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HRA Eligible Expenses

The key to making the most of your HRA is knowing about the wide variety of eligible expenses. You can use your HRA funds for numerous health care-related products and services – for yourself, your spouse, and your qualifying child or relative.

IRS regulations state that expenses reimbursed under your HRA may not be reimbursed under any other plan or program, and only your out-of-pocket expenses are eligible. These expenses must be incurred within the coverage period specified by the plan. Plus, expenses reimbursed under an HRA may not be used to claim any federal income tax deduction or credit.

A full explanation of the information listed in the Required Documentation column in the table below is available on our Acceptable Documentation page.

Expense
Description
HRA Expense Eligibility
(If Plan Allows)
Required
Documentation
Processing
Notes
Acupuncture Yes Standard  

Adoption, medical expenses

Potentially

Standard + legal documents pertaining to adoption

For medical expenses incurred before an adoption is finalized, if the child was a legal dependent when services were provided

Alcohol and drug rehab Yes Standard  
Allergy products and home improvements to treat severe allergies Potentially Standard + Medical Determination Form Examples of eligible expenses include: special vacuum cleaners, electro-static air purifiers, pillows and mattresses to alleviate certain allergies, etc. If the product would be owned without the allergy, then the expense is not considered eligible. See Capital expenses.
Alternative healers, dietary substitutes, drugs and medicines Potentially  Standard + Medical Determination Form  
Ambulance transport Yes Standard  
Artificial limbs Yes Standard  
Artificial teeth Yes Standard  
Bandages Yes Standard  
Bariatric surgery (i.e., Lap-Band, gastric bypass) Potentially Standard + Medical Determination Form Only if recommended by a physician to treat a medical condition.
Batteries for durable medical equipment Yes Standard Participant must note usage of batteries on receipt.
Birth control pills Yes Standard Birth control pills prescribed by a doctor are an eligible expense; however, OTC birth control pills (e.g., Plan B) require a doctor's prescription to be eligible expense.
Blood pressure monitoring devices Yes Standard  
Body scan / diagnostic testing Yes Standard  
Braille books and magazines Potentially Standard + Medical Determination Form If for the visually-impaired person, only the amount above the cost of regular printed material is reimbursable.
Breast pumps and lactation supplies Yes Standard Considered durable medical equipment.
Breast reconstruction surgery following mastectomy Yes Standard  
Burn garment Yes Standard  
Capital expenses Potentially Standard + Medical Determination Form The primary purpose of the expenditure must be for the medical care of the taxpayer, spouse, or dependent. The following information must be provided to determine eligibility:

1. A letter and/or prescription from a physician citing the medical necessity.
2. A written certification that states the item is for the patient's individual use, or the percentage of use in relation to other members of the household.
3. Third-party appraisal of the participant's home to substantiate the difference between the cost of capital expenditure and the increase in value to the participant's home (the cost of the appraisal is not reimbursable).
Carpal tunnel wrist supports Yes Standard  
Chelation (EDTA) therapy Yes Standard + Medical Determination Form Only if used to treat a medical condition such as lead poisoning
Childbirth classes Yes Standard See Lamaze classes
Chiropractor services Yes Standard  
Chondroitin sulfate Potentially Standard + Medical Determination Form Only if used to treat a medical condition
Christian Science practitioners Yes Standard  
Circumcision Yes Standard  
COBRA premiums No N/A  
Co-insurance, co-payments, and deductibles – dental Yes Standard  
Co-insurance, co-payments and deductibles – medical Yes Standard  
Co-insurance, co-payments and deductibles – vision Yes Standard  
Concierge medical fee No N/A A retainer fee (membership fee) that is billed for future services is not an eligible expense. Fees billed for actual qualified services rendered may be eligible for reimbursement.
Condoms and other contraceptive devices Yes Standard  
Contact lenses, equipment, and materials (e.g., Aosept, Allergan, Bausch & Lomb, Boston, Opti-Free, Renu) Yes Standard  
Controlled substances in violation of federal law No N/A  
Cosmetic prescriptions No N/A  
Cosmetics and perfume No N/A  
CPR classes Potentially Standard + Medical Determination Form  
Dental veneers No N/A  
Dental visits (non-cosmetic) Yes Standard Cosmetic dental procedures are not eligible.
Dentures Yes Standard  
Deodorant No N/A  
Diabetic supplies, test kits, and strips Yes Standard  
Diagnostic services Yes Standard  
Diapers or diaper service for newborns No N/A  
Diet foods No N/A  
Dietary supplements  Potentially Standard + Medical Determination Form  
Disabled dependent's qualified dental or vision expenses Yes Standard  
Disabled dependent's qualified medical expenses Yes Yes  
DNA collection and storage No N/A  
Doula (birthing coach) Potentially Standard + Medical Determination Form The expense is only eligible if the doula is a licensed health care professional and provides medical care. Participant must submit itemized statement detailing the medical services rendered.
Drug addiction treatment Yes Standard  
Drug overdose, treatment of Yes Standard  
Dual-purpose expenses (items that have both a medical and general-personal-cosmetic purpose) Potentially Standard + Medical Determination Form  
Durable medical equipment Yes Standard Crutches, wheelchairs, nebulizers, etc.
Ear piercing No N/A  
Ear plugs Potentially Standard + Medical Determination Form  
Egg donor fees Yes Standard  
Eggs and embryos storage fees Yes Standard Only temporary storage is eligible.
Electrolysis or hair removal No N/A  
Exercise equipment or programs Potentially Standard + Medical Determination Form Not unless recommended by a physician to treat a specific medical condition and the equipment would not otherwise be purchased but for treatment of the condition
Eye examinations, eyeglasses, equipment, and materials Yes Standard  
Face creams and moisturizers No N/A  
Face lifts No N/A  
Family counseling Potentially Standard + Medical Determination Form Not unless recommended to treat a  medical condition
Feminine hygiene products (tampons, etc.) No N/A  
Fertility treatments  Potentially Standard + Medical Determination Form Will qualify if procedures are intended to overcome the inability to conceive a baby; treatment must be for FSA participant, their spouse, or eligible dependents; treatments include: in vitro fertilization, surgery (including an operation to reverse prior surgery preventing pregnancy), shots, treatments, and gamete intrafallopian transfer (GIFT).
Fiber supplements (e.g., Benefiber, Metamucil) Potentially Standard + Medical Determination Form Only if recommended by a physician
Flu shots Yes Standard  
Fluoridation device Yes Standard  
Foods Potentially Standard + Medical Determination Form See Special foods; Meals; Alternative healers; and Dietary supplements.
Founder's fee No N/A  
Gauze pads Yes Standard  
Genetic testing Potentially Standard + Medical Determination Form If ordered for medical care
GIFT(gamete intrafallopian transfer) Potentially Standard + Medical Determination Form See fertility treatments.
Glucosamine Potentially Standard + Medical Determination Form  
Glucose monitoring equipment Yes Standard  
Guide dog or other service animal aide Potentially Standard + Medical Determination Form  
Hair loss/replacement treatment (e.g., Rogaine) Potentially Standard + Medical Determination Form  
Hair removal and transplants No N/A  
Hand lotion No N/A  
Health club dues and fees Potentially Standard + Medical Determination Form Not unless recommended by a physician to treat a specific medical condition and expense would not otherwise be incurred but for treatment of the condition. Expenses incurred for general health purposes are not eligible.
Hearing aids and hearing aid batteries Yes Standard  
Herbs and Herbal Supplements (e.g., St. John's Wort) Potentially Standard + Medical Determination Form Only if used to treat a specific medical condition
Hormone replacement therapy (HRT) Potentially Standard + Medical Determination Form Only if used to treat a medical condition
Hospital services Yes Standard  
Hot and cold packs Yes Standard  
Household help No N/A  
Illegal operations and treatments No N/A  
Immunizations Yes Standard  
Inclinator Yes Standard  
Incontinence supplies (e.g., Depends, Serenity) Yes Standard Products must have labels for bladder control/incontinence.
Insulin (prescription and over–the–counter) Yes Standard  
Insurance premiums Yes Standard Only qualified insurance premiums are reimbursable if allowed under your plan. Examples: health, dental, and/or vision plan premiums. Documentation requires a copy of the insurance premium billing notice AND proof of payment (copy of front and back of check, credit card confirmation, etc.) for qualified insurance policies. Itemized bills should include the insurance carrier name, participant name, amount charged, and coverage dates.
Laboratory fees Yes Standard  
Lactation consultant Potentially Standard + Medical Determination Form  
Lamaze classes  Yes Standard Only the portion of the class covering the birthing process is covered.
Language training Potentially Standard + Medical Determination Form Only qualifies for an individual with a diagnosed medical condition (e.g., dyslexia or disabled child)
Lasik eye surgery Yes Standard  
Lead-based paint removal Potentially Standard + Medical Determination Form Eligible if done to prevent a child who has or had lead poisoning from eating the paint. The wall surface must be within the child's reach.
Lifetime care–advance payments No N/A  
Lip balm (e.g., Burt's Bees Lip Balm, Chapstick) No N/A  
Lodging at a hospital or similar institution (patient only) Yes Standard  
Lodging not at a hospital or similar institution Yes Standard Up to $50 per night if the lodging is primarily for and essential to medical care. The service must be provided by a physician in a licensed hospital or medical care facility equivalent to a licensed hospital. An additional $50 per night may be reimbursable for a parent or companion who must accompany the patient.
Lodging of a companion Yes Standard If accompanying a patient for medical treatment
Lodging while attending a medical conference No N/A  
Long-term care premiums No N/A  
Marijuana or other controlled substances in violation of federal law No N/A  
Marriage counseling No Standard + Medical Determination Form Marriage counseling typically does not qualify for reimbursement under the health FSA; however, if the counseling is incurred to treat an underlying medical condition, the expense may be considered eligible.
Massage therapy Potentially Standard + Medical Determination Form  
Mastectomy-related special bras Yes Standard  
Meals at a hospital or similar institution (Patient Only)  Yes Standard Only meals for the person receiving care are eligible.
Meals not at a hospital or similar institution No N/A  
Meals of a companion No N/A  
Meals when attending a medical conference  No N/A  
Medic Alert bracelet or necklace Yes Standard  
Medical conference admission  Potentially Standard + Medical Determination Form  
Medical information plan changes Yes Standard  
Medical monitoring and testing devices Yes Standard  
Medical newsletter No N/A  
Medical records charges Yes Standard  
Medical services Yes Standard  
Medicare premiums Yes – but applies only to a retiree HRA plan Standard Requires a copy of the insurance premium billing notice AND proof of payment (copy of front and back of check, credit card confirmation, etc.) for qualified insurance policies. Itemized bills should include the insurance carrier name, participant name, amount charged, and coverage dates.
Medicated shampoo (to treat a specific medical condition like psoriasis; e.g., Dermarest shampoo) Potentially Standard + Medical Determination Form Only the amount in excess of the cost of normal shampoo is reimbursable.
Mouthwash No N/A  
Nasal strips (nose strips) Potentially Standard + Medical Determination Form  
Naturopathic healers Potentially Standard + Medical Determination Form Treatments using natural agents (e.g., air, water, wind, etc.) are not reimbursable.
Nebulizer Yes Standard  
Norplant insertion or removal Yes Standard  
Nursing services for a baby No N/A  
Nursing services provided by a nurse or other attendant Yes Standard  
Nutritionist's professional expenses Potentially Standard + Medical Determination Form  
OB/GYN Yes Standard  
Occlusal guards Yes Standard  
Office visits – dental Yes Standard  
Office visits – medical Yes Standard  
Office visits – vision Yes Standard  
Operations – dental Yes Standard Legal operations only. Cosmetic procedures are not eligible.
Operations – medical Yes Standard Legal operations only. Cosmetic procedures are not eligible.
Operations– vision Yes Standard Legal operations only. Cosmetic procedures are not eligible.
Optometrist Yes Standard  
Organ donors Yes Standard  
Orthodontia Yes Standard See our Orthodontia Expenses page for additional details
Orthopedic shoes and inserts Yes Standard The excess cost over ordinary shoes
Osteopath fees Yes Standard  
OTC pregnancy tests/fertility monitors Yes Standard  
Over-the-counter drugs used for general health and/or cosmetic purposes No N/A  
Over-the-counter medicines used to treat a specific medical condition Yes Standard + prescription See our Over-the-counter Expenses page for examples of OTC medicine and supplies.
Over-the-counter supplies Yes Standard See our Over-the-counter Expenses page for examples of OTC medicine and supplies.
Ovulation monitor Yes Standard  
Oxygen Yes Standard  
Physical exams Yes Standard Not employment–related exams
Physical therapy Yes Standard  
Podiatrist Yes Standard  
Pregnancy termination Yes Standard Legal terminations only
Pregnancy test kits Yes Standard  
Prescription drug discount programs No N/A  
Prescription drugs – dual-purpose (e.g., Propecia, Rogaine) Potentially Standard + Medical Determination Form Not unless the item is used primarily to prevent or alleviate a physical or mental defect or illness
Prescription drugs imported from another country No N/A  
Prescription drugs used for general health and/or cosmetic purposes No N/A  
Prescription drugs used to treat a specific medical condition Yes Standard  
Prescription eyeglasses Yes Standard  
Propecia Potentially Standard + Medical Determination Form Not unless hair loss is due to a medical condition
Prosthesis Yes Standard  
Psychiatrist Yes Standard  
Psychoanalysis Yes Standard  
Psychologist Yes Standard  
Radial keratotomy Yes Standard  
Reading glasses Yes Standard  
Retin-A Potentially Standard + Medical Determination Form  
Reversal of tubal ligation or vasectomy Yes Standard  
Rogaine Potentially Standard + Medical Determination Form Not unless hair loss is due to a medical condition
Safety glasses No N/A  
Sales tax on qualified medical expenses (e.g., OTC medications) Yes Standard Sales tax will automatically be reimbursed if receipt contains only FSA-eligible expenses. If not the participant is responsible for calculating the sales tax in order for it to be reimbursed.
School and education, special Potentially Standard + Medical Determination Form Only if recommended by a physician
Schools and education, residential No N/A  
Screening tests – dental or vision Yes Standard  
Screening tests – medical Yes Standard  
Shaving cream and lotion No N/A  
Shipping and handling fees on eligible expenses Yes Standard  
Sick-child facility No N/A  
Skin moisturizers and lotion No N/A  
Sleep deprivation treatment Potentially Standard + Medical Determination Form  
Smoking cessation programs Yes Standard  
Snoring cessation aids and medications (e.g, Breathe Right Spray, Snoreeze) Potentially Standard + Medical Determination Form  
Special foods  Potentially Standard + Medical Determination Form These foods are not eligible expenses unless recommended to treat a medical condition (e.g., gluten-free products). A cost comparison of the special food and the regular product must be provided, and the price difference will be reimbursed.

Example:

Gluten-free pasta = $2.50
Standard pasta = $1.25
Price difference = $1.25
Reimbursement amount = $1.25

Meal replacements are a substitute for food that an individual would normally consume. These products are not eligible for reimbursement (e.g., shakes, meal bars, etc.).
Sperm storage fees Potentially Standard + Medical Determination Form Temporary storage only
Stem cell, harvesting and/or storage Potentially Standard + Medical Determination Form  
Sterilization procedures Yes Standard  
Student health fee No N/A  
Sunglass clips No N/A  
Sunglasses (non-prescription) No N/A  
Sunglasses (prescription) Yes Standard  
Supplies to treat medical condition Yes Standard  
Surrogate expenses No N/A  
Take-home drug test No N/A  
Take-home pregnancy test Yes Yes  
Take-home urinary tract infection test Yes Standard  
Tanning salons and equipment No N/A  
Teeth whitening No N/A  
Telephone for hearing-impaired persons Yes Standard  
Therapy Yes Standard  
Thermometers Yes Standard  
Toiletries No N/A  
Toothbrushes and toothpaste No N/A  
Transplants Yes Standard  
Transportation and travel expenses for person receiving dental care Yes Standard July 1 - December 31, 2011 Mileage Rate:
Mileage is reimbursable at $.23.5 per mile.

January 1 - June 30, 2011 Mileage Rate:
Mileage is reimbursable at $.19 per mile.

Note: Participants are required to itemize mileage expenses on the claim form. However, mileage expenses would not apply to reimbursement requests for taxi, bus, plane or train fare. A participant may be reimbursed for the full amount of the fare. If the participant cannot get a fare receipt, they must itemize the amount on the claim form and indicate no receipt is obtainable.
Transportation and travel expenses for person receiving medical care Yes Standard July 1 - December 31, 2011 Mileage Rate:
Mileage is reimbursable at $.23.5 per mile.

January 1 - June 30, 2011 Mileage Rate:
Mileage is reimbursable at $.19 per mile.

Note: Participants are required to itemize mileage expenses on the claim form. However, mileage expenses would not apply to reimbursement requests for taxi, bus, plane or train fare. A participant may be reimbursed for the full amount of the fare. If the participant cannot get a fare receipt, they must itemize the amount on the claim form and indicate no receipt is obtainable.
Transportation and travel expenses for person receiving vision care. Yes Standard July 1 - December 31, 2011 Mileage Rate:
Mileage is reimbursable at $.23.5 per mile.

January 1 - June 30, 2011 Mileage Rate:
Mileage is reimbursable at $.19 per mile.

Note: Participants are required to itemize mileage expenses on the claim form. However, mileage expenses would not apply to reimbursement requests for taxi, bus, plane or train fare. A participant may be reimbursed for the full amount of the fare. If the participant cannot get a fare receipt, they must itemize the amount on the claim form and indicate no receipt is obtainable.
Transportation of someone other than the person receiving dental or vision care Potentially Standard Only certain cases are reimbursable:

1. A parent who must travel with a sick child receiving medical care
2. A nurse or other person who administers medication or injections to a patient
3. An individual's visits to a mentally-ill dependent, if recommended as part of treatment
Transportation of someone other than the person receiving medical care Potentially Standard Only certain cases are reimbursable:

1. A parent who must travel with a sick child receiving medical care
2. A nurse or other person who administers medication or injections to a patient
3. An individual's visits to a mentally-ill dependent, if recommended as part of treatment
Transportation to and from medical conference Potentially Standard + Medical Determination Form See Medical conference admission and Meals for a medical conference.
Tubal ligation Yes Standard  
Umbilical cord, freezing and storing of Potentially Standard + Medical Determination Form Collection and storage of indefinitely "in case needed" is not eligible for reimbursement
Vaccines Yes Standard  
Varicose veins, treatment of No N/A  
Vasectomy Yes N/A  
Viagra Yes Standard  
Virtual physical (body scan) Yes Standard  
Vision discount programs No N/A  
Vitamins Potentially Standard + Medical Determination Form  
Walker, wheelchair, or cane Yes Standard  
Weight-loss programs and/or drugs prescribed to induce weight loss Potentially Standard + Medical Determination Form Only if recommended by a physician
Wigs Potentially Standard + Medical Determination Form Not unless hair loss is due to a medical condition
X–rays – dental Yes Standard  
X–rays – medical Yes Standard