SPENDING ACCOUNT ELIGIBLE EXPENSE GUIDE

• Health Care Spending Account: This account may be used to pay for eligible medical, prescription, dental, vision and other eligible out-of-pocket expenses that are not covered

Yes (LM): The expense may be eligible for reimbursement if a Letter of Medical Necessity is provided to our office. The expense must be

Yes (LM): The expense may be eligible for reimbursement if a Letter of Medical Necessityis provided to Flex. The expense must be used to treat a

modifications Potentially qualifying expense To show that the expense is primarily for medical care, a note from a medical practitioner recommending the item to treat a

Legal Fees Under Certain Conditions - Note 1 No To procure a medical treatment Life Time Advanced Care Payments No No. Lip Balms No

Legal Fees Under Certain Conditions - Note 1 No To procure a medical treatment. Life Time Advanced Care Payments No

Any amounts then credited to your account for health expense reimbursement or dependent care expense reimbursement may be used for these respective expenses which you incurred

Sterilization procedures Yes No Student health fee No No Sunglasses clips No No Sunglasses (prescription) Yes Yes Sunglasses (nonprescription) No No Sunburn creams and