Health Care FSA Eligible Expenses

BNY Mellon Benefits Guide

Expenses are eligible for reimbursement from the Health Care FSA if they:

qualify for deduction on your federal income tax return; and

are not reimbursable under any health care benefits covering you or your family members.

Examples of qualified medical expenses include:

deductibles, copayments, prescriptions and certain over-the-counter items (insulin, over-the-counter drugs for which you have a valid prescription);

non-drug over-the-counter purchases, such as contact lens cleaner, bandages and blood pressure monitors);

costs for hearing exams; and

any costs above what your plan pays.

IRS regulations do not allow reimbursement for dietary supplements, such as vitamins. You cannot use the Health Care FSA to reimburse yourself for premiums you pay for health care coverage.

For a complete list of qualified medical expenses, consult a tax adviser. You can also see IRS Publication 502 (Medical and Dental Expenses), which is available on MySource or at www.irs.gov/Forms-&-Pubs.

Over-the-counter medicine (such as allergy, cold and pain medication) is only reimbursable under the Health Care FSA if you have a prescription from a physician.