Fsa expense guide_102903.doc

LIST OF ELIGIBLE FSA EXPENSES

This guide will provide a quick reference on Flexible Spending Account (FSA) questions. However, this listing is
solely provided as a guide for eligible expenses and is not intended to apply to all plans; each client's plan may
vary and therefore must be consulted. The terms of a particular plan govern any and all decisions regardless of
the information contained in this Guide.
This listing is not intended to be exhaustive.
This eligibility list is based on InfiSoft's understanding of the IRS rules and regulations pertaining to FSA
administration and is not intended to be legal advice. No liability, expressed or implied, is assumed by InfiSoft for
reliance upon this eligibility list for tax-exempt determination of specific health care or dependent cares expenses.
It is recommended that customers consult their own tax professional.
New: Over-the -Counter Drugs

Non-prescription antacids, allergy medicines, pain relievers, and cold medicines purchased to alleviate or treat the
personal injuries or illness of employees and their dependents are eligible for reimbursement through a Health
Care Flexible Spending Account. Vitamins and other dietary/nutritional supplements that are merely beneficial to
one’s general health remain ineligible for reimbursement. The IRS ruling does not affect existing FSA rules,
meaning your eligible expenses must still be incurred during your period of coverage and must not be
reimbursable through another plan. Over-the-counter items continue to be non-deductible for income tax
purposes and you will not be permitted to change your election during the current Plan Year as a result of the new
ruling.

Please refer to page 11 for a more detailed listing of eligible OTC expenses.

Eligibility Listing for Health Care Spending Account

General Information:

Eligible health care expenses are expenses incurred for medical care. Medical care expenses include
amounts paid for the diagnosis, care, mitigation, treatment, or prevention of disease or illness and for
treatments affecting any part or function of the body.
Generally, with the exception of expenses for cosmetic procedures and health insurance premiums,
any health care expenses which are deductible under the Internal Revenue Code and not covered by
insurance or any other source that provides benefits, are eligible for reimbursement through the Health
Care Spending Account. Eligible expenses may have been incurred for you, your spouse, children, and
any other person who is a qualified dependent under the Internal Revenue Code.
Any expense recommended for the bettering of general health is not eligible (example: health
fitness club).
Examples of eligible health care expenses include:
•
Medical and dental deductibles and co-payments Routine physical exams - comprehensive, limited, brief, or any other exam without a diagnosis Birth control items prescribed by your doctor Expenses in excess of medical, dental and vision plan limits MEDICAL EXPENSES
A doctor's prescription is generally not required to accompany the reimbursement request. However, in certain
instances, a doctor’s statement/prescription may be required or requested in order to determine if an expense is
eligible for reimbursement.
Acupuncture services are an eligible medical expense. Not eligible. However, medical expenses incurred by an adopted child who is
claimed as a dependent are eligible. Care must be for the adopted child and
incurred while the child qualifies as your dependent. Th e child's medical care
expenses are eligible during the adoption process as long as the child qualifies
as your dependent.
Payment to a treatment center for alcohol or substance abuse is an eligible medical expense. This includes meals and lodging provided by the center during inpatient medical treatment (i.e., mental, nervous or addictive treatments). The following are considered eligible medical expenses. Note: In the case that these expenses increase the value of the property, only the portion of the expense that exceeds the increase is eligible. For “special” purchase items, only the portion of the cost that exceeds the price of a “regular” item is allowable. For example, your doctor has recommended a special furnace filter that traps allergens and costs $12 more than a regular filter. You can only be reimbursed for the $12 cost difference. Humidifier (when the person suffers from allergies) Home/automobile air conditioners (when the person suffers from allergies) Special vacuum cleaners for persons with respiratory problems Pillows, mattress covers, etc. to alleviate an allergic condition Prescription and over-the-counter allergy medicines Expenses must be accompanied by a doctor's certification indicating the specific medical disorder, the specific treatment needed, and how this treatment will alleviate the medical condition. The amount paid for ambulance service is an eligible medical expense. The amount paid for artificial limbs/teeth is an eligible medical expense. The following expenses are considered eligible medical expenses: Sperm banks-semen storage for artificial insemination Egg donor - charges for recipient, as long as the recipient is the participant or participant’s dependent and the charges are not covered by any medical plan BIRTH CONTROL RELATED: The amount paid for birth control items prescribed by your doctor is an eligible Condoms and other devices are eligible when prescribed by doctor. Spermicides are eligible when prescribed by doctor. Eligible Birth Control Pills: (This list is not exhaustive.) Fees for storing blood for an upcoming surgery are considered eligible medical expenses. Storage for general use is not eligible. The part of the cost of Braille books and magazines that is more than the price for regular books and magazines is an eligible expense. Amounts paid for special equipment or improvements in your home, if primarily motivated by medical considerations, are eligible medical expenses. The amount paid for the improvements that increase the value of the property may be partly eligible as medical expenses. The amount paid for the improvement is reduced by the increase in the value of the property. The rest is the eligible medical expense. If the value of the property is not increased by the improvement, the entire cost is an eligible expense. Certain capital expenses made for the primary purpose of accommodating a personal residence to one's handicapped condition, that do not increase the value of a personal residence, may generally be included in full as medical expenses. Constructing entrance or exit ramps to your residence. Widening doorways at entrances or exits to your residence. Widening or otherwise modifying hallways and interior doorways. Installing railing, support bars, or other modifications to bathrooms. Lowering or making other modifications to kitchen cabinets and equipment. Altering the location of or modifying electrical outlets and fixtures. Installing porch lifts and other forms of lifts. Generally, this does not include elevators, because they may add to the fair market value of your residence, and any medical expense therefore would have to be decreased to that extent. Modifying fire alarms, smoke detectors, and other warning systems. Adding handrails or grab bars whether or not in bathrooms. Modifying areas in front entrance and exit doorways. Grading of ground to provide access to the residence. This list is not exhaustive. If expenses are incurred similar to those listed above to adapt a personal residence to one's handicapped condition, or to the handicapped condition of one's spouse or dependents, the full expenses are eligible as medical expenses provided the expenses do not increase the fair market value of the residence. Only reasonable costs incurred to accommodate a personal residence to the handicapped condition are considered to be incurred for the purpose of medical care or are directly related to medical care for these purposes. Additional costs attributable to personal motivations, such as for architectural or aesthetic reasons, are not allowable as eligible medical expenses. Operation and Upkeep. If a capital expense qualifies as an eligible medical expense, amounts paid for operation and upkeep also qualify as eligible medical expenses as long as the medical reason for the capital expense still exists. This is so even if none or only part of the original capital expense qualified as a medical care expense. Examples would be cost of fuel to operate, cost of repairs, and cleaning costs. Improvements to property rented by a handicapped person: Amounts paid by a handicapped person to buy and install special plumbing fixtures, mainly for medical reasons, in a rented house may qualify as eligible medical expenses. Special Equipment: The amount paid for the cost of special hand controls and other special equipment installed in a car for the use of a handicapped person is an eligible medical expense. Special Design: The amount by which the cost of a car specially designed to hold a wheelchair is more than the cost of a regular car is an eligible medical expense. Cost Of Operation: The cost of operating a specially equipped car, except as discussed under Transportation, is not an eligible medical expense. The costs of childbirth prep classes, Lamaze classes, and breast pumps are Fees paid to a chiropractor for medical care are eligible medical expenses. • Bedboards recommended by physician, back supports are also eligible. Fees paid to Christian Science practitioners are eligible medical expenses. Fees paid to an eligible provider are eligible medical expenses. Charges for
“ritual” circumcision performed by an ineligible provider (Rabbi) are not eligible.
Cosmetic surgery/procedure expenses can only be reimbursed from a health FSA when surgery/procedures are necessary to improve a deformity that arises from or is directly related to a birth defect, a disfiguring disease or an injury resulting from an accident or trauma. A cosmetic surgery/procedure is any surgery/procedure that is directed at improving the patient's appearance and does not meaningfully promote the proper function of the body or prevent or alleviate an illness or disease. See Hair Transplant and/or Electrolysis. Special bras for mastectomy patients - eligible Cosmetics (make-up) are not an eligible expense. Porcelain veneers (if rejected by the dental carrier), bonding, tooth whitening, and facelifts are generally not eligible. Tattooing and ear piercing are not eligible. Expenses must be accompanied by a doctor's certification indicating the specific medical disorder, the specific treatment needed, and how this treatment will alleviate the medical condition. Counseling must be performed to alleviate or prevent a physical or mental defect or illness. Eligibility is determined by the nature of the treatment and not the license of the practitioner. Psychotherapy, psychoanalysis - eligible. Marriage counseling - not eligible unless performed for the purpose of alleviating or preventing a physical or mental defect or illness. Sex therapy - cost of therapy is eligible, but cost of hotel room prescribed by therapist is not eligible. Non-licensed therapist – must be for medical care. Bereavement and grief counseling - eligible. The amount paid to buy or rent crutches is an eligible medical expense. (Also: canes, walkers, medical equipment.) See Medical Supplies. The cost of dancing lessons, swimming lessons, etc., even if a doctor recommends them for the general improvement of one's health, is not an eligible medical expense. Hydrotherapy is eligible if prescribed by a doctor. The cost of diabetic supplies is eligible for reimbursement. The amount paid to entitle a person to receive dental care from a dental maintenance organization is not an eligible expense. See Insurance policies and The amounts paid for dental treatment such as x-rays, fillings, braces, extractions, and dentures are eligible expenses. Services which may be deemed cosmetic such as teeth bleaching, bonding, porcelain veneers (unless allowed by the dental carrier) or whitening are not eligible for reimbursement. Bonding and sealants for dentures are eligible. See Cosmetic Surgery. Diapers (e.g., Depends) for a handicapped or disabled child or adult may be eligible. Ø Expenses must be accompanied by a doctor’s certification indicating the specific medical disorder, the specific treatment needed, and how this treatment will alleviate the medical condition. Fees paid to doctors are eligible medical expenses. This includes, but is not limited to, fees for: A physical without diagnosis or not covered by insurance – eligible. Any expense a doctor may charge to write a letter of medical necessity. Late fees, finance fees, etc. - not eligible.
See Prescription Drugs and Over-the-Counter Drugs. The amount paid for hair removal through electrolysis is generally considered cosmetic and is not an eligible medical expense unless deemed medically necessary. See Cosmetic Surgery/Procedures. The amount paid for eyeglasses and contact lenses needed for medical reasons is an eligible medical expense. This includes fees paid for the following: Contact lens fee, contact lens replacement, contact lens maintenance fee. Reading glasses, prescription sports goggles, scuba masks, or safety glasses. Medical necessity may be required. Radial Keratotomy or other laser eye surgery is eligible if done primarily to promote the correct function of the eye. “Clip ons” are eligible if in lieu of prescription sunglasses. Non-prescription sunglasses are not an eligible medical expense. Meals are only eligible if they are included as part of inpatient hospital care. Nutritional supplements (such as vitamins, herbal supplements, and natural medicines) may be eligible, but a doctor’s statement is required. For more information, please see Over-The-Counter Drugs and Other Medical Supplies. Bereavement counseling – see Counseling. Surgical hair transplants are not an eligible expense unless deemed medically necessary because of trauma, injury, or disease. See Cosmetic Surgery/Procedures. Expenses must be accompanied by a doctor's certification indicating the specific medical disorder, the specific treatment needed, and how this treatment will alleviate the medical condition. Cassette books for a visually handicapped person may be included. The difference in cost between the recorded book and the typewritten book is considered an eligible medical expense. Amounts paid for health club dues or steam baths for your general health or to relieve physical or mental discomfort not related to a particular medical condition are not eligible medical expenses. However, whirlpools are eligible expenses if prescribed by a doctor. Expenses must be accompanied by a doctor's certification indicating the specific medical disorder, the specific treatment needed, and how this treatment will alleviate the medical condition. An individual may deduct expenses incurred for the medical care of him/herself, his/her spouse, and his/her dependents. There is no exclusion of providers located in other countries, as long as the claimants are eligible dependents (claim on tax return) and the treatment involves medical care which could be legally provided within the United States (for example, obtaining laetrile treatments in Mexico is not an eligible expense because laetrile cannot be legally obtained in the U.S.). The cost of a public health screening (i.e., VDRL, cholesterol, diabetes glucose, blood pressure, etc.) is eligible. The cost of a hearing aid and the batteries needed to operate the aid are eligible medical expenses. Television adapter for the deaf, lip reading lessons, hearing exams are eligible. The amount to entitle one to receive medical care from a health maintenance organization is not an eligible medical expense. These amounts are treated as medical insurance premiums. See Insurance Policies and Plans. Amounts paid for hospital services are eligible medical expenses. The cost of household help, even if recommended by your doctor, is not eligible as a medical expense. Certain expenses paid to an attendant providing nursing type service may be eligible. See Nursing. The cost of hypnosis is an eligible expense. Expenses must be accompanied by a doctor’s certification indicating the specific medical disorder, the specific treatment needed, and how this treatment will alleviate the medical condition. Insurance premiums that are paid for projected medical expenses (including Dental or Vision) are not eligible expenses, although they may be claimed on tax forms. Federal voluntary Healthcare parts A & B, its deductibles, and life insurance are not eligible. Disability insurance premiums are not eligible. • See HMO/DMO-Health/Dental Maintenance Organizations. The amounts paid for laboratory fees that are part of your medical care are eligible medical expenses. Example: blood tests, cardiographs, metabolism test, stool exams, spinal test, urinalysis, x-ray exams, pap smears, cholesterol tests, thyroid profile, and storage fees for blood taken for future surgery. Laboratory handling fees are eligible. REMOVAL: The cost of removing lead-based paints from surfaces in your home to prevent a dependent who has or had lead poisoning from eating the paint is eligible. These surfaces must be in poor repair (peeling or cracking) or within the dependent's reach. The cost of repainting the scraped area is not an eligible medical expense. If, instead of removing the paint, you cover the area with wallboard or paneling, you would treat these items as capital expenses. Do not include the cost of painting the wallboard as a medical expense. • Radon mitigation is an eligible expense. Eligible medical expenses include tuition fees you pay to a special school for a dependent who has learning disabilities caused by a mental or physical handicap, including nervous system disorders. Your doctor must recommend that the dependent with the specific medical condition or disability attend the school. Tutoring fees you pay, on your doctor's certification, for the dependent's tutoring by a teacher who is specially trained and qualified to work with people who have severe learning disabilities, is an eligible expense. Example: Remedial reading for a dependent suffering from dyslexia. Speech therapy to improve reading disabilities - eligible. Expenses must be accompanied by a doctor's certification indicating the specific medical disorder, the specific treatment needed, and how this treatment will alleviate the medical condition. Legal fees paid to authorize treatment for mental illness are eligible. However, if part of the legal fees include, for example, guardianship or estate management fees, you may not include that part in medical expenses. Eligible medical expenses may include the cost of meals and lodging at a hospital or similar institution, if the main reason for being there is to receive medical care. See Nursing home. The cost of lodging (not provided in a hospital or similar institution) while away from home is an eligible medical expense if: The lodging is primarily for and essential to medical care. Medical care is provided by a doctor in a licensed hospital or in a medical care facility related to, or the equivalent of, a licensed hospital. The lodging is not lavish or extravagant under the circumstances. There is no significant element of personal pleasure, recreation or vacation in the travel away from home. The amount you include in medical expenses may not exceed $50.00 for
each night for each person. Lodging is included for a person for whom
transportation expenses are a medical expense because that person is
traveling with the person receiving the medical care. For example: a
parent traveling with a sick child is allowed up to $100.00 per night as a
medical expense for lodging. Meals are not an eligible expense.
Air conditioners, central air, heaters, humidifiers, air purifiers, which are home installations for the purpose of relieving an allergy or difficulty in breathing due to a medical condition are eligible. The maintenance cost for operating the devices, e.g., electricity for air conditioner use, is also an eligible medical expense as long as the medical reason for the device continues to exist. Also, the maintenance cost for a home swimming pool for a person suffering from emphysema can be considered an eligible expense. An appraisal of the property value before and after installation is required with submission. Only the portion of the expense that exceeds the increase in property value is eligible as a medical expense. Cost difference between regular filter and special air filters for furnace - eligible. Expenses must be accompanied by a doctor's certification indicating the specific medical disorder, the specific treatment needed, and how this treatment will alleviate the medical condition. Amounts paid for marijuana, even if prescribed by a physician, are not eligible for reimbursement. Clothes are not an eligible expense. The cost of childbirth prep classes, Lamaze classes and breast pumps are eligible expenses. Maternity girdle for back pain is an eligible expense. • Amounts paid to a plan that keeps medical plan information by computer and that can give the information when needed are eligible medical expenses (e.g., a national information bank that holds medical information on computer). Charges to transfer records due to a change in physicians are eligible. See Transplants. Expenses paid for medical supplies used to aid a person suffering from a physical defect/illness are eligible. This includes but is not limited to the following: Rental of medical healing equipment-wheelchairs, crutches, canes, walkers, etc. Diabetic supplies (including Diabetic training classes). Orthopedic shoes – only the cost difference between regular and orthopedic shoes The following expenses must be accompanied by a doctor's certification indicating the specific medical disorder, the specific treatment needed, and how this treatment will alleviate the medical condition. difference between regular and special mattress The cost of keeping a mentally handicapped person in a special home, not the home of a relative, on the recommendation of a psychiatrist to help the person adjust from life in a mental hospital to community living is an eligible medical expense. The cost of medical care, including meals and lodging in a nursing home or home for the aged, rest home or sanitarium, if the primary reason for being there is to get medical care, is an eligible medical expense. See Lodging. Eligible medical expenses may include wages and other amounts paid for nursing services. Services need not be performed by a nurse as long as the services are of a kind generally performed by a nurse. This includes services connected with caring for the patient's dressings, as well as bathing and grooming the patient. Only medical care services are eligible. Household services and personal care unrelated to medical care and not covered under your medical plan is not eligible. Extra rent or utilities expense for a large apartment with enough space (extra bedroom) for a nurse or private attendant is eligible. Over-the-counter drugs, intended for medical use only and not merely beneficial to the participant, are eligible expenses. An itemized receipt showing name of drug, date purchased and purchase price is required with claim. Examples of eligible OTC items • Antacids, anti-gas, laxatives, stomach and intestinal medicines • Allergy and asthma medicines, nasal sinus sprays • Pain relievers – topical creams and oral medicines • Cough drops, throat lozenges, cough syrup, cold medicines, flu relief • Nicotine gum or patches (for stop-smoking purposes) • Special ointment or cream specifically for burns • Antibiotic cream, cortisone cream, first aid spray, calamine lotion, bug-bite • Allergy eye drops, contact lens cleaning solution • Suppositories and cream for hemorrhoids • Bandages, first aid kits, cold/hot packs for injuries, rubbing alcohol Toiletries, cosmetics, and sundry items are not eligible for reimbursement Examples of ineligible OTC items • Toothpaste, toothbrushes, dental floss • Face cream, moisturizers, suntan lotion • Dietary supplements not considered a medical necessity Some dietary supplements or other personal items are “dual-purpose” items which may be merely beneficial to one’s general health or which may be used to treat a medical condition. The following is a partial listing of expenses which must accompanied by a doctor’s certification indicating the specific medical condition, the specific treatment needed, and how this treatment will alleviate the medical condition. Examples of dual-purpose items: • Weight-loss drugs to treat a diagnosed disease (i.e. obesity) • Feminine hygiene products (i.e. for use after surgery, child birth) • Sunscreen (i.e. persons diagnosed with skin cancer) • Joint supplements for diagnosed joint condition (i.e. Arthritis) • Dietary supplements to treat a specific medical condition (i.e. Vitamin C • Fiber supplements to treat a specific medical condition for a limited time • Sleeping pills Amounts paid for oxygen or oxygen equipment to relieve breathing problems caused by a medical condition are eligible medical expenses. Eligible if impotence is due to such organic causes as trauma, post-prostatectomy or diabetes. Expenses must be accompanied by a doctor's certification indicating the specific medical disorder, the specific treatment needed, and how this treatment will alleviate the medical condition. You may include in medical expenses an item ordinarily used for personal living, and family purposes only if it is used primarily to prevent or alleviate a disease or disability. Wigs - If recommended by a physician for the mental health of a person who has lost his/her hair due to a disease Hospital–Telephone, TV, newspapers, etc., are not eligible. Sanitary napkins, feminine hygiene products are not eligible. Amounts paid for medicines and drugs are eligible expenses if they legally
require a prescription by a doctor for its use by an individual. .
Amounts paid for psychiatric care are eligible medical expenses. Eligible expenses include the cost of supporting a mentally ill dependent at a specially equipped medical center where the dependent receives medical care. See Counseling. Amounts paid for psychoanalysis are eligible expenses. Payment for psychoanalysis that is part of a person's training to be a psychoanalyst is not an eligible expense. See Counseling. Amounts paid to a psychologist for medical care are eligible expenses. See Counseling. Cost for sales tax, shipping or handling fees associated with a reimbursable expense is eligible. Payments to a school for a mentally impaired or physically disabled person are eligible expenses if the reason for using the school is its resources for relieving the disability. For example, the cost of a school that teaches Braille to the visually impaired, lip reading to the hearing impaired, or gives remedial language training to correct a condition caused by a birth defect is an eligible expense. The cost of meals, lodging, and education supplied by a school or institution is eligible as a medical expense only if the reason for the patient being on-site is the resources the school has for relieving the mental or physical disability. The cost of sending a problem dependent to a school for benefits the dependent may get from the course of study and disciplinary methods is not an eligible expense. The cost of a boarding school while recuperating from an illness is not an eligible expense. The cost of a service animal for the blind or deaf is an eligible medical expense. Amounts paid for the care of the service animal are also eligible medical expenses. The cost difference between a regular smoke detector and a smoke detector for the hearing impaired is considered an eligible expense. Eligible if rendered for developmental delay or is restoratory or rehabilatory in nature. The cost of legal sterilization is an eligible medical expense. Amounts paid for legal operations/surgery that are not cosmetic in nature are eligible medical expenses. See Cosmetic Surgery. SCIENTOLOGY, CHURCH of: Fees are not eligible due to the fact that no actual medical care is involved. The cost of using a tanning bed for the treatment of psoriasis is an eligible medical expense. Expenses must be accompanied by a doctor's certification indicating the specific medical disorder, the specific treatment needed, and how this treatment will alleviate the medical condition. The cost and repair of special telephone equipment that allows a deaf person to communicate over a regular telephone is an eligible medical. Eligible medical expenses may include the cost of equipment that displays the audible parts of television programs as subtitles for the deaf. This may be the cost of an adapter that attaches to a regular set. It also may be the excess cost of specially equipped television over the cost of the same model regular television et. Therapy received as medical or mental treatment is an eligible expense. 'Patterning' Exercises–Payments made to an individual for giving 'patterning' exercises to a mentally handicapped dependent are eligible. These exercises consist of physical manipulation of the dependent's arms and legs to imitate crawling and other normal movements. Massage prescribed by physician for specific disorder is eligible. Expenses for massage or hydrotherapy must be accompanied by a
doctor's certification indicating the specific medical disorder, the specific
treatment needed, and how this treatment will alleviate the medical
condition.
You may include in medical expenses payments for surgical, hospital, laboratory and transportation expenses for a donor or a possible donor of a kidney or other organ (heart, eye, etc.). Cost to transfer medical records in order to find organ donors is eligible. Amounts paid for transportation primarily for and essential to medical care qualify as medical expenses. An individual may be reimbursed 14¢ per mile or actual car expenses when traveling in his/her own vehicle to visit a licensed practitioner for medical reasons. (Mileage documentation is not required as long as the mileage and dates of service are provided.) The cost of tolls and parking can be added to this amount. Trips to pharmacy to pick up prescriptions and/or medical supplies. Bus, taxi, train, plane fare, or ambulance service. Actual car expenses, such as gas and oil. Do not include expenses for general repair, maintenance, depreciation, and insurance. Parking fees and tolls (receipt required). Cost of transportation for parents if accompanying a child who needs medical care. Transportation expenses of a nurse or other person who can give injections, medications, or other treatment required by a patient who is traveling to get medical care and is unable to travel alone. Transportation expenses for regular visits to see a mentally ill dependent, if these visits are recommended as part of treatment. Transportation to Alcoholics Anonymous meetings. Transportation expenses to and from work, even if the condition requires an unusual means of transportation. Transportation expenses if for non-medical reasons only, travel is to another city such as a resort area, for an operation or other medical care prescribed by a doctor. Transportation of disabled to and from work is not eligible. A trip or vacation taken for a change in environment, improvement of morale, or
general improvement of health, even if made on the advice of a doctor is not an
eligible medical expense. Child care fees while at doctor's office are not eligible.
Trips to doctor, dentist are eligible. See Transportation.
Expenses for medical care, for services that are actually incurred, that are included in the tuition fee of a college or private school are eligible medical expenses if the charges are separately stated on the bill or given by the school. Tuition fees paid to a private school as a personal preference over public schooling for general education are not an eligible expense. See Learning Disability and Schools, Special. See Over-The-Counter Drugs and Other Medical Supplies. Expenses for a water bed used in the aid of a special ailment and not for general well-being are eligible. Expenses must be accompanied by a doctor's certification indicating the specific medical disorder, the specific treatment needed, and how this treatment will alleviate the medical condition. These are eligible as a medical expense if prescribed by a doctor. Expenses must be accompanied by a doctor's certification indicating the specific medical disorder, the specific treatment needed, and how this treatment will alleviate the medical condition. The cost of a weight-loss program, to improve your general health, is not an
eligible medical expense. The weight-loss program must treat a medical
condition (e.g., obesity, hypertension).
•
The cost of food is not an eligible expense. Expenses must be accompanied by a doctor's certification indicating a specific medical disorder that requires a weight-loss program, specific treatment needed and how treatment will alleviate the medical condition. Amounts paid for an autoette or a manual or motorized wheelchair used mainly for the relief of sickness or disability is an eligible medical expense. The cost of operating and keeping up the autoette or wheelchair is also an eligible medical expense. See Medical Supplies. Amounts paid for x-rays for medical reasons are eligible medical expenses. Medical and dental x-rays are eligible.
Dependent Day Care Spending Account
Most work-related expenses incurred during the plan year for the care of a qualified person will qualify for non-taxable reimbursement through the Dependent Day Care Spending Account. Your child/dependent care expense must be incurred to allow you and your spouse, if married, to work or look for work. See exception for student-spouse or spouse not able to care for self. You must have made payments for child/dependent care to someone you or your spouse could not claim as a dependent and if the person you made payments to was your child, he/she must have been 19 or older by the end of the year. Provider information: To identify the care provider, you must provide the provider's: a) Name, b) Address, and c) Taxpayer Identification Number or Social Security Number. Only work-related expenses qualify for dependent care
reimbursement. Your expenses must have been for the well-being and
protection of a qualifying person. Expenses are considered work-related
only if they allowed you and your spouse, if married, to work or look for
work and they are for a qualifying person's care. For example, the cost
of a baby-sitter while you and your spouse go out to eat is not a
work -related expense.
Generally, if you are married, both you and your spouse must work. In certain cases, however, your spouse does not have to work. (See Work Requirements.) Expenses for the care of a qualifying person. Your work can be for others, full-time or part-time, or in your own business or partnership. Work may include actively looking for work. Unpaid volunteer or volunteer work for a nominal salary does not qualify. Both you and your spouse, if married, must work unless your spouse is a full-time student or disabled. Your spouse is considered to have worked if for any month he or she was: 1) A full-time student, or 2) Physically or mentally unable to care for self. Note: A full time student is one who is enrolled at a school during at
least some part of each of five calendar months of the calendar year, not
necessarily consecutive, for the number of hours considered to be a full
time course of study. A student who attends school only at night is not a
full time student. However, a full time student can attend some night
classes.
Payments to relatives. Considered work-related payments you made
to relatives who are not your dependents, even if they live in your home.
However, do not consider any payments you made to:
A dependent for whom you or your spouse, if married, can claim as an exemption, or Your child who was under the age of 19 at the end of the year. Expenses you pay for household services done in and around your home that were necessary to run your home are work-related expenses if they were at least partly for the well-being and protection of a qualifying person. The services of a housekeeper, maid, or cook are usually considered necessary to run your home if performed at least partly for the benefit of the qualifying person. However, do not include payment for services of a chauffeur or gardener. Household services do not include expenses for a qualifying person's: If part of an expense is work-related and part for other purposes, you must allocate the expense. Consider only the part that is work-related. However, you do not have to allocate the expense if the part for the other purpose is small. All of your expenses for housework are work-related even if only a part is for a qualifying person. Example: You pay a housekeeper to care for your 9-year-old and 15-year-old children so you can work. The housekeeper spends most of the time doing regular household work, cleaning and cooking, and spends 30 minutes driving you to and from work. The entire expense of the housekeeper is a work-related expense. You do not have to deduct any amount for being driven to and from work, because the time involved is minimal. You do not have to deduct any amount for the care of the 15-year-old (not a qualifying person) because the household expense is partly for the care of the 9-year-old, who is a qualifying person. The main reason to have expenses for the care of a qualifying person must be for the person's well-being and protection. These expenses do not include amounts you paid for clothing, entertainment, food or schooling. However, if these amounts are incident to and cannot be separated from the cost of caring for a qualified person, you can consider the total cost. For example, if a nursery school or day-care center provides lunch and educational services as a part of its preschool child care service, you can consider the entire cost. Do not consider the cost of schooling in the first grade or higher. You must divide the total cost between the cost of caring for the child and cost of schooling. You can include the cost of care provided outside your home if the care
was for your dependent under age 13 or for any other qualifying person
who regularly spends at least eight hours each day in your household.
Care that is provided outside your home by a dependent/day care center
can be included provided the center (if it serves seven or more children
or adults) complies with all the applicable state and local regulations.
The cost of getting a qualifying person to and from your home and the
care location is not considered a work-related expense. This includes
the cost of buses, subways, taxis, or private car.
Meals and lodging provided for housekeeper. If your housekeeper
ate in your home, add to your work-related expenses the part of your
total food cost that was for the housekeeper. If you have extra expenses
for your housekeeper's lodging, add these expenses to your work-related
expenses. For example, if you moved to an apartment with an extra
bedroom for the housekeeper, add the extra rent and utility expenses for
this bedroom to your work-related expenses.
Taxes paid on wages. If you pay wages for household help, you may
have to pay the employer's portion and withhold the employee's portion
of the Social Security tax (FICA). You also may have to pay federal
unemployment tax (FUTA) and similar state taxes.
FICA/Social Security taxes. FICA/Social Security taxes are eligible
dependent care expenses, as long as the day care provider is the
employee the taxes are being paid on.
Payment to a housekeeper while you are out sick. Do not include as
work -related expenses amounts you pay to a housekeeper for household
and care services while you are off from work.
Your work-related expenses must be for the care of one or more members of your home who are qualifying persons. A qualifying person is: Your dependent under the age of 13 for whom you can claim an exemption Your dependent who was unable to care for himself or herself and for whom you can claim an exemption (or could claim an exemption except the person had a gross income exceeding the exemption amount) Your spouse who is physically or mentally unable to care for himself/herself. Physical or mental incapacity must be disabling. Persons who are not able to dress, clean or feed themselves because of physical or mental problems are considered unable to care for themselves. Persons with mental defects who require constant attention to prevent them from injuring themselves or others are considered unable to care for themselves. The law imposes limits on the amount of non-taxable dependent care reimbursement an individual can receive. An individual cannot be reimbursed for any amount over the lowest limit that applies to his/her situation. The limits are as follows: If the individual is married, both the individual and his/her spouse must earn income, unless the spouse is disabled or a full time student. The amount of expenses that qualify for reimbursement is limited to the income earned by the spouse with the lower earnings. If the spouse is a full time student or disabled, the law assumes that he/she has a monthly income of at least $200 if the individual has one qualified person, or at least $400 if the individual has two or more qualified persons. There is a $5000 limit on the total amount of tax-free dependent care assistance that an individual can receive in any year ($2500 if the individual and his/her spouse file separate tax returns). If the employer of the individual's spouse also has a dependent care assistance plan, the $5000 limit applies to the total amount of tax-free dependent care assistance that the individual and his/her spouse, as a couple, can receive in any year from all employer-sponsored plans. The $5000 limit is not affected by the number of qualified persons an individual has.
Eligible Expense Listing for Dependent Day Care Account

ELIGIBLE EXPENSES:
Day camps, nursery schools, and after-school programs and day care centers are eligible.
All must be expenses that allow you and your spouse (if married) to be gainfully employed.
Gainful employment includes being a full-time student (See General Information). Expenses for
care of a dependent below the first grade are eligible even if education is provided.
Care provided at your home, at a provider's home, or at a dependent care center (providing the
center complies with all applicable state and local regulations and it provides service to seven or
more individuals) is eligible. Care provided outside your home, either in a day care center or at
the provider's home, is eligible only if the care is provided to a dependent under the age of 13
whom you are allowed to claim as an exemption for federal income tax purposes or if the care is
provided to any other qualifying person who regularly spends at least eight hours each day in
your household.
Lodging provided for a housekeeper can be paid when submitted with dependent care charges.
Utilities for provider's lodging when submitted with dependent care charges.
Meals for provider when submitted with dependent care charges.
Taxes paid on wages for household help.
FICA/Social Security taxes as long as the day care provider is the employee whose taxes are
being paid.
Household services needed for well-being and protection of a qualifying individual.
INELIGIBLE EXPENSES:
Dancing lessons, field trips, swimming lessons, diapers, transportation, meals, clothing, and
educational services. Note: If these expenses are part of total bill and cannot be separated, they
are eligible.
Overnight camp.
Baby-sitting school fees paid for a healthy child while parent is recuperating from an illness
(regardless of doctor's advice).
Payment for chauffeur or gardener.
Tuition for schooling.
Placement fees for finding a dependent care provider (i.e., Au Pair).
Payment to a housekeeper while you are out sick.
GENERAL INFORMATION

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Cancelled checks do not represent sufficient documentation of a day care expense. Receipts submitted with a claim form should include the following: - Name and address of provider - Dates of service - Amount of dependent care charge - Tax Identification Number (Social Security Number if no TIN or indicate tax-exempt for tax-exempt provider) - Age of the child (either on the receipt or on the claim form) Foreign nationals are eligible day care providers only if they can demonstrate that they may lawfully work in the United States and have (1) a Social Security Number, (2) an employer identification number (“EIN”), or (3) an individual taxpayer identification number (“ITIN”). Qualifying individual is a person under the age of 13 who can be claimed as a tax exemption or any other dependent who is physically or mentally unable to care for himself/herself. - Unpaid volunteer work or volunteer work for a nominal salary does not qualify. - Full time student: One who is enrolled at a school during at least some part of each of five calendar months of the calendar year, not necessarily consecutive, for the number of hours considered to be a full time course of study. A student who attends school only at night is not a full time student. Future or projected expenses cannot be reimbursed until services have been rendered. A dependent for whom you or your spouse, if married, can claim a tax exemption, or your child who is under the age of 19 as of the end of the year, is not eligible as a dependent care provider even though he/she provided care for another dependent.

Source: http://www.pactadm.net/docs/2005FSAELIGIBLEEXPENSES.pdf