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Provess Flexible Benefits
4050 Katella Avenue, Suite 213
Los Alamitos, CA 90720

Phone: (866) 639-5289
E-Fax: (866) 264-4093
E-mail: admin@provess.com

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  • Health Care FSA Ineligible Expenses The following list represents expenses that are frequently submitted for reimbursement under Health Care Flexible Spending Accounts (FSA) and are generally ineligible for reimbursement under an FSA. This list is not intended to be exhaustive and is intended only to be used as a general guide. Consequently, expenses contained in this generally ineligible list may be reimbursable if the supporting claims documentation shows that the expense was incurred for medical care. Payment of claims will be based on the rules set out in the applicable regulations, your employer?s plan design and on the information in the required substantiation documentation.
    Air conditioner May be eligible if used to treat a specific medical condition Air purifier May be eligible if used to treat a specific medical condition Automobile modifications
    For physically handicapped individuals Babysitting
    Breast pump
    Only eligible if to treat or mitigate a specific medical condition Breastfeeding classes
    Capital expenses
    May be eligible if for improvements to home to accommodate physical disability Cayenne pepper
    May be eligible if used to treat a specific medical condition Child care
    Child or newborn instruction
    COBRA premiums
    Allowed only as tax deduction on personal income tax (Publication 502). Strictly prohibited under cafeteria plan regulations from being reimbursed under a health FSA (Prop. Treas. Reg. Sec. 1.125-2, Q/A 7(b)(4)) Concierge Physician Fees (Retainer fees)
    Cord blood storage
    May be eligible if being used to treat a specific and imminent medical condition. ?Just-in-case? storage NOT eligible Cosmetic procedures
    May be eligible if surgery is necessary to correct a deformity arising from, or directly related to, a congenital abnormality, a personal injury resulting from an accident or trauma, or disfiguring disease. CPR classes
    Dancing Lessons
    Deodorant
    Dependent care expenses
    Diaper Service
    Diet Foods
    Dietary supplements
    May be eligible if used to treat a specific medical condition ? Use to benefit general health NOT eligible. DNA collection and storage
    Temporary storage may qualify if collected as part of diagnosis, treatment or prevention of an existing or imminent medical condition Doula services
    Ear piercing
    Ear plugs
    May be eligible if used to treat a specific medical condition Egg and Embryo Storage
    Storage fees for undefined future conception are ineligible Elder care expenses
    Electrolysis
    Exercise equipment/programs
    May be eligible only if prescribed by physician to treat medical condition (obesity) and only while condition exists Experimental drugs
    Funeral expenses
    Hair removal procedures/products
    Hair transplant
    Hair treatments
    Health club memberships
    May be eligible only if prescribed by physician to treat medical condition (obesity) and only while condition exists Herbal Medicines
    May be eligible if used to treat a specific medical condition Homeopathic Medicine
    May be eligible if used to treat a specific medical condition Hot tub
    May be eligible only if prescribed by physician to treat medical condition and only while condition exists Humidifier
    May be eligible if used to treat a specific medical condition Illegal operations/treatments
    Imported drugs
    Insurance premiums
    Allowed only as tax deduction on personal income tax (Publication 502). Strictly prohibited under cafeteria plan regulations from being reimbursed under a health FSA (Prop. Treas. Reg. Sec. 1.125-2, Q/A 7(b)(4)) Jacuzzi
    May be eligible only if prescribed by physician to treat medical condition and only while condition exists Late payments fees
    Lead-based paint removal
    For expense related to removing lead-based paint to prevent a child who has (or has had) medical condition from eating the lead-based paint. Legal fees
    May be eligible if eligible medical care could not have been provided without legal assistance Lipsticks
    Lodging while attending a medical conference
    Long-term care premiums
    Marriage Counseling
    Maternity clothes
    Mattresses
    In rare cases the expense in excess of the cost of a regular mattress may be eligible for reimbursement if prescribed by physician to treat specific medical condition Meals
    Medical marijuana
    Medical newsletter
    Missed appointment fees
    Nail polish
    Natural Medicine
    May be eligible if used to treat a specific medical condition Nursing services for healthy baby
    Patented Medicine
    May be eligible if used to treat a specific medical condition Perfume
    Over-the counter items
    Examples of generally ineligible items as generally NOT used for medical care:
    ·	Alertness pills 
    ·	Baby bottles 
    ·	Baby formula 
    ·	Battery operated toothbrushes 
    ·	Chap stick 
    ·	Cold cream 
    ·	Cosmetics 
    ·	Cotton Balls 
    ·	Dental Floss 
    ·	Deodorant 
    ·	Diapers 
    ·	Diet drinks and bars 
    ·	Electric toothbrush 
    ·	Emergency kits 
    ·	Energy bars/drinks 
    ·	Facial care creams 
    ·	Feminine hygiene 
    ·	Hair clippers 
    ·	Hair conditioner 
    ·	Hair removal products 
    ·	Hair restoration products 
    ·	Hand lotion 
    ·	Moisturizers 
    ·	Mouthwash 
    ·	Nail clippers 
    ·	Nasal wash 
    ·	Petroleum jelly 
    ·	Q-Tips 
    ·	Skin care products 
    ·	Razor 
    ·	Razor blades 
    ·	Rogaine 
    ·	Shampoo 
    ·	Soaps 
    ·	Shaving cream 
    ·	Sunglasses (unless prescription) 
    ·	Sunscreen 
    ·	Teeth whiteners 
    ·	Tissue 
    ·	Toiletries 
    ·	Toothbrush 
    ·	Toothpaste 
    ·	UV protection clothing 
    ·	Vaseline 
    ·	Vitamins for well-being 
    ·	Warranties 
    ·	Weight loss foods 
    ·	Wrinkle reducers
    
    Personal trainer fees
    May be eligible only if incurred for limited duration and a medical practitioner has recommended a supervised exercise regimen to treat a specific disease or injury (i.e. obesity or knee injury) Physician retainer fee (Concierge fees)
    Prescription drug discount program fees
    Rogaine
    May be eligible if for diagnosis of high blood pressure Rubbing alcohol
    May be eligible if used to treat a specific medical condition Special schools, educational
    Expenses for mentally impaired or physically disabled individual qualify IF purpose of using the school is to relieve disability. Special schools, residential
    May be eligible if for treatment of behavioral, emotional and addictive conditions IF primary purpose of the program is medical care Sperm, storage fees
    May be eligible only if for temporary storage and use for immediate conception Stem cell, harvesting and/or storage
    May be eligible if being used to treat a specific and imminent medical condition. ?Just-in-case? storage NOT eligible Student health fee
    Sunglasses
    Prescription sunglasses only are eligible Sunscreen with SPF 30 or greater
    May be eligible with the SPF details clearly stated on the receipt by a third party ( e.g. pharmacy) Swimming lessons
    Tanning salons and equipment
    Teeth whitening
    Veneers
    Vision discount programs
    Vitamins
    May be eligible if used to treat a specific medical condition ? but NOT for use to maintain general health

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