Is there a list of FSA exclusions?

Plan members who have a 2017 FSA (either a healthcare FSA or a limited purpose FSA [also known as an L-FSA]) or a health savings account (HSA) can go to PayFlex’s website to see a comprehensive list:

 

stateoftn.payflexdirect.com

 

Once there, click on the tab labeled “Common Eligible Expense Items” and then click the blue hyperlink that says “Common Eligible Health Care Expenses.”  This will bring up toward the bottom of the screen a list of expense types (left hand column) and then notes as to whether it is-

 

  • Eligible
  • Requires a Letter of Medical Necessity (from a clinician or physician)
  • an OTC Medicine or Drug that Requires a Prescription
  • Ineligible

 

These are all expense items that the IRS has strict rules about, and as an IRS-approved flexible benefits administrator PayFlex must strictly adhere to the rules surrounding each of these.   PayFlex may also ask for substantiating documentation from an FSA enrollee.  PayFlex must strictly adhere to the rules surrounding FSA reimbursments.

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