NCFLEX Sample List of FSA Eligible Expenses 2020

1 flexible spending account Over-the-counter (OTC) medications are now reimbursable under FSAs without CARES Act of 2020 Update requiring a prescription or completing a Letter of Medical Necessity Form. This provision is retroactive to January 1, 2020. Menstrual care products are now reimbursable as Eligible Expenses , including tampons and pads. Eligible Health FSA Expenses Acupuncture Diaper rash ointment Petroleum jelly Alcoholism treatment Dietary supplements Prosthesis Allergy medication, nasal sprays Drug addiction treatment Pregnancy tests Ambulance Doula Prenatal vitamins Analgesics, fever reducers, pain Ear wax removal kits Psychiatrists' and psychologists' fees reducers (aspirin, ibuprofen, Eye exams, eye surgery Radial keratotomy and lasik eye acetaminophen) Eye glasses (protection plans/ surgery Antacids and heartburn relief warranties are NOT Eligible Expenses )

2 Routine physical & other non Antibiotic ointments Eczema treatments diagnostic services or treatments Anti-itch creams and hydrocortisone Feminine hygiene products Sinus medication creams Fertility treatments (in vitro Smoking cessation programs Arthritis pain relieving creams fertilization, surgery) Speech therapy Athlete's foot treatment, anti-fungal First-aid cream Special education for the blind creams Glucosamine Special plumbing for handicapped Artificial teeth/dentures Hearing devices and batteries Sterilization ( , tubal Bandages Hemorrhoid treatments ligation,vasectomy) and reversal Birth control Hospital services Stomach and digestive relief items Blood pressure monitors Incontinence products Sunburn cream (Solarcaine).

3 Braces Infertility treatments Surgical fees Braille-books and magazines Insulin Telephone, special for hearing Breast pumps and lactation supplies Laboratory fees impaired Cancer screening Lactose intolerance tablets Television audio display equipment Chiropractors Lamaze classes for hearing impaired Chondroitin Latex gloves Therapeutic care for drug and Co-insurance amount you pay alcohol addiction received as Laxatives Cold/hot packs medical treatment Medical alert bracelets Cold medicines, tablets, syrups, Thermometers Medical information plan cough drops & lozenges Toothache and teething pain Menstrual pain relievers relievers Co-pay amount you pay Mentally handicapped persons cost Compression hose (30-40 mmHg or Transportation Expenses for person of special home care to receive medical care higher) Mineral supplements Condoms Urinary pain relief medication Motion sickness pills Vaccines Contact lenses and eyeglasses Nasal spray and strips Contact lens solutions Walkers Nicotine gum, patches Wart removal, , W Freeze Off Cost of medically necessary Nurses fees (including nurses' board operations and related treatments (certain wart medicines may require and social security tax paid by you) a prescription).

4 Crutches Obstetrical Expenses Wheelchair Deductible medical coverage Orthotics (amounts you pay) X-rays Over-the-counter medications Yeast infection medication Dental fees Oxygen Diabetic supplies Eligible Health FSA Expenses Only with a Letter of Medical Necessity Form Compression hose (20-30 mmHg) Massage therapy, rolfing therapy S ervice animal (guide dogs are Exercise programs or equipment Occupational therapy Eligible without a LOMN). Fiber supplements Orthopedic shoes ( reimbursement Tuition/meals/lodging for special Humidifier is permitted for the cost difference needs schooling Hypnosis between orthopedic shoes and regular Varicose vein, treatment of Infertility treatments shoes.) Vitamins Lead-base paint removal Scooter, electric Water-Pik 1.

5 flexible spending account Sample Eligible Expenses FOR FSA REIMBURSEMENTS. Never Eligible COBRA premiums C. osmetic products and cosmetic Hair transplants*. Concierge service fees - only medical surgery (unless to remediate Hand sanitizer services actually provided are Eligible damage from an illness or injury) Household help for reimbursement ; membership fees Disposable diapers Maternity clothes for concierge services are not Eligible for Diet program foods Teeth whitening*. reimbursement Electric toothbrush Electrolysis *Unless prescribed by a doctor to treat an Fitness programs* existing illness or injury. Eligible Dependent Care FSA Expenses Babysitters Nursery schools Day camp Daycare centers After-school programs Eldercare (Overnight camps are NOT Eligible ).

6 Expense eligibility is subject to change. If you are unsure if an expense is Eligible for reimbursement , please call P&A Group at (866) 916-3475 or chat with a customer service rep through online chat at 2.