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Eligible Expenses (Limited Purpose FSA)

You can use your account to pay for a variety of dental and vision care products and services for you, your spouse, and your dependents. The IRS determines which expenses are eligible for reimbursement.

Keep Your Receipts

A good rule of thumb is to keep receipts and other supporting documentation related to your expenses and reimbursement requests. The IRS may request itemized receipts to verify select expenses. Credit card receipts, canceled checks, and balance forward statements do not meet the requirements for acceptable documentation.

Eligible Expenses

  • Braille books and magazines (difference in cost only)
  • Co-insurance (dental)
  • Co-insurance (vision)
  • Contact lenses and solutions
  • Copayment (dental)
  • Copayment (vision)
  • Corneal keratotomy
  • Deductible for dental plan
  • Deductible for vision plan
  • Dental care (for non-cosmetic purposes, including sealants)
  • Dental reconstruction (including implants)
  • Dental veneers
  • Dental, oral, and teething pain products (over-the-counter)
  • Dentures, bridges, etc.
  • Diagnostic services (dental or vision)
  • Eye drops and treatments (over-the-counter)
  • Eye examinations
  • Eye related equipment/materials
  • Eye surgery or treatment to correct vision
  • Eyeglasses (prescription)
  • Guide dog (dog, training, care)
  • Laser eye surgery
  • Lasik
  • Occlusal guards to prevent teeth grinding
  • Office visits (dental)
  • Office visits (vision)
  • Operations (for vision and dental only)
  • Optometrist/ophthalmologist fees
  • Ortho keratotomy
  • Orthodontia (braces and retainers)
  • Radial keratotomy (RK)
  • Reading glasses (over-the-counter)
  • Sales tax, shipping and handling fees (for any eligible expense)
  • Student health fees for dental services (billed for actual services received)
  • Student health fees for vision services (billed for actual services received)
  • Sunglasses (over-the-counter)
  • Sunglasses (prescription)
  • Teeth bleaching or whitening
  • Toothpaste, medicated (difference in cost only of medicated toothpaste over the standard toothpaste)
  • Toothpaste, toothbrush, floss, etc.
  • Transportation, parking and related travel expenses (essential to receive eligible care)
  • Vision care
  • Vision products (over-the-counter)
  • X-ray fees (dental)