Save up to 30% on eligible expenses Enroll in a TASC Flexible Spending Account (FSA) so you can use pretax dollars to pay for common, everyday expenses and reduce your taxable income. FSA Eligible Expenses Eligible Medical Expenses
- Acupuncture
- Artificial limbs
- Bandages & dressings
- Birth control, contraceptive devices
- Birthing classes/Lamaze (only the mother’s portion, not the coach/spouse, and the class must be only for birthing instruc- tion, not child rearing)
- Blood pressure monitor
- Chiropractic therapy/exams/adjustments
- Contact lens and contact lens solutions
- Co-payments
- Crutches (purchased or rented)
- Deductibles & co-insurance
- Diabetic care & supplies
- Feminine care products (tampons, pads, etc)
- Eye exams
- Eyeglasses, contacts, or safety glasses (prescription)
- First aid kits & supplies
- Hearing aids & hearing aid batteries
- Heating pad
- Incontinence supplies
- Infertility treatments
- Insulin
- Lactation expenses (breast pumps, etc.)
- Laser eye surgery; LASIK
- Legal sterilization
- Medical supplies to treat an injury or illness
- Mileage to and from doctor appointments
- Optometrist’s or ophthalmologist’s fees
- Orthopedic inserts
- Personal Protective Equipment (PPE; facial masks, hand santizer, sanitizing wipes)*
- Physical exams
- Physical therapy (as medical treatment)
- Physician’s fee and hospital services
- Pregnancy tests
- Prescription drugs and medications
- Psychiatric care, psychotherapy (as medical treatment)
- Sales tax on eligible expenses
- Sleep apnea services/products (as prescribed)
- Smoking cessation programs & deterrents (gum, patch)
- Treatment for alcoholism or drug dependency
- Vaccinations & flu shots
- X-ray fees Eligible OTC Medicines and Drugs Over-the-counter (OTC) medicines and drugs are reim- bursable via FSA, HRA, and HSA without a prescription or physician’s note. Eligible OTC products include items that are primarily for a medical purpose, and are compliant with federal tax rules under IRS Code Section 213(d).
- Allergy, cough, cold, flu & sinus medications
- Anti-diarrheals, anti-gas medications & digestive aids
- Canker/cold sore relievers & lip care
- Foot care (corn/wart medication, antifungal treatments, etc.)
- Hemorrhoid creams & treatments
- Itch relief (calamine lotion, Cortizone cream, etc.)
- Oral care (denture cream, pain reliever, teething gel, etc.)
- Pain relievers (Tylenol, Advil, Bengay, etc.)
- Skin care (sunscreen w/SPF15+, acne medication, etc.)
- Sleep aids & stimulants (nasal strips, etc.)
- Stomach & nausea remedies (antacids, Dramamine, etc.)
- Wound Treatments/Washes (hydrogen peroxide, iodine)
Total Administrative Services Corporation I 2302 International Lane I Madison, WI 53704-3140 I www.tasconline.com Below is a partial list of reimbursable expenses that may be incurred by you, your spouse, or qualified dependents. NOTE: If you (or your spouse) enroll in an HSA Plan, you may only enroll in a Limited-Purpose Healthcare FSA (LPFSA). The eligible expenses under an LPFSA are limited to Dental and Vision expenses only. *PPE expenses must be used for the purpose of preventing the spread of coronavirus. EMPLOYEE EDUCATIONEMPLOYEE EDUCATION Continued on next page...
Use your TASC Card® to pay for eligible expenses at the point of purchase instead of paying out-of-pocket and requesting a reimbursement. FSA Eligible Expenses Page 2 For more information regarding eligible expenses, please review IRS Publication 502/503 at irs.gov or ask your employer for a copy of your Summary Plan Description (SPD). Eligible Dental Expenses
- Braces and orthodontic services
- Cleanings
- Crowns
- Deductibles, co-insurance
- Dental implants
- Dentures, adhesives
- Fillings Eligible Dependent Care Expenses Does not cover medical costs. Use the Healthcare FSA for medical expenses incurred by your dependents.
- Fees for licensed day care or adult care facilities
- Before and after school care programs for depen- dents under age 13
- Amounts paid for services provided in or outside of your home (including babysitters or nursery school)
- Nanny expenses attributed to dependent care
- Nursery school/preschool fees
- Summer Day Camp (primary purpose must be custodial care and not educational in nature)
- Late pick-up fees Eligible Disability Expenses
- Automobile equipment and installation costs for a person with a disability in excess of the cost of an ordinary automobile; device for lifting a person with a mobility impairment into an automobile
- Braille books or magazines (in excess of cost of non- Braille editions)
- Note-taker in school for a child with a hearing impair- ment
- Seeing eye dog (buying, training, and maintaining)
- Special devices, such as a tape recorder or typewrit- er for a person with a visual impairment
- Visual alert system in the home or other items such as a special phone required for a person with a hear- ing impairment
- Wheelchair or autoette (cost of operating/maintaining)
Requiring Additional Documentation The following expenses are eligible only when incurred to diagnose or treat a diagnosed medical condition. Such expenses require a Letter of Medical Necessity from your medical practitioner explaining the medical necessity of the expense (diagnosed condition, onset of condition, etc.) and including the practitioner’s signature.
- Counseling or therapy
- Ear plugs
- Massage treatments
- Nursing services for care of a special medical ail- ment
- Orthopedic shoes (excess cost of ordinary shoes)
- Oxygen equipment and oxygen
- Support hose (non-compression)
- Varicose vein treatment
- Veneers
- Vitamins & dietary supplements
- Wigs (for mental health condition of individual who loses hair because of a disease)
Questions? Ask your employer or contact your Plan Administrator: Total Administration Services Corporation - www.tasconline.com - 1-800-422-4661 FX-4248-012323 Questions? Ask your employer or contact your Plan Administrator: Total Administration Services Corporation - www.tasconline.com - 1-800-422-4661 FX-4248-012423
Attachment: FSA Eligible Expenses (PDF)