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Medical FSA Eligible Expenses

„ Ofice visit copays „ Contacts

„ Prescription drug copays „ Contact lens solution

„ Medical and dental deductibles „ Dental services
„ Over-the-counter medications „ Orthodontia
(with a doctor’s prescription) „ Acupuncture

„ Hearing aids „ Laser vision correction surgery
„ Eye glasses

Limited Purpose Medical FSA

As previously stated, if you are enrolled or are going to enroll in the HSA
Plan, you may participate in a limited purpose medical FSA. This account
is designed to complement an HSA and allows for reimbursement of
eligible dental and vision expenses. Similar to the medical FSA, you may
contribute up to $2,550 in the limited purpose medical account.

Limited Purpose Medical FSA Eligible Expenses
„ Eye glasses „ Dental services

„ Contacts „ Orthodontia
„ Contact lens solution „ Laser vision correction surgery

Employee Benefits