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Acceptable Items for Health Care FSA


Lisa Hand

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The breast pump would be medically if the infant was unable to breast feed or failing to thrive. Then its use would be "primarily to prevent or alleivate a physical or medical defect or illness." and can be documented as such by their provider.

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Guest Steven7

I have to make judgement calls for our Flexible Spending Accounts. In the past I have found IRS Publications 502 and 503 to be most helpful in clarifying the questions that have arisen. (they can be obtained at the IRS web site at: http://www.irs.ustreas.gov/plain/forms_pubs/pubs.html)

In handling a Medical FSA I allow whatever is acceptable in the list found in Pub 502. As a general rule, if an item is claimed that is not clearly specified, I ask for a note from a physician stating that the purchase is medically necessary.

I have received a claim requesting reimbursement for a breast pump. I cannot find any reference to breast pumps in Pub 502. Has anyone else had a similar claim request and what was the basis for your decision?

The reason I ask is because the claimant is himself a physician and I am sure he can find someone to write a note for him.

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We have also reimbursed expenses for breast pumps. Sometimes the babies are prone to allergies and need the breast milk. If the mother is working, this seems like the only way to accomplish that. The important thing seems to be that it be for the health of the baby and not for the mother.

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  • 2 weeks later...
Guest Curt Stoller

A client of ours has a Full Flex Plan and a particpant wants to know if he can claim the cost of installing a ramp and widening door ways for his disabled dependent Child. I note that Pub 502 address these as Capital Improvements. Your thoughts please.

------------------

Curt Stoller

curtstoller@stollerco.com

[This message has been edited by Curt Stoller (edited 03-04-99).]

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Curt,

The IRS has specifically held that improvements such as ramps and widened door ways to accommodate a handicapped individualare deductible in full. Rev. Rul. 87-106, says that these types of expenses are deemed NOT to improve the value of the property, so you don't have to worry about a partial deduction. If you want a copy of the revenue ruling, let me know and I'll send it to you.

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Guest myvettee

I frequently have this question asked. I do not find it in any of the IRS publications currently in my file. Here's the question:

Is teeth bleeching, whitening an allowable expense in the Cafeteria, section 125K flexible spending account plan? Thanks in advance for your help! Yvette

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Guest Steven7

Teeth Bleaching or whitening is a cosmetic procedure. I would not permit reimbursement for anything cosmetic. The regs prohibit it.

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Cosmetic procedures are prohibited unless "...it is necessary to improve a deformity arising from, or directly related to, a congentital abnormality, personal injury resulting from an accident or trauma, or a disfiguring disease." (IRS Publication 502) Depending on the situation, it may be allowable, detailed documentation would be required to prove the procedure is treatment as decribed above.

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Guest Steven7

Granted, if the condition arises from a congenital abnormality, etc., it can be covered. Who was it that once said "Often the outcome of dental trauma can result in intrapulpal bleeding with subsequent color change of the elements

involved."? Oh, yeah, that was Carratu, P.; Amato. M; Nicolo, M. at the University of Federico in Naples (Italy).

Okay, I stand humbly corrected. I would, however, be careful in allowing it. I would require the dentist to specify (in writing) what illness, condition or injury caused the problem before reimbursing. Folks who have their teeth bleached do so for cosmetic reasons. I would guess that the root cause (pun intended) of the color change, in most cases, is something other than that which would permit reimbursement.

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Guest patti pierce stone

I am also responsible for determining eligible claims. Since the first of this year, I have received several "alternative medicine" claims. I know that accupuncture is covered ... specified in Pub. 502. I recently denied a claim for herbal therapy by an herbologist, although I did have the benefits representative send a note indicating we'd research.

My stance on the herbologist/therapy is #1, that herbs would be in the same classification as OTC drugs and thereby would not be eligible; and #2, that a herbologist is not a licensed practitioner.

Today we received a claim for theraputic massage -- I find nothing in Pub. 502 that covers this at all and tend to declare it ineligible as well.

I welcome all comments and opinions.

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