EXAMPLES OF MEDICAL EXPENSES WHICH CAN BE …
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EXAMPLES OF MEDICAL EXPENSES WHICH CAN BE REIMBURSED UNDER THE SECTION 125 FLEXIBLE BENEFITS PLAN:
Deductibles Coinsurance Dr. Office Visits
Well-baby care Physicals & checkups Pap Smears
Mammograms Obstetrics Immunizations
Prescription Drugs Contraceptives Insulin
Ostomy Supplies Lab Tests Splints, Crutches
Hearing Aids Chiropractor Visits Physical Therapy
Psychotherapy Routine Dental Care Crowns, Fillings, Bridges
Dentures Orthodontia X-Rays
Eye Exams Prescription Glasses Contact lenses and solutions
Noncosmetic Surgery Prenatal Vitamins Acupuncture
Organ Transplants Sterilizations Podiatric treatment
Hospitalization Home Health Care Lasik Surgery
Ambulance Guide Dog Learning Disability
Prosthesis Psychiatric care Wheelchairs
Portable Oxygen MRI, CAT scan Smoking Cessation Programs
EXAMPLES OF MEDICAL EXPENSES WHICH CAN ONLY BE REIMBURSED WITH A PHYSICIANS DIAGNOSIS OF MEDICAL NECESSITY AND PRESCRIPTION
Weight Loss Prescriptions * Weight Loss Programs* (does not include food)
Vitamins
EXAMPLES OF OVER-THE-COUNTER ITEMS WHICH CAN BE REIMBURSED UNDER THE SECTION 125 FLEXIBLE BENEFITS PLAN:
Reading glasses Thermometer Crutches Contact Solution and Eyedrops
Blood pressure monitor Band aids Blood sugar test kit Hot and Cold packs (not medicated)
Incontinence Products Sunscreen over 30 SPF First Aid Kits Breast Pump and lactation supplies
Over-the-counter drugs and medicines Menstrual supplies
EXAMPLES OF MEDICAL EXPENSES AND OVER-THE –COUNTER EXPENSES WHICH CANNOT BE REIMBURSED UNDER THE SECTION 125 FLEXIBLE BENEFITS PLAN:
Cosmetic Surgery Cosmetic Prescriptions Teeth Bleaching
Hair Transplants Health Club Fees Electrolysis
Herbs Nutritional Supplements Marijuana
Rogaine Maternity Clothes Toothpaste
Body Lotions Dental floss Sanitary needs
Sunglasses Toiletries Soap
Toothbrush Diapers Baby wipes
Baby nurse Moisturizers Body or face wash
Deodorants Q-tips RX from other countries
IMPORTANT! If you are making contributions into a Health Savings Account, only dental, vision and expenses you incur after the statutory deductible has been met will qualify!!
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