Various Eligible Expenses
You can use your Limited Expense Health Care FSA (LEX HCFSA) funds to pay for a variety of dental and vision care products and services for you, your spouse, and your dependents. The IRS determines which expenses can be reimbursed by an FSA.
Keep Your Receipts
Please save your receipts and other supporting documentation related to your LEX HCFSA expenses and claims. The IRS may request itemized receipts to verify the eligibility of your expenses. Credit card receipts, canceled checks, and balance forward statements do not meet the requirements for acceptable documentation.
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|=||Eligible with a detailed receipt|
|=||Eligible with appropriate documentation:|
|=||Requires Prescription from your doctor, plus detailed receipt|
|=||Requires letter of Medical Necessity signed by your doctor, plus detailed receipt|