Health Care Spending Account Eligible Expenses

Qualified medical expenses can be reimbursed through your Health Care Spending Account. These expenses are defined by the Internal Revenue Code and the University of Iowa Health Care Spending Account Plan. The IRS defines qualified medical expenses as the costs of diagnosis, cure, mitigation, treatment, or prevention of disease, and the costs for treatments affecting any part or function of the body. Medical care expenses must be primarily to alleviate or prevent a physical or mental defect or illness. They do not include expenses that are merely beneficial to general health.

Medical expenses that can be reimbursed to you through any other source, such as group health insurance, are not reimbursable. Per IRS and Plan guidelines, any expense covered by an insurance plan must be processed through that insurance plan before consideration can be given for reimbursement from a Health Care Flexible Spending Account. The explanation of benefits from the insurance plan will be required for processing.

You can use your account to receive reimbursement for qualified expenses for yourself, your spouse and qualifying dependent(s). Any expense covered by an insurance plan must be processed by the insurance before consideration can be given for reimbursement from a health care spending account. Expenses that have been reimbursed or could be reimbursed under another medical plan are not eligible.

The key to making the most of your Health Care Spending Account is understanding the expenses that qualify for reimbursement. When submitting a claim for reimbursement, you are responsible for insuring the expenses are acceptable per the IRS guidelines, and appropriate supporting documentation is provided.

Eligible Expenses

The following is a summary of common qualified expenses for reimbursement under your University of Iowa Health Care Spending Account. The list is intended to be a general guide of eligible expenses and is not all-inclusive. All expenses are subject to change in accordance with plan and IRS regulations. Further, this list does not guarantee reimbursement.

We urge participants to be aware of excessive stockpiling. Stockpiling occurs when a plan participant buys a large quantity of OTC items (typically at the end of the plan year) for the purpose of exhausting unused FSA funds. The IRS has indicated that FSA reimbursements should be limited to a reasonable quantity of OTC items for use during the plan year. The University of Iowa reserves the right to use discretion when reviewing claims to determine what is a reasonable quantity.
  • Acupuncture
  • Alcoholism treatment
  • Artificial limbs
  • Bandages
  • Birth control, condoms
  • Birthing classes/Lamaze (not child rearing)
  • Blood pressure monitor
  • Blood sugar test kit/test strips
  • Breast feeding supplies for lactating women (storage bags, storage bottles, pump conversion kits, nipple shields, breast pads, and breast cream)
  • Breast pump (for lactating women)
  • Chemical dependency treatment
  • Chiropractic care
  • Contact lenses and solution
  • Co-pay, co-insurance, and deductibles
  • CPAP cleaning devices such as SoClean
  • Defibrillator
  • Dental treatments
  • Dentures
  • Diabetic supplies
  • Diagnostic equipment (blood pressure monitor, pulse oximeter)
  • Eye exams
  • Eyeglasses (prescription and readers)
  • Face masks and face shields
  • First aid kits (containing eligible first aid supplies listed below; limit $50 per kit, limited to purchase no more than 3)
  • First aid supplies
    • Adhesive pads
    • Arm slings
    • Bandages
    • Cold compresses
    • Elastic bandages
    • Gauze pads/wrap
    • Hot/cold pack
    • Isopropyl/rubbing alcohol
  • Flu shots
  • Hand sanitizer
  • Hearing aids and hearing aid batteries
  • Heart rate monitor
  • Humidifiers/vaporizers
  • Incontinence supplies
  • Infertility and fertility services covered by insurance
  • Insulin
  • Laser eye surgery, LASIK
  • Massage (for medical condition)
  • Medical alert bracelet/necklace
  • Medical exams
  • Medical supplies
    • Athletic/sports braces
    • Athletic tape
    • Back braces/supports
    • Bedpans
    • Callous remover files
    • Canes/crutches/walkers
    • Carpal tunnel wrist supports
    • Cholesterol testing kits
    • Donut pillow/foam ring
    • Heating pad/heat wraps
    • Ice pack
    • Mastectomy bra
    • Thermometers
    • Truss
    • Wheelchair 
  • Mental health treatment
  • Mileage to and from appointments (2021 rate: $0.16 per mile; 2020 rate: $0.17 per mile)
  • Nasal strips
  • Nebulizer
  • Orthodontia
  • Orthotic insoles
  • Ovulation monitor/kits
  • Peak flow meter
  • Pregnancy tests
  • Prenatal vitamins
  • Prescription drugs and medications
  • Sleep apnea services/products
  • Sterilization/reversals
  • Sunscreen (SPF 15 or higher)
  • Smoking cessation programs
  • Vaccinations/immunizations

Eligible Expenses Requiring a Letter of Medical Necessity

Products and services that may be used for general health or cosmetic purposes are generally ineligible. If a medical condition necessitates the purchase of a potentially eligible item or service, the expense may qualify for reimbursement under your Health Care Spending Account. In order for the following items to be considered for reimbursement, the item or service must be prescribed by a licensed healthcare provider and you must submit a letter of medical necessity (pdf). If approved, the letter is valid for 12 months from the issue date. The letter must be valid on the date the expense is incurred to be eligible for reimbursement.   

  • Activity tracker/smartwatch (limit $150)
  • Compression hose/socks
  • Diagnostic equipment (otoscope, stethoscope)
  • Ear plugs
  • Fitness program/gym membership
  • Glucosamine
  • HEPA filters/vacuums
  • Medical alert system
  • Melatonin
  • OTC infertility treatments
  • Speech therapy (when denied by insurance)
  • Vitamins/supplements
  • Waterpik water flosser
  • Weight loss program fees
  • Wigs

Eligible Over-the-Counter Expenses

Updated 4/1/2020 due to CARES Act
New Federal regulations included in the CARES (Coronavirus Aid, Relief and Economic Security) Act that was passed on March 27, 2020 establish that distributions from Health Care Flexible Spending Accounts will be allowed to reimburse the cost of over-the-counter medicines or drugs without a prescription. This update is retroactive to purchases made on January 1, 2020 or later. 

 The list is intended to be a general guide and is not all-inclusive.

  • Acne medications
  • Allergy medications
  • Analgesics/antipyretics
  • Antacids/acid reducers
  • Anti-arthritics
  • Anti-candidal/yeast
  • Antidiarrheal
  • Anti-fungal
  • Antihistamines
  • Anti-itch creams
  • Aspirin and pain relievers
  • Asthma medications
  • Birth control gels/spermicides, Plan B
  • Cold and flu remedies
  • Cold sore/fever blister remedies
  • Cough suppressants/expectorants
  • Cough drops
  • Decongestants
  • Denture cleaner
  • Diaper rash ointments and creams
  • Douches (medicated)
  • Eye drops
  • Fever reducers
  • Fluoride treatments
  • Hemorrhoid treatments
  • Hormone therapy
  • Lactose intolerance
  • Lice treatments
  • Medicated hand cream
  • Menstrual care products:
    • tampons
    • pads
    • liners
    • cups
    • sponges, or similar products.
    • underwear such as Thinx 
  • Migraine relief
  • Motion sickness
  • Ophthalmic drops/ointments
  • Sinus products
  • Sleep aid medication (Diphenhydramine, Doxylamine succinate)
  • Smoking cessation aids
  • Toothache relief
  • Topical antibiotic cream/ointment
  • Topical steroid
  • Wart remover

Ineligible Expenses

The following expenses are not eligible to be reimbursed under your University of Iowa Health Care Spending Account. The list is intended to be a general guide and is not all-inclusive. Please note that a Letter of Medical Necessity does not make an ineligible expense eligible for reimbursement.

  • After sun products for extending tan/moisturizing skin
  • Athletic mouth guards
  • Baby Monitors (including Owlet)
  • Breast feeding convenience items
  • Bug spray
  • Clothing
  • Colon cleaning
  • Concierge fees
  • Cosmetic products
    • Body/face/hand creams
    • Facial cleansers
    • Make-up
    • Perfumes
  • Counseling
    • Career
    • Life Coach
    • Marriage
  • Dental floss
  • Diet food
  • Dietary supplements
  • Educational testing
  • Ergonomic chairs/equipment
  • Funeral expenses
  • Hair removal and/or replacement treatments (for cosmetic purposes)
  • Home massage devices
  • Household help
  • Insurance premiums
  • Lifetime care/nursing home pre-payments
  • Lip balm/moisturizing (even with SPF listed as an ingredient)
  • Long term care services
  • Lotions/moisturizers (even with SPF listed as an ingredient)
  • Massage (for general health)
  • Medical pre-payments (pre-birth costs)
  • Medical savings account
  • Personal care/convenience Items
  • Personal hygiene products
    • Body sprays
    • Deodorant
    • Mouthwash
    • Shampoo/conditioner
    • Toothbrush/toothpaste
  • Prescription drug additives (flavors)
  • Prescription drug discount programs
  • Recreational/sporting equipment
  • Sunglasses (non-prescription, clip-ons, magnetic clips)
  • Suntan lotion (even with SPF listed as an ingredient)
  • Teeth whitening/veneers (except in the case of birth defect, disease, or accident)
  • Vacations
  • Vitamins/supplements for general health
  • Work-related expenses

Please contact University Benefits at with questions. For the most detailed information on a particular item, you can also refer to IRS publication 502 Medical and Dental Expenses.


Contact Information

University Benefits Flexible Spending Accounts

Campus Address
120 USB
Mailing Address

120 University Services Building
Iowa City, IA 52242-1911
United States

Monday-Friday, 8 a.m.-5 p.m.