Medical FSA and HSA Expense Eligibility List

14. Your family or friends living abroad with whom You were planning to stay are unable to provide accommodations due to life threatening illness, life threatening injury or death

• Explain the major characteristics of the following group medical expense plans: basic medical expense insurance, major medical insurance, and dental insurance.. • Describe

May qualify if used to treat or alleviate a specific medical condition, and if the expense would not have been incurred "but for" the condition. SURROGATE EXPENSES

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

May qualify if used to treat or alleviate a specific medical condition, and if the expense would not have been incurred “but for” the condition.* To show that the expense is

Potentially Meals that are part of the cost of inpatient care at a hospital or similar institution will qualify if the principal reason for the recipient’s being there is to

To show that the expense is primarily for medical care, a note from a medical practitioner recommending the item to treat a specific medical condition (for example, arthritis) is

Acknowledging that such risks exist, I on behalf of myself, my child and any other party who may have the right to assert any rights for or on behalf of my child, do hereby