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Eligible Limited FSA Expenses

Expenses reimbursed by a limited health care FSA are limited before you reach your plan's deductible. After you reach your deductible, the limited FSA may work like a traditional health care FSA, depending on your employer's plan. Here's how it works:

Before you meet your health plan's deductible:
Your limited health care FSA funds are available only for certain expenses, including:
• Dental care and orthodontia, such as fillings, X-rays, braces, caps and mouth guards
• Vision care, including eyeglasses, contact lenses, solutions and supplies, and LASIK eye surgery
• Preventive care not covered under your health plan (vaccines, flu shots and diagnostic tests, for example)
Prescriptions and eligible over-the-counter items are reimbursable only for dental, vision and preventive care.

After you meet your health plan's deductible:
You may get reimbursed for all FSA-qualified health care expenses, depending on your employer's plan. That's right. Meet your deductible, and your limited health care FSA may work like a standard health care FSA. See our qualified health care expenses list. Your after-deductible reimbursements may not be limited to dental, vision or preventive care.

All expenses must be qualified medical, vision, pharmacy or dental benefit expenses as defined in Section 213(d) of the Internal Revenue Code.

Effective January 1, 2011 over-the-counter medicines will not be FSA-eligible without a doctor's prescription as a result of Health Care Reform.

Though the information on this page is general, it may be updated without notice. If any information conflicts with your employer's plan documents, your employer's plan documents will govern. Please see your employer's Summary Plan Description for more information about which health care expenses may be reimbursed by your limited health care FSA.

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Limited FSA Pre-Deductible Health Care Expenses
Expense Covered Not Covered IRS Guidelines
Obstetrical care X The cost of an annual obstetrical exam is a qualified preventive care expense.
X The cost of obstetrical care for any other reason is not reimbursable.
Occlusal guard See Mouth guard.
Oncologist X
Operation X
Ophthalmologist X Amounts paid to an ophthalmologist for eye exams and vision care are qualified vision expenses.
X Amounts paid for medical care of the eyes, as provided by an ophthalmologist, are not reimbursable.  
Optometrist X Amounts paid to an optometrist for eye exams and vision care are qualified vision expenses.
X Amounts paid for medical care of the eyes, as provided by an optometrist, are not reimbursable.  
Organ donor X
Orthodontia X The cost of orthodontia care (including braces) is a qualified dental expense.
Orthopedic shoes and inserts X
Orthotics X
Osteopath X
OTC See Medicine, over-the-counter.
Out-of-network provider See Reasonable & Customary.
Over-the-counter See Medicine, over-the-counter.
Ovulation monitor X
Oxygen X

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