading of property exterior
Gym memberships
Gynecologist Detailed receipt
HCG injections Prescription
Hair colorants
Hair regrowth products
Hair removal
Hair transplants
Hair treatments
Halfway houses (transition homes) Letter of Medical Necessity
Hand controls (car modification) Letter of Medical Necessity
Hand sanitizers Detailed receipt
Hand sanitizing wipes Detailed receipt
Handicap placards and license plates Detailed receipt
Headache medications Detailed receipt
Headphones for hearing impaired Letter of Medical Necessity
Health club dues
Health reimbursement arrangements (HRA)
Health savings account (HSA) contributions
Health screenings Detailed receipt
Hearing aid accessories Detailed receipt
Hearing aids Detailed receipt
Heart rate monitors Detailed receipt
Heat therapy Letter of Medical Necessity
Heat wraps Detailed receipt
Heating pads Detailed receipt
Hemorrhoid treatments Detailed receipt
Herbal medications
High colonic irrigation Letter of Medical Necessity
Holistic healer Letter of Medical Necessity
Home birth (with a licensed midwife) Detailed receipt
Home health services Letter of Medical Necessity
Home modifications
Homeopathic care Letter of Medical Necessity
Homeopathic medications
Hormone replacement therapy (HRT) Letter of Medical Necessity
Hospice care Detailed receipt
Hospital services Detailed receipt
Hot packs Detailed receipt
Household help
Human guide Letter of Medical Necessity
Humidifiers Letter of Medical Necessity
Hydrogen peroxide Detailed receipt
Hydrotherapy Letter of Medical Necessity
Hyperbaric oxygen therapy Letter of Medical Necessity
Hypnosis therapy Letter of Medical Necessity
Hypnotherapy Letter of Medical Necessity
Hypoallergenic encasement products Letter of Medical Necessity
Illegal surgeries and treatments
Immunizations Detailed receipt
Implantable Collamer Lens surgery (ICL) Detailed receipt
Imported drugs
Inclinator
Incontinence supplies (adult diapers) Detailed receipt
Infant diapers
Infection control Detailed receipt
Infertility treatments Detailed receipt
Infrared Sauna
Infrared mammograms Detailed receipt
Injection snoreplasty Letter of Medical Necessity
Insect bite devices Detailed receipt
Insect bite treatment solutions Detailed receipt
Insect bite treatment wipes Detailed receipt
Insect sting treatment solutions Detailed receipt
Insect sting treatment wipes Detailed receipt
Insulin Detailed receipt
Insulin pouches Detailed receipt
Insulin pumps Detailed receipt
Insurance premiums
Intense pulsed light therapy Letter of Medical Necessity
Internal Family System therapy (IFS) Letter of Medical Necessity
Intrauterine devices (IUD) Detailed receipt
Inversion systems Letter of Medical Necessity
Irrigation syringes Detailed receipt
Joy-stick system (car modification) Letter of Medical Necessity
Kenesio tape Detailed receipt
Ketamine Therapy Letter of Medical Necessity
Kinesiology Letter of Medical Necessity
Knee scooters Detailed receipt
LAP-BAND surgery Detailed receipt
LASIK eye surgery Detailed receipt
Laboratory fees Detailed receipt
Lactation consultant Detailed receipt
Lactation supplies Detailed receipt
Lactose intolerance pills Detailed receipt
Language training for a medical condition Letter of Medical Necessity
Lap pools
Laser bacterial reduction Detailed receipt
Laser eye surgery Detailed receipt
Laser treatments Letter of Medical Necessity
Late fees
Latex gloves Detailed receipt
Laxatives Detailed receipt
Lead-based paint removal
Left-foot accelerators (car modification) Letter of Medical Necessity
Left-handed gear selections (car modification) Letter of Medical Necessity
Legal fees
Lice treatment Detailed receipt
Lice treatment medications Detailed receipt
Lice treatment supplies Detailed receipt
Licensed birthing centers Detailed receipt
Life Alert medical emergency alert system Detailed receipt
Life coach
Lifestyle screenings Detailed receipt
Light boxes Letter of Medical Necessity
Light therapy Letter of Medical Necessity
LipiFlow Letter of Medical Necessity
Listening systems for hearing impaired Letter of Medical Necessity
Lodging/hotel/motel (Limit of $50 per night for patient and $50 per night for one caregiver.) Letter of Medical Necessity
Long-term care premiums
Long-term care services Letter of Medical Necessity
Long-term disability insurance premiums
Magnetic therapy Letter of Medical Necessity
Makeup
Marriage counseling
Massage chairs
Massage therapy Letter of Medical Necessity
Massage wheel Letter of Medical Necessity
Mastectomy Camisole Detailed receipt
Mastectomy bras Detailed receipt
Maternity clothes
Maternity global fees Detailed receipt
Mattresses Letter of Medical Necessity
Meals
Medi-Scope Detailed receipt
Medical ID bracelets Detailed receipt
Medical ID necklaces Detailed receipt
Medical care outside U.S. Detailed receipt
Medical emergency alert systems Detailed receipt
Medical equipment maintenance Detailed receipt
Medical equipment repairs Detailed receipt
Medical information storage plans Detailed receipt
Medical literature, books, pamphlets, or audio
Medical newsletters
Medical records charges Detailed receipt
Medical savings account (MSA) contributions
Medical slings Detailed receipt
Medicare Part A Taxes
Medicare premiums
Medicare supplement premiums
Medicated cold creams Detailed receipt
Medicated conditioners Detailed receipt
Medicated lip products Detailed receipt
Medicated lotion Detailed receipt
Medicated mouth rinses Detailed receipt
Medicated ointments Detailed receipt
Medicated shampoos Detailed receipt
Medicated soaps Detailed receipt
Medicated toothpastes Detailed receipt
Medication flavorings Detailed receipt
Medications from other countries (consumed in the U.S.)
Medications from other countries (consumed in the other country) Detailed receipt
Medicine droppers Detailed receipt
Menstrual care products Detailed receipt
Menstrual cups Detailed receipt
Menstrual cycle medications Detailed receipt
Menstrual discs Detailed receipt
Menstrual liners Detailed receipt
Menstrual pads Detailed receipt
Menstrual sponges Detailed receipt
Metabolic Services Letter of Medical Necessity
Metabolic support programs Letter of Medical Necessity
Microdermabrasion/ Microneedling Letter of Medical Necessity
Midwife services Detailed receipt
Migraine medications Detailed receipt
Mileage reimbursement (travel related to healthcare services) Detailed receipt
Mira Dry Letter of Medical Necessity
Missed appointment fees
Modified-effort steering (car modification) Letter of Medical Necessity
Mole removal Detailed receipt
Moleskins Detailed receipt
Motion sickness medications Detailed receipt
Nasal Care Detailed receipt
Nasal sprays Detailed receipt
Nasal strips Detailed receipt
Natural lens replacement Detailed receipt
Naturopathic healer Letter of Medical Necessity
Nerve ablation
Neti pot supplies Detailed receipt
Neti pots Detailed receipt
Neurofeedback therapy Detailed receipt
Newborn-care instruction
Nicotine gums (over-the-counter) Detailed receipt
Nicotine patches (over-the-counter) Detailed receipt
Nipple shields Detailed receipt
Nitrile gloves Detailed receipt
Non-prescription ski goggles
Non-prescription sports goggles
Non-prescription swim goggles
Note-taker for a hearing impaired child in school Letter of Medical Necessity
Nursing bras
Nursing home expenses Letter of Medical Necessity
Nursing pads Detailed receipt
Nursing services Detailed receipt
Nursing supplies Detailed receipt
Nutritional supplements
Nutritionist Letter of Medical Necessity
Obstetrical care Detailed receipt
Occlusal mouth guards Detailed receipt
Occupational therapy Detailed receipt
Office visits Detailed receipt
Ointment rubs Detailed receipt
Operation (for non-cosmetic purposes) Detailed receipt
Oral appliances Detailed receipt
Oral pain relieving creams Detailed receipt
Organ donor's expenses Detailed receipt
Ortho-bionomy therapy Letter of Medical Necessity
Orthodontics Detailed receipt
Orthokeratology Detailed receipt
Orthokeratology (ortho-K) Detailed receipt
Orthopedic inserts Detailed receipt
Orthopedic shoes Letter of Medical Necessity
Orthopedic supports Detailed receipt
Osteopathic fees Detailed receipt
Ostomy supplies Detailed receipt
Otoscope Detailed receipt
Over allowable amounts Detailed receipt
Over maximum allowable charges Detailed receipt
Over-the-counter medications Detailed receipt
Ovulation kits Detailed receipt
Ovulation monitors Detailed receipt
Oxygen Detailed receipt
Ozone therapy Letter of Medical Necessity
PET scans Detailed receipt
PRK eye surgery Detailed receipt
Pain relievers Detailed receipt
Pain relieving creams Detailed receipt
Palm grips (car modification) Letter of Medical Necessity
Paramedic shears
Parking at medical facility Detailed receipt
Particulate respirator masks Detailed receipt
Pastoral counseling
Paternity testing
Patterning exercise therapy Detailed receipt
Pedal extender (car modification) Letter of Medical Necessity
Pedometer
Penile prostheses Detailed receipt
Perfume
Period-proof underwear Detailed receipt
Periodontal rinse Detailed receipt
Personal electronics
Personal hygiene items
Personal trainer fees Letter of Medical Necessity
Petroleum jelly Detailed receipt
Phone consultations with a licensed provider Detailed receipt
Physical exams Detailed receipt
Physical exams for caregiver
Physical fitness exercise classes Letter of Medical Necessity
Physical fitness exercise programs Letter of Medical Necessity
Physical therapy Detailed receipt
Physical treatment unrelated to specific health problems
Physio-Neuro Therapy (PNT) Letter of Medical Necessity
Piercings (including piercings for migraine relief)
Pill cutters Detailed receipt
Pill organizers Detailed receipt
Pillows Letter of Medical Necessity
Platelet rich plasma injection Detailed receipt
Polygraph testing
Porcelain margins Detailed receipt
Porch lifts
Portable power station Letter of Medical Necessity
Positional therapy devices Letter of Medical Necessity
Power seats (car modification) Letter of Medical Necessity
Pregnancy charges paid monthly per contract Detailed receipt
Pregnancy test kits Detailed receipt
Pregnancy tests Detailed receipt
Prenatal portrait services
Prenatal vitamins Detailed receipt
Prepayments
Prescription drug discount programs
Prescription drugs Prescription
Prescription drugs for cosmetic purposes
Prescription ski goggles Detailed receipt
Prescription sports goggles Detailed receipt
Prescription swim goggles Detailed receipt
Preventive care screenings Detailed receipt
Preventive care services Detailed receipt
Private hospital rooms Detailed receipt
Professional therapeutic pastes Detailed receipt
Progesterone hormones Prescription
Prolotherapy Letter of Medical Necessity
Prosthetics Detailed receipt
Protection plans
Prothrombin time (INR) home testing devices Detailed receipt
Provider discounts
Psychiatric care Detailed receipt
Psychoanalysis Detailed receipt
Psychotherapy Detailed receipt
Pulse oximeters Detailed receipt
Pulsed electromagnetic field wearable device Detailed receipt
Push/pull levers (car modification) Letter of Medical Necessity
Quad forks (car modification) Letter of Medical Necessity
Quad key holders (car modification) Letter of Medical Necessity
Quad key turners (car modification) Letter of Medical Necessity
Radial keratotomy (RK) Detailed receipt
Radon home system Letter of Medical Necessity
Radon test kits Detailed receipt
Railings or bars for support
Raised roofs (car modification) Letter of Medical Necessity
Ramps (car modification) Letter of Medical Necessity
Reacher grabber tools
Reading glasses Detailed receipt
Reasonable and customary (R&C) fees Detailed receipt
Recliner chairs
Reconstructive surgery (following accident, medical procedure, medical or condition) Detailed receipt
Record copy fees Detailed receipt
Records transfer fees Detailed receipt
Red light therapy Letter of Medical Necessity
Reflexology Letter of Medical Necessity
Rehabilitation centers Letter of Medical Necessity
Rehydration liquids Detailed receipt
Remote switches (car modification) Letter of Medical Necessity
Rescue suction device
Residential treatment programs Detailed receipt
Resorts
Respite care Letter of Medical Necessity
Retainer Detailed receipt
Retinal imaging services Detailed receipt
Retinol cream Detailed receipt
Retreats
Right-hand turn signal (car modification) Letter of Medical Necessity
Rubbing alcohol Detailed receipt
SAD lights Letter of Medical Necessity
Safety glasses (non-prescription)
Safety glasses (prescription) Detailed receipt
Safety rails Detailed receipt
Sales tax Detailed receipt
Sanitary napkins Detailed receipt
Scar medications Detailed receipt
Schools and education Letter of Medical Necessity
Scientology auditing
Sclerotherapy (varicose vein procedure) Letter of Medical Necessity
Scooter lifts (car modification) Letter of Medical Necessity
Seat cushion Letter of Medical Necessity
Seat lift mechanisms Letter of Medical Necessity
Self rising portable smart seat Letter of Medical Necessity
Semi auto-injector Detailed receipt
Service animals Detailed receipt
Sexual dysfunction Letter of Medical Necessity
Sharps containers Detailed receipt
Shipping and handling fees (for healthcare related expenses) Detailed receipt
Shoe cushions Detailed receipt
Shoe inserts Detailed receipt
Shoe insoles Detailed receipt
Shower
Shower chairs Letter of Medical Necessity
Sink fixtures
Sinks
Sinus medications Detailed receipt
Siren detector (car modification) Letter of Medical Necessity
Sitz baths Detailed receipt
Skin sanitizing wipes Detailed receipt
Skin tag removal Letter of Medical Necessity
Sleep aids Detailed receipt
Sleep apnea services Detailed receipt
Sleep deprivation treatments Detailed receipt
Sleep studies Detailed receipt
Sleep study Detailed receipt
Smart home upgrades
Smoke detector systems
Smoking cessation drugs (prescription) Prescription
Smoking cessation gum (over-the-counter) Detailed receipt
Smoking cessation patches (over-the-counter) Detailed receipt
Smoking cessation programs Detailed receipt
Snore guards Letter of Medical Necessity
Snow blowers
Somnoplasty Detailed receipt
Spas
Speaker phone
Special equipment (related to healthcare expenses) Letter of Medical Necessity
Special food diet
Special home for mental disabilities Letter of Medical Necessity
Speech therapy Detailed receipt
Spermicide Detailed receipt
Splint Detailed receipt
Stairway modifications
Steamer or inhaler - hand held Letter of Medical Necessity
Steering column extension (car modification) Letter of Medical Necessity
Steering cuff (car modification) Letter of Medical Necessity
Steering knobs (car modification) Letter of Medical Necessity
Sterilization procedures Detailed receipt
Stethoscope Detailed receipt
Stretch mat Letter of Medical Necessity
Structural integration Letter of Medical Necessity
Student health plan premiums
Sublingual allergy drops Letter of Medical Necessity
Sun protective clothing
Sunburn treatments Detailed receipt
Sunglass clips
Sunglasses (non-prescription)
Sunglasses (prescription) Detailed receipt
Sunscreens Detailed receipt
Supplements
Support hose Detailed receipt
Support stockings Detailed receipt
Suppositories Detailed receipt
Surcharges Detailed receipt
Surgery (for non-cosmetic purposes) Detailed receipt
Surgical procedures (for non-cosmetic purposes) Detailed receipt
Surrogate carrier
Surrogate expenses
Swimming lessons
Swimming pool maintenance
Swimming pools
Syntonic phototherapy Letter of Medical Necessity
TENS units and supplies Detailed receipt
Tampons Detailed receipt
Tanning salons and equipment
Tape recorders visually impaired Letter of Medical Necessity
Taxes on healthcare services and products Detailed receipt
Teeth bonding Letter of Medical Necessity
Teeth grinding prevention devices Detailed receipt
Teeth whitening
Teething gels Detailed receipt
Telephone
Telephone consultation fees with a licensed provider Detailed receipt
Telephones for hearing impaired Detailed receipt
Television
Temporary dental procedures Detailed receipt
Testosterone hormones Prescription
Therapeutic horseback riding (equine-assisted therapy) Letter of Medical Necessity
Therapeutic listening Detailed receipt
Thermography Detailed receipt
Thermometer Detailed receipt
Throat lozenges Detailed receipt
Tips/gratuities
Toe caps and finger caps Detailed receipt
Toilet accessories Letter of Medical Necessity
Toilet safety bars Letter of Medical Necessity
Toilet safety frames Letter of Medical Necessity
Toilet safety rails Letter of Medical Necessity
Toilet seat risers Letter of Medical Necessity
Toiletries
Toilets
Tonometer Letter of Medical Necessity
Toothache and teething pain relievers Detailed receipt
Toothbrush
Toothpaste
Topical analgesics Detailed receipt
Topical steroids Detailed receipt
Tracking device Letter of Medical Necessity
Transfer boards (car modification) Letter of Medical Necessity
Transplants Detailed receipt
Transportation and parking (for related eligible expenses) Detailed receipt
Transportation fares (taxi, rental car, bus, etc.) Detailed receipt
Travel expenses Letter of Medical Necessity
Tri-pins, three-pronged grip (car modification) Letter of Medical Necessity
Tubal ligation Detailed receipt
Tubal ligation reversal Detailed receipt
Tumor removal Detailed receipt
Typewriter for the visually impaired Letter of Medical Necessity
UV protection clothing
Ultra violet ray (UVR) treatments Letter of Medical Necessity
Ultrasound Detailed receipt
Umbilical cord freezing Letter of Medical Necessity
Umbilical cord storage Letter of Medical Necessity
Underwear
Underwear, disposable or non-disposable (menstrual care) Detailed receipt
Urinalysis Detailed receipt
Usual, customary, and reasonable (UCR) fees Detailed receipt
V-grips (car modification) Letter of Medical Necessity
Vaccinations Detailed receipt
Vacuum cleaners
Vaginal laser therapy Letter of Medical Necessity
Vaginal rejuvenation
Vaporizers Detailed receipt
Varicose vein surgery Letter of Medical Necessity
Vasectomy Detailed receipt
Vasectomy reversal Detailed receipt
Vibration therapy Letter of Medical Necessity
Violence prevention classes Letter of Medical Necessity
Virtual visits Detailed receipt
Vision care Detailed receipt
Vision correction procedures Detailed receipt
Vision discount programs
Vision masks (non-prescription)
Vision masks (prescription) Detailed receipt
Vision products (over-the-counter) Detailed receipt
Vision training Letter of Medical Necessity
Visual alert system for hearing impaired Letter of Medical Necessity
Vitamins
Walkers Detailed receipt
Warning system modifications
Warranties
Wart removal (freezing products) Detailed receipt
Wart removal (medicated bandages and gels) Detailed receipt
Water pick flossers Letter of Medical Necessity
Waterproofing of cast Detailed receipt
Weight loss counseling Letter of Medical Necessity
Weight loss foods
Weight loss medication Detailed receipt
Weight loss programs Letter of Medical Necessity
Weight scales Letter of Medical Necessity
Well-child visits Detailed receipt
Wheelchair carriers (car modification) Letter of Medical Necessity
Wheelchair lifts
Wheelchair ramps Detailed receipt
Wheelchair replacement parts Detailed receipt
Wheelchair tie downs (car modification) Letter of Medical Necessity
Wheelchairs Detailed receipt
Wheelchairs (car modification) Letter of Medical Necessity
Wigs Letter of Medical Necessity
Window air conditioners
Window controls (car modification) Letter of Medical Necessity
Wobble chairs
Work-related physical exams for employee Detailed receipt
Wrist supports Detailed receipt
X-rays Detailed receipt
YAG laser treatment Letter of Medical Necessity
Yeast infection medications Detailed receipt
Yoga