Manage Your Flexible Benefits (FSA, HSA, HRA, TSA Resources)

There are thousands of eligible expenses for tax-free purchase with a Health Care Flexible Spending Account (FSA), Health Reimbursement Arrangement (HRA) and Health Savings Account (HSA), including prescriptions, doctor’s office copays, health insurance deductibles, and coinsurance.

The list below outlines medical expenses the IRS typically considers eligible for tax deduction. These expenses can be reimbursed through your health care flexible spending account (FSA), health reimbursement arrangement (HRA) or health savings account (HSA).

To be eligible, medical expenses must be medically necessary. The IRS defines an eligible medical expenses as one incurred primarily to alleviate or prevent physical or mental defect or illness. This includes the costs of equipment, supplies, and diagnostic devices, as well as dental expenses, some insurance premiums and transportation costs. This does not include expenses that are merely beneficial to general health, such as vitamins or a vacation.

*Items marked are "potentially eligible expenses" that require a Note of Medical Necessity from your health care provider to qualify for reimbursement.

*Items marked are "potentially eligible expenses" that require a Note of Medical Necessity from your health care provider to qualify for reimbursement.

• Cosmetic Surgery/Procedures
• Dancing/Exercise/Fitness Programs
• Diaper Service
• Electrolysis
• Personal Trainers
• Health Club Dues*
• Insurance Premiums and Interest
• Long Term Care Premiums (HSA only)
• Marriage Counseling
• Maternity Clothes
• Swimming Lessons
• Teeth Whitening/Bleaching
• Vitamins or Nutritional Supplements

Many over-the-counter (OTC) treatments are also eligible now because the Coronavirus Aid, Relief and Economic Security (CARES) Act removed the requirement for a physician’s prescription or Letter of Medical Necessity for many OTC items.

There are a variety of items that are not generally eligible for reimbursement you should know. Please find a list of Eligible and Ineligible Items here.

The easiest way to purchase eligible items is with your Benefit Access Debit Card. The card is valid where VISA is accepted for payment.

A Medical Determination Form completed by your health care provider listing the diagnosis of your medical condition and the recommendation of the OTC drug is required for reimbursement.

• Anti-baldness / hair loss / hair replacement such as Rogaine—only if to replace hair loss due to a medical condition (e.g., cancer treatment) and not for balding due to age

• Glucosamine / Chondrotin for arthritis or other medical condition—not reimbursable if taken for overall joint health

• Herbal supplements used to treat a specific disease—such as St. John’s Wort for depression

• Retin-A and other acne medicines—not reimbursable if used for cosmetic purposes such as wrinkle reduction

• Vitamins are not an eligible expense, unless prescribed by a physician to treat a specific medical condition—for example, iron to treat, not prevent, anemia; calcium supplements to treat, not prevent, osteoporosis. A doctor’s note detailing the specific medical condition will be required for reimbursement

• Weight loss / dietary supplements—must be for a specific medical condition such as obesity

To be eligible for reimbursement, dependent care expenses must be for an eligible dependent and for care that allows the FSA participant to work or look for work. The expenses listed below are typically considered eligible by the IRS. These expenses can be reimbursed through your dependent care FSA. For a complete listing, see IRS Publication 503 on irs.gov.

Child care provided by a baby sitter, day care facility or before or after school program, as well as summer day camp, are eligible. Extracurricular activities such as dance or piano lessons are not eligible.

Senior care provided by a sitter or a day care facility is eligible if the senior is considered an eligible adult. See Eligible Dependent. Medical care, nursing care and transportation costs are not eligible.

Show more about non-reimbursable dependent care expenses. The following expenses are not reimbursable through a dependent care FSA.

• If married, both you and your spouse must be actively employed. If one spouse is actively employed, the other spouse must be incapable of self-care or a full-time student.
• The funds to be used from your dependent care FSA must not exceed the lesser of your or your spouse's earned income for the plan year.
• Care may be provided in your home or another location but not by someone who is your minor child or dependent for income tax purposes (e.g. an older dependent child).
• If the services are provided by a day care facility that cares for six or more individuals at the same time, the facility must comply with state day care regulations.

Many over-the-counter (OTC) treatments are eligible now because the Coronavirus Aid, Relief and Economic Security (CARES) Act removed the requirement for a physician’s prescription or Letter of Medical Necessity for many OTC items.

Healthcare debit cards cannot be used to purchase OTC drugs and medicines. If a healthcare debit card is used to pay for these items, the transaction will be denied at the point of sale. In this case, you will need to pay for the expense out-of-pocket and submit a claim, along with an NMN or a prescription, to be reimbursed.

The IRS requires that expenses for medical procedures and services, and all OTC drugs be medically necessary in order to be eligible for reimbursement. This means they must be primarily to alleviate or prevent physical or mental defect or illness. Medical Determination Form completed by your health care provider listing the diagnosis of your medical condition and the recommendation of the treatment is required for reimbursement.

Some services or drugs may have dual purpose. For example, a procedure may generally be deemed cosmetic in nature but may also be used to treat a medical condition. In order to show that such a treatment is medically necessary, the IRS requires you submit a note from your provider, or a Medical Determination Form explaining your diagnosis and the recommendation for treatment.

For a list of services and OTC drugs requiring a Medical Determination Form, see the eligible expenses list. If your expense requires a letter for reimbursement, download the Medical Determination Form, have your provider complete the form, and submit it with your claim.

In some cases, prescription drugs and medical services must be prescribed as medically necessary by your health care provider for those items to be reimbursable.

A note from your provider listing the diagnosis of the medical condition and the treatment recommendation, called a Medical Determination Form must be submitted with your claim. Over-the-counter drugs also require a Note of Medical Necessity (NMN) from your provider.

For a more detailed list refer to Internal Revenue Code Section 213(d) on irs.gov.

Nonqualified distributions will be taxed as part of gross income and will incur a 20% penalty. After age 65, the 20% penalty is dropped, though the distribution is still treated as taxable income.

Please refer to our Health Savings Account Education Guide. More about how much I can contribute each year to my HSA. The 2021 maximum annual contribution is $3,600 for single coverage and $7,200 for family coverage. In 2022, those maximum annual contributions will increase to $3,650 for single and $7,300 for family.

Yes. Full year statutory contribution limits are permissible, but the HSA owner must maintain eligibility throughout the "testing period," which runs from the last month of the initial eligibility year through the end of the 12-month period following that month.

In 2019, the maximum annual contributions are $3,500 for single coverage and $7,000 for family coverage.

If HSA owners are not eligible for this entire testing period, they must include in their gross income the contributions made for the months when they were not otherwise qualified. This amount will also be subject to a 10% penalty. The tax and penalty do not apply if the HSA owner is no longer HSA-eligible because of death or disability.

If either spouse has family coverage under a QHDHP, both are treated as having family coverage.

The 2019 maximum statutory contribution limit is $7,000 for family coverage. Whether each spouse opens an individual account or one spouse opens an account, the collective total must not exceed the family maximum.

First, confirm that the retailer can accept FSA cards by reviewing our participating retailer list. To find a retailer who can accept your Benefit Access debit card, review the IIAS Merchant List.

• Please call 866-898-9795.
• The automated system will walk you through the prompt to create your own self-selected PIN for your Benefits Access Card.

No. You can continue to use your Benefits Access Card as you always have—no change required, by simply swiping the card and providing a signature.

No. The PIN is the same for all cards issued to you. If you choose this option, make sure other family members are aware of the PIN. Alternatively, other family members can continue to pay using the signature process.

Yes. Simply let the merchant know that you wish to pay using the signature process (credit) and they will direct you accordingly.

When I swipe my Benefits Access debit card, what options do I have to complete the payment?

No. PINs will only allow you to pay for eligible goods and services as they do today. Cash back and ATM transactions will not be allowed.

Keep in mind, the use of a PIN is not required to access your funds via the Benefits Access Card. You can continue to use your Benefits Access Card as you always have by simply swiping your card and providing a signature.

You may have received a letter asking for a receipt to verify the eligibility of a purchase. We do all we can to automatically verify your debit card transactions, as required by the IRS. However, if we’re unable to, you will receive a letter or email requesting itemized receipts for card transactions. More about why I got a receipt request letter when I used my debit card

We want to help you understand and/or reduce these letters, so here are a few things you should know.

If you are asked to provide a receipt, it must include: merchant or provider name, service received or item purchased, date of service, and amount of the expense. Cancelled checks, handwritten receipts, your debit card transaction receipts or previous balance receipts cannot be used to verify an expense. If you don’t have the receipt, you can contact the provider who can usually supply the receipt from their files.