Encircled icon of a desktop computer monitorEncircled hand hold a mobile device on which the screen shows a check markArrow pointing leftArrow pointing rightAt symbol indicating an email addressInstitution IconMenu IconGo to first page symbolClosed book iconBookmark with tabsEncircled image of a handheld calculatorCalculator IconEncircled monthly calendarCalendar shaped box with checkmarkMonth view of a CalendarCaret DownCaret LeftCaret RightCheckmark on a circlular backgroundCheck mark in a square boxChild IconCircleClock faceClose or Cancel symbolThree cogs enmeshedComment bubbleComment bubbleTwo comment bubbles addressing each other in conversationIcon indicating a database as a stack of circlesEncircled image of a small hand laid atop a larger handDependent Care FSA IconDesktop computer monitor over a circle with a shadowDesktop computer iconEncicled open document folderMoney IconEncircled dollar signUS Dollar symbolDotted Arrow IconEdit IconGo to last page symbolPen with checked checkbox within a circleEnvelope IconExclamation Mark within a Triangular SignEncircled hand holding dollar billsEncircled compassEye IconFacebook LogoEdit IconStar IconFax IconEncircled hand holding a dollar signAdobe Acrobat PDF iconSingle, blank file iconTwo files in a stackLightning bolt symbolEncircled file iconA group of peopleEncircled white crossHealth Care Flexible Spending Account IconHeartbeat IconEncircled "i" characterText file icon symbolizing a paper letterEncircled image of two files, one laid above the otherEncircled icons of a tooth and an eyeLimited Expense Healthcase FSA IconEncircled lightbulbList IconLock IconEncircled megaphoneMedkit IconEncircled chat bubbleMobile phone over a circle with a shadowPause IconEncircled stack of coinsPhone IconPlay IconMouse Pointer IconPrescription SymbolPrinter IconQuestion Mark IconEncircled question markEncircled cloud with download symbolSearch IconSecure EmailSign In IconSign out of this siteSpinning circle indicating a process is activeEncircled starStar IconWrench within a circleTwitter LogoUser Icon with Plus SymbolDownload on the App StoreFSAFEDS LogoGet it on Google PlayUnited States Office of Personnel Management
Close Open Menu

FAQs

Most Popular Questions

What expenses are eligible for reimbursement only if medically necessary?

Some expenses are eligible for reimbursement only when a doctor or other licensed health care practitioner certifies that they are medically necessary. Your doctor's certification must indicate your specific medical disorder, the specific treatment needed, how this treatment will alleviate your medical condition, and the length of treatment required. Examples include:

  • Air conditioners, central air, heaters, and humidifiers installed in your home for allergy relief
  • Cosmetic surgery following an accident, disease or other surgery
  • Home medical equipment (such as reclining chairs, bed boards, special mattress)
  • Hydrotherapy
  • Water fluoridation units
  • Weight loss program for treatment of a specific disease (such as heart disease or diabetes), not including cost of food
  • Wigs for hair loss due to chemotherapy or radiation treatment

FSAFEDS has a sample Letter of Medical Necessity (LMN) (PDF) that you and your health care provider can use. A personal letter from your provider will also suffice as long as it includes all the information necessary to determine medical necessity. Please note, if the treatment extends beyond the time period listed on the previous LMN, you need to submit a new LMN covering the new time period. You must also submit a new LMN each year that you participate in FSAFEDS - the length of time cannot be indefinite.

If the LMN does not contain all of the information listed below, your letter may be denied.

  • Date
  • Employee name and Social Security number or FSAFEDS ID number
  • Patient name
  • Diagnosis (specific medical condition or disorder)
  • CPT code assigned to your diagnosis
  • Specific treatment prescribed by the provider
  • How the treatment will alleviate the condition
  • Duration of the treatment
  • Provider signature, license number, state and telephone number