Sterling

Eligible Expenses

Some plans do not allow for all of these expenses to be covered. Please check with your plan administrator or Sterling to verify the details of your plan before incurring these types of expenses for reimbursement. The list below is just a sample of eligible and ineligible expenses. For a complete list, see
IRS Publication 502 Section 213(d)

Expense	Standard FSA	Limited FSA or HSA-Compatible
01 - Rx (prescription)	Yes	No
02 - Co-payment (medical)	Yes	No
03 - Office visit (medical)	Yes	No
04 - Dental	Yes	Yes
05 - Over-the-counter (drugs and medicines)	Yes (Rx)**	No
06 - Contact lenses and solutions	Yes	Yes
07 - Vision	Yes	Yes
08 -Psych / therapy	Yes	No
09 - Chiropractic care	Yes	No
10 - Lab (medical)	Yes	No
11 - Orthodontia	Yes	Yes
12 - Hospital fees	Yes	No
13 - X-ray (medical)	Yes	No
Acne treatments (over-the-counter)	Yes (Rx)**	No
Acupuncture	Yes	No
Adoption (medical expenses related to)	Yes	No
Adoption fees	No	No
Alcoholism treatment	Yes	No
Allergy and sinus medicine and products (over-the-counter)	Yes (Rx)**	No
Allergy medication	Yes (Rx)**	No
Allergy treatments and products	Yes (Letter)*	No
Alternative dietary supplements (for treatment of a medical condition)	Yes (Letter)*	No
Alternative drugs, medicines and treatment products (for treatment of a medical condition)	Yes (Letter)*	No
Alternative healers (for treatment of a medical condition)	Yes (Letter)*	No
Ambulance and emergency health services	Yes	No
Anesthesia (for non-cosmetic purposes)	Yes	No
Antacid (over-the-counter)	Yes (Rx)**	No
Antibiotic ointment (over-the-counter)	Yes (Rx)**	No
Aspirin or other pain reliever (over-the-counter)	Yes (Rx)**	No
Asthma medicines or treatments (over-the-counter)	Yes (Rx)**	No
Athletic treatments / braces	Yes	No
Bandages and related items (over-the-counter)	Yes	No
Birth control (over-the-counter)	Yes (Rx)**	No
Birth control (prescription or other)	Yes	No
Blood pressure monitor	Yes	No
Body scans	Yes	No
Braille books and magazines (difference in cost only)	Yes	Yes
Breastfeeding classes	Yes	No
Breast pump (for a lactating woman)	Yes	No
Breast reconstruction surgery (following mastectomy)	Yes (Letter)*	No
COBRA premiums (dental; paid with after-tax dollars only)	No	No
COBRA premiums (medical; paid with after-tax dollars only)	No	No
COBRA premiums (other; paid with after-tax dollars only)	No	No
COBRA premiums (prescription; paid with after-tax dollars only)	No	No
COBRA premiums (vision; paid with after-tax dollars only)	No	No
Cancer (fixed indemnity) insurance premiums	No	No
Canker and cold sore treatments (over-the-counter)	Yes (Rx)**	No
Car modifications (as required for a medical condition diagnosed by a licensed health care professional)	Yes (Letter)*	No
Chest rubs (over-the-counter)	Yes (Rx)**	No
Child or newborn care instruction	No	No
Childbirth classes (charges for mother only)	Yes	No
Chiropractic office visit or treatment	Yes	No
Christian Science practitioners	Yes	No
Cholesterol test kits and supplies	Yes	No
Co-insurance (dental)	Yes	Yes
Co-insurance (medical)	Yes	No
Co-insurance (prescription)	Yes	No
Co-insurance (vision)	Yes	Yes
Co-payment (dental)	Yes	Yes
Co-payment (medical)	Yes	No
Co-payment (other)	Yes	No
Co-payment (vision)	Yes	Yes
Cold and flu medicine (over-the-counter)	Yes (Rx)**	No
Cold cream (over-the-counter)	No	No
Compression or anti-embolism socks, stockings or hose	Yes (Letter)*	No
Concierge medical fees (billed for actual services received)	Yes	No
Concierge medical fees (billed for future availability of services, with no services actually received)	No	No
Condoms	Yes	No
Contraceptives (prescription)	Yes	No
Contraceptives (over-the-counter)	Yes (Rx)**	No
Cord blood storage (for future treatment of a birth defect or known medical condition)	Yes (Letter)*	No
Cord blood storage (for unidentified future use)	No	No
Corn and callus remover (over-the-counter)	Yes (Rx)**	No
Corneal keratotomy	Yes	Yes
Cosmetic procedures or surgery	No	No
Cosmetic procedures or surgery for birth defects, accidents, and/or disease	Yes (Letter)*	No
Cough drops and sore throat lozenges (over-the-counter)	Yes (Rx)**	No
Cough syrup (over-the-counter)	Yes (Rx)**	No
Counseling (for treatment of a medical condition)	Yes	No
Counseling (marriage)	No	No
CPR classes (adult or child)	No	No
Crutches, canes, walkers or like equipment (purchase or rental)	Yes	No
Dancing lessons (for treatment of a medical condition)	Yes (Letter)*	No
Deductible for dental plan	Yes	Yes
Deductible for medical plan	Yes	No
Deductible for prescription plan	Yes	No
Deductible for vision plan	Yes	Yes
Dental care (for non-cosmetic purposes, including sealants)	Yes	Yes
Dental co-insurance	Yes	Yes
Dental co-payment	Yes	Yes
Dental insurance / plan premiums (paid with after-tax dollars only)	No	No
Dental products for general health	No	No
Dental reconstruction (including implants)	Yes	Yes
Dental veneers	Yes (Letter)*	Yes (Letter)*
Dentures, bridges, etc.	Yes	Yes
Dermatology treatments and products	Yes (Letter)*	No
Diabetic monitors, test kits, strips and supplies	Yes	No
Diagnostic services (other than dental or vision)	Yes	No
Diagnostic services (dental or vision)	Yes	Yes
Diaper rash ointments and creams	Yes (Rx)**	No
Diapers and diaper services	No	No
Dietary supplements (for treatment of a medical condition)	Yes (Letter)*	No
Doula or birthing coach	Yes (Letter)*	No
Drug addiction treatment	Yes	No
Drugs (imported)	No	No
Drugs (prescription)	Yes	No
Dyslexia treatment	Yes (Letter)*	No
Ear drops and wax removal (over-the-counter)	Yes (Rx)**	No
Electrolysis	No	No
Emergency kits (over-the-counter)	No	No
Exercise equipment or program (as treatment for a medical condition diagnosed by a licensed health care professional)	Yes (Letter)*	No
Eye drops and treatments (over-the-counter)	Yes (Rx)**	Yes (Rx)**
Eye examinations	Yes	Yes
Eye related equipment/materials	Yes	Yes
Eye surgery or treatment to correct vision	Yes	Yes
Eyeglasses (over-the-counter)	Yes	Yes
Eyeglasses (prescription)	Yes	Yes
Face lifts	No	No
Feminine hygiene products	No	No
Fertility monitor (over-the-counter)	Yes	No
Fertility treatment (for employee, spouse or dependent)	Yes	No
Fertility treatment (for non-dependent surrogate)	No	No
First aid kits (over-the-counter)	Yes	No
Fitness programs (as treatment for a medical condition diagnosed by a licensed health care professional)	Yes (Letter)*	No
Flu shots	Yes	No
Funeral expenses	No	No
Gastrointestinal medication (over-the-counter)	Yes (Rx)**	No
Guide dog (dog, training, care)	Yes	Yes
Hair regrowth products	No	No
Hair removal	No	No
Hair transplant	No	No
Hair treatments	No	No
Hand lotion (over-the-counter)	No	No
Health club dues (as treatment for a medical condition diagnosed by a licensed health care professional)	Yes (Letter)*	No
Health insurance / plan premiums (paid with after-tax dollars only)	No	No
Health savings account (HSA) contributions	No	No
Hearing aids and batteries	Yes	No
Herbal or homeopathic medicines (over-the-counter)	Yes (Letter)*	No
Home improvements (as required for a medical condition diagnosed by a licensed health care professional)	Yes (Letter)*	No
Hospital (fixed indemnity, $x per day) insurance premiums	No	No
Hospital services and fees	Yes	No
Household help	No	No
Humidifier, air filter and supplies	Yes (Letter)*	No
Illegal operations or substances	No	No
Immunizations	Yes	No
Incontinence supplies	Yes	No
Individual dental insurance / plan premiums (paid with after-tax dollars only)	No	No
Individual insurance / plan premiums (paid with after-tax dollars only)	No	No
Individual medical insurance / plan premiums (paid with after-tax dollars only)	No	No
Individual prescription insurance / plan premiums (paid with after-tax dollars only)	No	No
Individual vision insurance / plan premiums (paid with after-tax dollars only)	No	No
Infertility treatment (for employee, spouse or dependent)	Yes	No
Insulin, testing materials and supplies	Yes	No
Insurance or health insurance / plan premiums (paid with after-tax dollars only)	No	No
Insurance / plan premiums (paid with pre-tax dollars)	No	No
Laboratory fees	Yes	No
Lactose intolerance (over-the-counter)	Yes (Rx)**	No
Lamaze classes (charges for mother only)	Yes	No
Laser eye surgery	Yes	Yes
Lasik	Yes	Yes
Late payment fees charged by health care provider	No	No
Laxatives (over-the-counter)	Yes (Rx)**	No
Learning disability treatments	Yes	No
Lice treatment (over-the-counter)	Yes (Rx)**	No
Listening therapy	Yes	No
Lodging (limited to $50 per night for patient to receive medical care and $50 per night for one caregiver)	Yes (Letter)*	No
Long-term care premiums (up to IRS tax-free limit, see IRS Publication 502)	No	No
Long-term care services	No	No
Long-term disability insurance premiums	No	No
Magnetic therapy (over-the-counter)	Yes (Letter)*	No
Massage therapy (for treatment of a medical condition)	Yes (Letter)*	No
Mastectomy-related special bras	Yes	No
Maternity clothes	No	No
Medical abortion	Yes	No
Medical co-insurance	Yes	No
Medical co-payment	Yes	No
Medical equipment (for treatment of medical condition) and repairs	Yes	No
Medical insurance / plan premiums (paid with after-tax dollars only)	No	No
Medical literature, books, pamphlets or audio	No	No
Medical monitoring and testing devices	Yes	No
Medical records charges	Yes	No
Medical savings account (MSA) contributions	No	No
Medical supplies (for treatment of a medical condition)	Yes	No
Medicare alternative insurance / plan premiums (paid with after-tax dollars only)	No	No
Medicare Part B insurance	No	No
Medicare alternative insurance / plan premiums (vs. Part A & Part B, paid with after-tax dollars only)	No	No
Medicare supplement policy premiums	No	No
Medicines (over-the-counter)	Yes (Rx)**	No
Medicines (prescription)	Yes	No
Midwife	Yes	No
Mileage (for travel to / from anything other than eligible care)	No	No
Mileage (for travel to / from eligible health care)	Yes	No
Modified equipment (difference in cost only)	Yes (Letter)*	No
Monitors and test kits (over-the-counter)	Yes	No
Motion and nausea	Yes (Rx)**	No
Nasal sprays	Yes (Rx)**	No
Nasal strips (over-the-counter)	Yes (Rx)**	No
No show fees charged by health care provider	No	No
Non-prescription drugs and medicines (for non-cosmetic purposes)	Yes (Rx)**	No
Norplant insertion or removal	Yes	No
Nursing services (wages and taxes)	Yes	No
Nutritional supplements (for treatment of a medical condition)	Yes (Letter)*	No
OB/GYN fees	Yes	No
Occlusal guards to prevent teeth grinding	Yes	Yes
Occupational therapy (related to a medical condition or disability)	Yes	No
Office visits (chiro)	Yes	No
Office visits (dental)	Yes	Yes
Office visits (medical)	Yes	No
Office visits (psych/therapy)	Yes	No
Office visits (vision)	Yes	Yes
Operations (for non-cosmetic purposes)	Yes	No
Operations (for vision and dental only)	Yes	Yes
Optometrist / ophthalmologist fees	Yes	Yes
Organ transplants (recipient and donor)	Yes	No
Orthotics	Yes	No
Ortho keratotomy	Yes	Yes
Orthodontia (braces and retainers)	Yes	Yes
Orthopedic and surgical supports	Yes	No
Orthopedic shoes and inserts (difference in cost only of specialized orthopedic shoe over like non-specialized shoe)	Yes (Letter)*	No
Over-the-counter acne treatments	Yes (Rx)**	No
Over-the-counter allergy and sinus medicine	Yes (Rx)**	No
Over-the-counter antacid	Yes (Rx)**	No
Over-the-counter antibiotic ointment	Yes (Rx)**	No
Over-the-counter aspirin or other pain reliever	Yes (Rx)**	No
Over-the-counter asthma medicines or treatments	Yes (Rx)**	No
Over-the-counter bandages and related items	Yes	No
Over-the-counter canker and cold sore treatments	Yes (Rx)**	No
Over-the-counter chest rubs	Yes (Rx)**	No
Over-the-counter cold and flu medicine	Yes (Rx)**	No
Over-the-counter cold and flu prevention	Yes (Rx)**	No
Over-the-counter cold cream	No	No
Over-the-counter cough drops and sore throat lozenges	Yes (Rx)**	No
Over-the-counter cough syrup	Yes (Rx)**	No
Over-the-counter health care products (eligible)	Yes (Rx)**	No
Over-the-counter health care products (not eligible)	No	No
Over-the-counter medication (including for motion sickness, sleep aids and sedatives)	Yes (Rx)**	No
Over-the-counter products for dental, oral and teething pain	Yes (Rx)**	Yes (Rx)**
Over-the-counter products for general dental care	No	No
Over-the-counter vision products	Yes	Yes
Ovulation monitor (over-the-counter)	Yes	No
Oxygen	Yes	No
Pain reliever (over-the-counter)	Yes (Rx)**	No
Parental fees (billed for actual services received; for disabled children)	Yes	No
Parental fees (billed for future availability of services, with no services actually received; for disabled children)	No	No
Personal use items (toothbrush, toothpaste, etc.)	No	No
Physical exams	Yes	No
Physical therapy	Yes	No
Physician retainer fee (for on-call or concierge services)	No	No
Pregnancy tests (over-the-counter)	Yes	No
Prescription co-insurance	Yes	No
Prescription co-payment	Yes	No
Prescription drugs (for non-cosmetic purposes)	Yes	No
Prescription drugs for cosmetic purposes	No	No
Prescription drugs for hair regrowth	No	No
Prescription insurance / plan premiums (paid with after-tax dollars only)	No	No
Propecia (for treatment of a medical condition)	Yes (Rx)**	No
Prosthesis	Yes	No
Psychiatric care	Yes	No
Psychoanalysis	Yes	No
Psychologist fees	Yes	No
Radial keratotomy (RK)	Yes	Yes
Reading glasses (over-the-counter)	Yes	Yes
Reconstructive surgery (following accident or medical procedure or condition)	Yes (Letter)*	No
Removal of benign mole, cyst or tumor	Yes	No
Retainer fee (to physician for on-call or concierge services)	No	No
Retin-A (for non-cosmetic purposes)	Yes (Rx)**	No
Rogaine or other hair regrowth medications (even if prescribed)	No	No
Sales tax, shipping and handling fees (for any eligible expense)	Yes	Yes
Smoking cessation (programs / counseling)	Yes	No
Smoking cessation drugs (prescription)	Yes	No
Smoking cessation gum or patches (over-the-counter)	Yes (Rx)**	No
Special equipment	Yes (Letter)*	No
Special foods (gluten-free, salt-free or other for treatment of a medical condition; difference in cost only)	Yes (Letter)*	No
Special school (for mental and physical disabilities)	Yes (Letter)*	No
Speech therapy	Yes	No
Spermicidals	Yes (Rx)**	No
Sterilization	Yes	No
Student health fees for dental services (no services actually received; billed for future availability of services)	No	No
Student health fees for dental services (billed for actual services received)	Yes	Yes
Student health fees for medical services (no services actually received; billed for future availability of services)	No	No
Student health fees for medical services (billed for actual services received)	Yes	No
Student health fees for prescription services (no services actually received; billed for future availability of services)	No	No
Student health fees for prescriptions (billed for actual services received)	Yes	No
Student health fees for vision services (no services actually received; billed for future availability of services)	No	No
Student health fees for vision services (billed for actual services received)	Yes	Yes
Sunglasses (over-the-counter)	No	No
Sunglasses (prescription)	Yes	Yes
Sunscreen with SPF<15 or suntan lotion (over-the-counter)	No	No
Sunscreen with SPF 15+ and "broad spectrum", sunburn creams and ointments (over-the-counter)	Yes	No
Supplies (for treatment of a medical condition)	Yes	No
Surgery (for non-cosmetic purposes)	Yes	No
Swimming lessons (for treatment of a medical condition)	Yes (Letter)*	No
Teeth bleaching or whitening	No	No
Teeth grinding prevention devices	Yes	Yes
Therapy (for treatment of a medical condition)	Yes	No
Toothache and teething pain reliever (over-the-counter)	Yes (Rx)**	Yes (Rx)**
Toothpaste, medicated (difference in cost only of medicated toothpaste over the standard toothpaste)	Yes (Rx)**	No
Toothpaste, toothbrush, floss, etc.	No	No
Transgender treatments/surgery	Yes (Letter)*	No
Transportation, parking and related travel expenses (essential to receive eligible care)	Yes	Yes
Transportation, parking and related travel expenses, for non-eligible expenses	No	No
Tubal ligation	Yes	No
Tuition or educational classes	No	No
Tuition or educational classes (for a specific medical condition	Yes (Letter)*	No
Urological products	Yes	No
UV protection clothing	No	No
Vaccinations	Yes	No
Varicose vein removal surgery (for medical care)	Yes	No
Vasectomy	Yes	No
Viagra and similar prescription medications	Yes	No
Vision co-insurance	Yes	Yes
Vision co-payment	Yes	Yes
Vision insurance / plan premiums (paid with after-tax dollars only)	No	No
Vitamins (over-the-counter, for general health purposes)	No	No
Vitamins (prescription)	Yes	No
Walking aids (canes, walkers, crutches and related supplies)	Yes	No
Warranties or other charges for future anticipated services (with none actually received)	No	No
Wart removal treatments (over-the-counter)	Yes (Rx)**	No
Weight loss counseling	Yes (Letter)*	No
Weight loss foods	No	No
Weight loss program (to improve or maintain general health)	No	No
Weight loss program (for treatment of a medical condition)	Yes (Letter)*	No
Weight loss drugs (for treatment of a medical condition)	Yes (Rx)**	No
Wheelchair and repairs	Yes	No
Wound care (over-the-counter)	Yes	No
X-ray fees (dental)	Yes	Yes
X-ray fees (medical)	Yes	No

*Under Internal Revenue Service (IRS) rules, some health care services and products are only eligible for reimbursement from your Flexible Spending Account (FSA) when your doctor or other licensed health care provider certifies that they are medically necessary. Your provider must indicate your (or your spouse's or dependent's) specific diagnosis, the specific treatment needed, and how this treatment will alleviate your medical condition. You will see "Yes (Letter)" if a letter is required.

**FSA funds can no longer be used to purchase over-the-counter medications (such as aspirin, allergy and cold medications, etc.) without a written doctor's prescription. You will see "Yes (Rx)" if a prescription is required. There are still many over-the-counter medical products that can be purchased without a doctor's prescription (such as contact lens solutions and diabetic test kits and supplies), so be sure to check before you purchase.