Page 13 - Centennial Enrollment
P. 13
HSA Qualified Expenses






When to use When NOT to use



 Medical deductible and  Insurance premiums
coinsurance payments  Babysitting/childcare


 Medical, dental, and vision care

services not covered through plan  Cosmetic surgery

design  Health club costs


 Medical, dental, and vision care  Over-the-counter medication

services for your spouse or without a written prescription
dependents (e.g., aspirin, ibuprofen)


 Medicare Part D and COBRA

coverage


 Over the counter medications with Visit www.irs.gov and view Section 213(d) of the

a written prescription IRS Tax Code publication 502 “Medical and Dental
Expenses” for a complete list









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