PARTIAL LIST OF ELIGIBLE MEDICAL EXPENSES
*If necessary for medical care; Doctors Letter of medical necessity and diagnosis required.
DENTAL EXPENSES
Bridges, Crown, Dentures, Exams, Fillings, Orthodonia (proof of payment or financial contract required), x-rays, Insurance Deductibles, Co-payments after insurance
HEARING EXPENSES
Exams, Hearing Devices and Aids (including batteries), Special Communicatin Equipment for the Deaf
VISION CARE
Exams, Contact Lenses, Frames, Lenses, Oculist Services, Optician Services, Optometrist Services, Laser Vision correction
OTHER REIMBURSABLE HEALTH CARE EXPENSES
Special schools for handicapped persons - must have specific programs to deal with the handicap. Special home modifications for handicapped; cannot increase value of Home. Life fee to retirement home for medical care - contract must allocate an amount to medical fees and medical care must be rendered with the Plan Year.
TRANSPORTATION
YOU MAY INCLUDE as medical expenses amounts paid for transportation primarily for and essential to medical care (2011 rate was 19 cents per mile; 2012 rate is 23 cents per mile). YOU MAY NOT INCLUDE transportation expenses to and from work, even if your condition requires an unusual means of transportation; transportation expense if you choose to travel to another city, such as a resort area, for an operation or other medical care prescribed by your physician.
LODGING
YOU MAY INCLUDE in medical expenses the cost of meals and lodging at a hospital or similar institution if your main reason for being there is to receive medical care. YOU MAY INCLUDE in medical expenses the cost of lodging (not privided in a hospital or similar institution) while away from home IF the lodging is primarily for and essential to medical care provided by a physician in a licensed hospital or equivalent and there is no significant element of personal pleasure. The amount you include in medical expenses may not exceed $50.00 a night for each individual. Lodging expenses is eligible for a eprson who must accompany the individual receiving medical care, for example, a partent traveling with a sick child. Proof of medical care required. Meals of a companion are not an eligible expense.
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PARTIAL LISTING OF NON-ELIGIBLE EXPENSES
The following expenses are not eligible for reimbursement under a Health FSA:
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DEPENDENT CARE - IMPORTANT RESTRICTIONS
If married, the total payments made in a taxable year, under this and any other Dependent Care Plan, cannot exceed the lesser of your earned income or your spouse's earned income, during that taxable year. The expenses are necessary to enable you (and your spouse, if married) to work or actively serach for employment. Your Spouse, must work outside the home, be a full-time sutudent or be disabled. Your IRS Code 152 dependend as revised by WFTRA, including modificiations made by IRS code 105(b) and by IRS Notice 2004-79 must be under age 13, or your dependent is physical or mentally incapable of care for himself or herself (a disabled spouse or elderly parent, for example). If services were provided outside the home, the dependent for who services were incurred spends at least eight (8) hours a day in your household and must have the same principle place of abode as the taxpayer for more than half of the year. The person providing the service will not be claimed as a dependent on your income tax return for the Pla Year in which the service was provided. Daycare expenses are reimburseable for the amount you current have deposited in your account.
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CONSULT IRS PUBLICATIONS 502 AND 503 FOR ADDTIONAL GUIDANCE OR YOUR PERSONAL TAX ADVISOR
PUBLICATION 502 AND 503 DO NOT DESCRIBE ALL FLEXIBLE SPENDING ACCOUNT RESTRICTIONS
For more information contact the EBC Flexible Spending Account office at (405) 232-1190 Ext. 301 or (800) 219-8115 Ext. 301
(10/2010)