Medical Reimbursement Account (MRA) Eligible Expenses

Introduction

This guide includes a list of health care expenses and lets you know whether you can use the money in your Medical Reimbursement Account (MRA) to pay for the health care expense. Eligible health care expenses are health care costs that result from the diagnosis, care, treatment, improvement, or prevention of a disease or illness.

About Your MRA

Who can I spend my MRA funds on?

You can use your MRA to pay for eligible health care services received or health care items purchased by you, your spouse or domestic partner, and your children or dependents.

Who qualifies as my dependent?

A dependent is a child or relative who lives with you for more than half the year and receives more than half of his/her financial support from you. Dependents may include full-time students ages 19 through 26 and children over age 19 who are permanently disabled. A relative must receive more than half of his/her financial support from you and not be your child or the child of any other taxpayer to qualify as a dependent.

How to Use the Guide

Unless we specifically mention it in this guide, the rules related to the health care expense apply to both the SF MRA and SF Covered MRA programs.

    1. Find the health care expense.
    2. See if the expense is eligible for reimbursement.
      • Each expense is in one of three categories:
      • Eligible – This expense is eligible for reimbursement from your MRA.
      • Potentially Eligible – This expense may be eligible for reimbursement based on meeting certain requirements.
      • Ineligible – This expense is not eligible for reimbursement from your MRA.
    3. If the expense is potentially eligible for reimbursement, find out what additional requirements apply or additional documentation you need to provide. For expenses where “Provider’s Statement Required,” the documentation needs to include: provider’s name,patient’s name, description of the medical condition, description of the treatment needed, length of time the treatment will be needed, and explanation of how the treatment will help the medical condition.
HEALTH CARE EXPENSE TYPEELIGIBLE FOR REIMBURSEMENTSPECIAL REQUIREMENTS
A
AA, Alcoholism, Drug, or
Substance Abuse Treatments

• Alcohol or substance abuse treatment
center, including meals and lodging
Yes
Abortion Yes
Acne Treatment
• Acne medication
• Acne peels
• Cryosurgery
• Dermabrasion
• Laser Treatment
Yes
Activity Tracker
• Fitness Tracker
• Heart Rate Monitor
• Pedometer
• Smart Watch
Yes Eligible if purchased on or after 12/1/2019
Data plans, accessories, and insurance for these products are not eligible for reimbursement.
Acupuncture
• Acupuncture
• Acupressure
Yes
Adoption Fees No You may submit health care expenses for
an adopted child once they become your
qualified dependent, including health care
expenses incurred during the adoption
process, such as physical examinations.
Affordable Care Act (ACA) Penalties No Tax penalties for not complying with the individual mandate of the Affordable Care Act (also known as the ACA or “Obamacare”) are not eligible for reimbursement.
Air Conditioner Potentially Eligible Provider’s statement required.
Air Purifier
• Including Air Filter
Yes Eligible if purchased on or after 12/1/2019
Allergy Relief (Equipment and Supplies)
• Humidifier
• Nebulizer
• Removal of flooring
• Special pillows, mattress covers, etc. to
alleviate an allergic condition
• Special vacuum cleaners
• Vaporizer
Potentially Eligible Provider’s statement required.
Allergy Relief (Medicine and Shots)
• Allergy shots
• Nasal irrigation supplies (e.g. Neti Pot)
• Over-the-counter allergy medication
• Prescription allergy medication
• Saline eye drops
• Saline nasal aspirators or sprays
Yes
Ambulance Services Yes
Anti-Itch Lotions and Creams Yes
Artificial Insemination
• Fertility exams
• Embryo replacement and storage
• Egg donor: recipient’s medical expenses
• In-vitro fertilization
• Sperm bank/semen storage for
artificial insemination
• Sperm implants due to sterility
• Sperm washing
• Surrogate pregnancy: donor’s medical
expenses, surrogate’s medical expenses
Yes See also Fertility Treatments
Artificial Limb (prosthesis) or
Teeth (dentures or implants)
Yes
Asthma Medicines Yes
Audio Books
• Books on tape
• Books on CD
• Books online or other digital formats
Potentially Eligible Documentation of a visual impairment
or other disability that necessitates an
audio/electronic version is required.
Automobile
• equipment such as hand controls, lifts, or
ramps
• Special-design vehicles
Potentially Eligible Provider’s statement required.
B
Baby Formula Yes
Bike Share and Bike Share Membership
The cost of temporarily renting a bicycle including but not limited to the following companies:
• Bay Wheels
• Jump
Potentially Eligible Provider’s statement required.
Does not include the rental of electric scooter.
Eligible if purchased on or after 12/1/2019.
Birth Control / Family Planning
• Birth control pills, patches, or rings
• Condoms
• Diaphragm or IUD
• Norplant or Depo-Provera
• Ovulation kits
• Spermicides
• Tubal ligation
• Vasectomy
Yes
Blood Storage Yes
Body Scan
• CT body scanning
• Full body scanning
Yes
Botox Treatment Potentially Eligible Provider’s statement required.
Botox used to improve a deformity that arises from, or is directly related to, a birth defect, a disfiguring disease or an injury resulting from
an accident or trauma is an eligible expense. Botox used for the treatment of migraines is an eligible expense.
Braces and Other Orthodontics Yes
Braille Books and Magazines Yes
Breast Pump and Lactation Supplies
• Breast pump
• Breast pump accessories
• Lactation creams/ointments
• Lactation pads/shields
• Storage bags/bottles
Yes
C
Capital Modification (House)
A capital modification is an expense incurred for the primary purpose of accommodating a personal residence to a disability.
• Constructing ramps
• Widening doorways
• Installing railing or support bars to
bathrooms, stairways, etc.
• Lowering or modifying kitchen or
bathroom cabinets
• Altering the location of, or modifying
electrical outlets and fixtures
• Installing porch lifts and other forms
of lifts
• Modifying fire alarms, smoke detectors,
and other warning systems
• Modifying hardware on doors
• Grading of ground to provide access to
the residence
• Isolation of lead-based paint through wall
covering (wallboard, paneling)
• Removal of lead-based paint
This list is not exhaustive.
Potentially Eligible Only reasonable costs incurred to accommodate a personal residence to the disability are eligible. Additional costs for personal reasons, such as architectural or aesthetic reasons, are not allowable as medical expenses.
Childbirth-Related
• Childbirth prep classes (Lamaze)
• Midwife fees
• Maternity girdles (for back pain) or
special support hose (for leg circulation)
• Home pregnancy tests
• Ovulation kits
• Doula fees
• Lactation consultants
Yes
Chiropractor Fees Yes
Christian Science Practitioners Yes
Church of Scientology Practitioners No
Circumcision Potentially Eligible Fees for “ritual” circumcision performed by a non-health care provider (e.g., rabbi, mohel) are not eligible.
Classes, Health-Related Potentially Eligible Provider’s statement required. The purpose of the training must be for the treatment of a medical condition and not for the promotion of general health
Coinsurance
• The portion of a medical bill exceeding the deductible that is shared with the health insurer.
Yes
Cold and Flu Medicine
(e.g. Dayquil, Nyquil, Sudafed, Theraflu, Triaminic, Tylenol Cold and Flu)
Yes
Cold Sore/Fever Blister Treatment Yes
Colonic Cleansing/Wash
• Colon hydrotherapy
Potentially Eligible Provider's statement required
Concierge (Boutique) Fees Yes Membership or retainer fees to a provider for eligible health care services.
Condoms Yes
Contact Lenses and Contact Lens Cleaner Yes
Contraceptive Products Yes See Birth Control / Family Planning.
Copayments Yes See Insurance Co-Pays.
Cosmetic Products
• Face soaps
• Creams
• Makeup
• Perfumes
• Hair removal
No
Counseling
• Psychotherapy and psychoanalysis
• Sex therapy
• Bereavement and grief counseling
• Telephone counseling
• Marriage counseling
Yes
Cough Relief, Cough Medicine,
and Cough Drops
Yes
Crutches
D
Dancing or Swimming
• Lessons, etc.
No
Decongestants
(e.g. Claritin-D, Neo-Synephrine, Sudafed)
Yes
Deductibles Yes See Insurance Deductibles
Dehydration/Rehydration
(e.g. Pedialyte)
Yes
Dental Care and Prevention
• Bonding and sealants for dentures
• Braces or other orthodontics
• Cleaning
• Crowns
• Dentures
• Extractions
• Filings
• Medicated toothpaste
• Occlusal guard
• Porcelain veneers (if not cosmetic)
• Sealants (non-denture)
• X-rays
This list is not exhaustive.
Yes
Dental Products
• Dental Floss
• Non-medicated toothpaste
• Teeth whitening kits
• Toothbrushes
No
Dental Treatment – Cosmetic
• Teeth whitening or bleaching
• Porcelain veneers
This list is not exhaustive
Potentially Eligible Provider’s statement required.
A cosmetic surgery or procedure can be an eligible expense if it is necessary to improve a deformity that arises from, or is directly related to, a birth defect, a disfiguring disease or an injury resulting from an accident
or trauma.
Dentist Fees
• General/Family Dentist
• Oral Surgeon
• Orthodontist
• Endodontist
• Periodontist
This list is not exhaustive.
Yes
Diabetic Supplies
• Sterile cotton balls
• Alcohol prep swabs
• Glucose tablets
• Glucometer and test strips
• Insulin
• Needles (lancets)
• Syringes
• Glucagon emergency kit
• Ketone urine test strips
• Training classes
Yes
Diapers or Diaper Service Potentially Eligible Diapers for disabled individual, other than a newborn, are eligible, but only if needed to relieve the effects of a particular disease.
Disabled Dependent Care Expenses Potentially Eligible Provider’s statement required
Eligible if purchased on or after 12/1/2019
Doctor Fees
• Anesthesiologist
• Chiropodists
• Chiropractor
• Christian Science Practitioner
• Dermatologist
• Gynecologist
• Naturopath
• Neurologist
• Obstetrician
• Oculist
• Oncologist
• Ophthalmologist
• Optician
• Optometrist
• Orthopedist
• Osteopath
• Otorhinolaryngologist
• Pediatrician
• Physician
• Podiatrist
• Psychiatrist
• Physiotherapist
• A physical without diagnosis or not
covered by insurance
• Consultations
• Transfer of medical records
• Any expense a doctor may charge to
write a provider’s statement
This list is not exhaustive.
Yes Fees include the portion of the expense not paid for by other health insurance (the “out‑of‑pocket” portion). Late fees, finance fees, fees for missed appointments, etc., are not eligible medical expenses.
Drugs/Medicines – Prescriptions Potentially Eligible Expenses must involve prescription drugs/medicines that could be legally provided within the U.S.
Drugs/Medicines – Over-the-Counter
• Anti-Itch Lotions and Creams
• Asthma Medicines
• Cold Sore/Fever Blister Treatment
• Cold and Flu Remedies
• Contraceptive Products
• Cough Medicine and Relief
• Decongestants
• Dehydration/Rehydration
• Diaper Rash
• Eye Drops
• Hand Sanitizer
• Hemorrhoidal Preparations
• Migraine Relief
• Motion Sickness
• Sinus Products
• Smoking Cessation
• Sunburn Relief
• Sunscreen
• Teething/Toothache Relief
• Topical Steroids
• Wart Removal
This list is not exhaustive.
Yes
Drug Addiction Treatment YEs
E
Electrolysis or Hair Removal Potentially Eligible Provider’s statement required.
Electrolysis or hair removal can be an eligible expense but only if it is necessary to improve a deformity that arises from, or is directly related to, a birth defect, a disfiguring disease or an injury resulting from an accident or trauma.
Exercise Equipment and Programs
• Exercise videos
• Exercise DVDs
Potentially Eligible Provider’s statement required.
The exercise equipment and program must treat a medical condition diagnosed by a health care provider (e.g., obesity, diabetes, high blood pressure). The cost of a weight loss program to improve your general health
and appearance is not an eligible
Eye Drops Yes
Eyeglasses and Eye Care
• Eye examinations
• Contact lens, fitting fee,
replacement lens
• Contact lens solutions
• Reading glasses
• Prescription glasses, prescription sports
goggles, prescription sunglasses, scuba
masks or safety glasses
• Artificial eye and polish
• LASIK/laser surgery, radial keratotomy, or other vision correction surgery
• Vision insurance premiums
Yes The following items are not eligible:
• Eyeglass or other
vision-related warranties
• Non-prescription sunglasses
• Non-prescription cosmetic contact lenses
• Clip-on sunglasses
F
Face Masks (for respiratory protection) Yes
Facility Fees
• Hospital
• Nursing home
• Rehabilitation facility
• Home for mentally or physically disabled
Yes
Feminine Hygiene
• Maxi pads
• Menstrual cups
• Tampons
Yes
Fertility Treatments
• Artificial insemination
• Fertility exams
• Embryo replacement and storage
• Egg donor: donor’s medical expenses,
recipient’s medical expenses
• In-vitro fertilization
• Sperm bank/semen storage for artificial insemination
• Sperm implants due to sterility
• Sperm washing
• Surrogate pregnancy: donor’s medical
expenses, surrogate’s medical expenses
• Reverse vasectomy
• Reverse tubal ligation
Yes
Fiber Supplements Yes
First Aid Supplies/Wound Care
(e.g. Band-Aids, Neosporin)
Yes
Fitness Tracking Device
• Heart rate monitor
• Pedometer
• Smart watch
Yes Eligible if purchased on or after 12/1/2019.
Data plans, accessories, and insurance for these products are not eligible for reimbursement.
Fluoride Treatments
(e.g., fluoride rinses)
Yes
Food Supplements
(e.g. Ensure, Pediasure)
Yes
Founder’s Fee/Lifetime
Care Advance Payments
Potentially Eligible Provider’s statement required
Eligible if purchased on or after 12/1/2019
Funeral Expenses No
G
Gender Re-Assignment
• Surgery
• Counseling
• Hormone therapy
Yes
Genetic Counseling and Testing (for a medical condition) Yes Eligible if purchased on or after 12/1/2019
Guide Dogs
• Cost of the animal
• Care of the animal
Potentially Eligible Provider’s statement required.
Gym Fees
• Gym Membership Fees
• Fitness Class
• Trainer Fees
• Yoga Class
Potentially Eligible Provider’s statement required.
Amounts paid for gym fees for your general
health not related to a particular medical
condition are not eligible expenses.
H
Hair Loss Treatment Potentially Eligible Provider’s statement required.
Hair loss treatment can be an eligible expense if it is necessary to improve a deformity that arises from, or is directly related to, a birth defect, a disfiguring disease or an injury resulting from an accident or trauma. Treatment for hair loss that occurs as a normal part of aging or inherited or genetic baldness, or for cosmetic purposes, would not be covered.
See also Wigs or Toupees.
Hair Transplant Potentially Eligible Provider’s statement required.
Surgical hair transplants can be an eligible expense if it is necessary to improve a deformity that arises from, or is directly related to, a birth defect, a disfiguring disease
or an injury resulting from an accident or trauma. Treatment for hair loss that occurs as a normal part of aging or inherited or genetic baldness, or for cosmetic purposes, would not be covered.
See also Wigs or Toupees.
Health Club Dues Potentially Eligible Provider’s statement required.
Amounts paid for health club dues or steam baths for your general health or to relieve physical or mental discomfort not related to a particular medical condition are not eligible expenses.
Health Expenses Incurred Outside of the United States Potentially Eligible Provider’s statement required.
Expenses must involve medical care or drugs medicines that could be legally provided within the U.S.Provider’s statement required. Expenses must involve medical care or drugs medicines that could be legally provided within the U.S.
Health Institute Fees Potentially Eligible Provider’s statement required
Health institute fees are the expenses associated with attending health-related courses, retreats, workshops, room & board, and wellness coaching.
Eligible if purchased on or after 12/1/2019.
Health Insurance Premiums Yes See Insurance Premiums.
Health Screenings or Routine Medical
Exams
(e.g. VDRL, cholesterol, diabetes
glucose, blood pressure)
Yes
Healthy San Francisco Participant Fees Potentially Eligible Eligible for reimbursement through SF MRA.
Not eligible from reimbursement through
SFCovered MRA.
Hearing Aids
• Purchase price and maintenance cost for hearing aid
• Batteries needed to operate the hearing aid
• Television or telephone adapter for the deaf
• Lip reading lessons
• Hearing exams
Yes The cost of the television or telephone would not be eligible. An eligible expense would only include special modifications needed for a disabled person to use the television or telephone.
Hearing Exams Yes
Heart Monitors Potentially Eligible Provider’s statement required.
Monitors tracking heart rate during exercise for general purposes not eligible.
Hemorrhoidal Preparations Yes
Hippotherapy
Therapeutic horseback riding
Potentially Eligible Provider’s statement required.
Recreational horseback riding is not an eligible expense.
Home for Mentally Disabled Persons Yes The cost of keeping a mentally disabled person in a special home, not the home of a relative, on the recommendation of a psychiatrist to help the person adjust from life in a mental hospital to community living.
Hospital Services/Fees
• Private room fees
• Hospital kits (water pitcher, razor, toothbrush, lotion, etc.)
Yes
House Modification Potentially Eligible See Capital Modification.
Household Help
• Cleaning services
• Cook/chef
• Personal assistant
• Driver
• Gardener
No Certain expenses paid to an attendant
providing nursing type service may be eligible.
See Nursing Services.
Human Chorionic Gonadotropin (HCG)
Injections
Potentially Eligible Provider’s statement required.
HCG injections may be eligible for infertility treatment or to test for tumors, but not for general weight loss or steroid enhancement unrelated to a medical condition.
Hypnosis Potentially Eligible Provider’s statement required.
Hypnosis may qualify if performed by a licensed professional to treat a medical condition (e.g., smoking cessation or weight loss due to a diagnosed medical condition). Hypnosis does not qualify if performed for
personal well-being, such as general stress relief.
I
Incontinence Supplies Yes
Insurance Co-Pays Yes The flat dollar amounts paid for medical
services by the program participant.
Insurance Deductibles Yes The portion of a medical claim that is not covered by a health insurance provider and must be paid by the program participant.
Insurance Premiums
• Any medical, dental or vision insurance
premium (HMO, DMO, PPO, etc.)
• Long-term care insurance premium
• Medicare (parts A, B & D)
• Life insurance
• Disability insurance premiums
• Student health fees
• COBRA premiums
Yes
J
Joint Supplements Yes
L
Laboratory Fees
• Blood tests
• Cardiographs
• Cholesterol test
• Genetic testing
• Laboratory handling fees
• Metabolism test
• Pap smears
• Shipping and transport fees
• Spinal test
• Stool exams
• Storage fees for blood taken for surgery in the near future (not long-term storage)
• Thyroid profile
•Urinalysis
•X-ray exams
This list is not exhaustive.
Yes
Lactose Intolerance Supplements Yes
Lead-based Paint
• Removal of paint
• Covering of paint
Potentially Eligible Provider’s statement required.
The cost of repainting the scraped area is not
an eligible expense.
Legal Fees for Medical Care
Authorizing Treatment for Mental Illness
Yes Fees related to guardianship or estate management are not eligible expenses.
Lice Treatment Yes
Lodging
(Hospital or Similar Institution)
• Hospital
• Nursing home
• Rehabilitation facility
Yes Lodging at a hospital or similar institution is
an eligible expense if the primary reason for
being there is to receive medical care.
Lodging (Non-Hospital)
• Hotel
• Motel
Potentially Eligible The cost of lodging not provided in a hospital or similar institution while away from home is an eligible medical expense if:
• the lodging occurred at the same time as
the medical treatment;
• the lodging is primarily for and essential to
medical care;
• medical care is provided by a doctor in a
licensed hospital or medical care facility
equivalent of, a licensed hospital;
• the lodging is not lavish or extravagant
under the circumstances; and
• there is no significant element of personal
pleasure, recreation, or vacation in the travel
away from home
M
Marijuana No Payments for medications or treatments
illegal in the United States are ineligible
for reimbursements. State law does not
supersede federal law (e.g., California
marijuana dispensaries).
Mastectomy-related supplies
• Breast form cover
• Breast forms
• Removable liquid adhesive
• Special Bra for mastectomy
Yes Eligible if purchased on or after 12/1/2019.
Maternity
• Childbirth prep classes (Lamaze)
• New parent/Newborn childcare classes
• Midwife fees
• Maternity girdles (for back pain) or
special support hose (for leg circulation)
• Home pregnancy tests
• Ovulation kits
• Doula fees
• Lactation consultants
Yes
Mattress Potentially Eligible Provider’s statement required.
Meals
• Hospital
• Nursing home
• Rehabilitation facility
Yes Meals at a hospital or similar institution are
eligible expenses if the main reason for being
there is to receive medical care.
Medical Alert
• Medical alert bracelet
• Medical alert systems
Yes
Medical Conferences Potentially Eligible Provider’s statement required.
Medical Information
• Electronic maintenance of medical
plan info
• Fees to transfer records due to a change
in physicians
Yes
Medical Supplies
• Back braces or supports
• Bandages
• Blood pressure kit
• Cholesterol testing kit
•Corn-removal treatments or pads
• CPAP and supplies (for sleep apnea)
• Defibrillator
• Diagnostic devices
• Diabetic supplies
• Educational material related to a diagnosed illness
• First aid kit
• Glucose kit
• Heating pad/pack, ice pack
• Inclinator
• Orthopedic shoe inserts, or orthotics
• Orthopedic shoes
• Physician’s scales
• Surgical Stockings
• Thermometers
• Truss
• Wheelchairs, walkers, canes, crutches
This list is not exhaustive.
Yes
Mental Health Services Yes See Therapy.
Migraine Relief
(e.g. Advil Migraine, Motrin Migraine,
Excedrin)
Yes
Motion Sickness
(e.g. Dramamine, Marezine)
Yes
N
Nursing Home Yes
Nursing Services
• Wages and other fees paid for
nursing services
• Extra rent or utility expenses for a
participant to move into a larger
residence with extra space (bedroom) for
a nurse or private attendant
Yes
Nutritional Supplements
• Vitamins
• Minerals
Yes
Nutritional Supplements
• Body Building Supplements
• Protein Bar
• Protein Shakes
Potentially Eligible Provider’s statement required
Eligible if purchased on or after 12/1/2019
O
Optician/Optometrist Fees Yes
Orthodontics Yes
Over-the-Counter Drugs Yes See Drugs/Medicines – Over-the-Counter.
Over-the-Counter Hormone Therapy Yes
Oxygen
• Oxygen tanks
• Oxygen equipment
Yes
P
Pain Relief
e.g. Advil, Aleve, Aspirin, Ibuprofen,
Motrin, Naprosyn, Naproxen
Yes
Pedometer Yes Eligible if purchased on or after 12/1/2019
Penile Implants Potentially Eligible Provider’s statement required.
A penile implant is an eligible expense only if
impotence is due to organic causes such as
trauma, post-prostatectomy, or diabetes.
Personal Care Services
• Adult Day Care
• Emergency Response Systems
• Home Health Care
• Homemaker Services
• Long-Term Care
• Maintenance Care
• Personal Care
• Transportation Services
Potentially Eligible Provider’s statement required
Eligible if purchased on or after 12/1/2019
Personal Hygiene Products
• Toothpaste, toothbrush,
mouthwash, floss
• Deodorant
• Shampoo, conditioner, hair spray
• Bath soap, hand soap
• Shaving cream
No
Pest Control
• Rodent Control
• Cockroach Control
Potentially Eligible Provider’s statement required
Eligible if purchased on or after 12/1/2019
Prescription Drugs Yes Prescription drugs are an eligible expense if
prescribed by a doctor and legally purchased
in the United States.
Prescription Drug Additives
• Additives used to improve the taste of
medicine
No
Prosthesis Yes
Psychiatric Care Yes
Psychoanalysis Yes
Psychologist Yes
R
Radiology Fees
• X-Rays
• CT Scan
• MRI
This list is not exhaustive.
Yes
Radon Mitigation Yes
Rehydration Productions
(e.g. Pedialyte)
Yes
S
Sales Tax or Shipping & Handling Yes Costs for sales or state-mandated taxes and
shipping or handling fees associated with an
eligible expense; e.g., shipping and handling
fees for lab work and other specimens,
donors, etc.
Service Animals for Disabled Persons
• Cost of the animal
• Care of the animal
Potentially Eligible Provider’s statement required.
Sinus Products
• (e.g. 4-Way, Vicks, Allergy Buster)
Yes
Sleeping Aids
(e.g. Unisom)
Yes
Smoke Detector for Disabled Persons Yes
Smoking Cessation
(e.g. Commit, Nicoderm CQ,
Nicorette, Nicotrol)
Yes
Snoring Cessation Aids Yes
Special Education for Disabled Persons
• Tuition
• Lodging
• Meals
• Tutoring fees
Potentially Eligible Provider’s statement required.
The cost of a school for a mentally impaired
or physically disabled person is an eligible
expense if the primary reason is to treat
or relieve the disability. (e.g., school for
the visually impaired; lip reading to the
hearing impaired; or remedial language
training to correct a condition caused by a
birth defect). The cost of a boarding school
while recuperating from an illness is not an
eligible expense.
Special Foods/Diet
(e.g. Sugar free, Fat free, Gluten free,
Diabetic, Low cholesterol)
No See Weight Loss Products for separate eligibility rules.
Speech Therapy Yes
Sterilization/Sterilization Reversal
• Vasectomy
• Tubal ligation
Yes
Stop-Smoking Program or Tools Yes
Sunburn Relief Yes
Sunscreen Yes
Swimming Pools or Whirlpools Potentially Eligible Provider’s statement required.
Surrogate Pregnancy
• Donor’s medical expenses
• Surrogate’s medical expenses
Yes
Surgery, Non-Cosmetic Yes
Sun-Protective Clothing Potentially Eligible Provider’s statement required.
Sun-protective clothing used for general
health or personal reasons is not eligible.
T
Tanning Bed Potentially Eligible Provider’s statement required.
Telehealth, Telemedicine
• Medical consultation via electronic
communication technology such as live
video, text message, email
Yes
Telephone for Disabled Persons
• Purchase price of special equipment
• Repair of special equipment
Yes The cost of the telephone is not eligible. An
eligible expense would only include special
modifications needed for a disabled person to
use the telephone.
Television for Disabled Persons
• Purchase price of special equipment
• Repair of special equipment
Yes The cost of the television is not eligible. An
eligible expense would only include special
modifications needed for a disabled person to
use the television
Therapy
• Chemotherapy
• Chiropractor fees
• Counseling
• Genetic Counseling
• Hydrotherapy
• Hypnotherapy
• Marriage counseling
• Massage therapy
• Occupational therapy
• Physical therapy
• Radiation therapy
• Somatic Therapy including Feldenkrais and Alexander technique
• Speech therapy
• Telephone counseling
Yes
Toothache/Teething Relief Yes
Topical Steroids
(e.g. Hydrocortisone)
Yes
Transcutaneous Electrical Nerve
Stimulation (TENS) Unit
Yes
Transplants, Organ or Tissue
• Surgical, hospital, laboratory, and
transportation fees
• Cost to transfer medical records in order
to find organ donors
Yes
Transportation for Medical Care
• Mileage and gas for personal automobile
• Plane fare
• Transportation fare (including bus, subway, train, ferry or bike share)
• Transportation for companion if accompanying a patient who is unable to travel alone
• Transportation for regular visits to see a mentally ill dependent if visits are recommended as part of the treatment
• Transportation to alcohol or drug rehabilitation meetings
• Transportation to pharmacy to purchase eligible expenses
• Transportation to provider for medical treatment
Potentially Eligible Transportation expenses may be reimbursed
when the transportation is primarily for, and
essential to, medical care. Documentation
must accompany the claim to support its
relation to medical care.
For reimbursement for mileage for personal
automobile, the following information must
be included with the request:
• Dates of travel
• Number of miles traveled
• Provider’s name
• Provider’s address
• Receipt or invoice for medical services
corresponding to dates of travel
The mileage reimbursement rate is
determined by the IRS, which is subject to
change. The current IRS mileage rate may be
found on the IRS website at www.irs.gov.
For reimbursement for plane, train, taxi, ridesharing
(e.g. Uber, Lyft), metro/subway, ferry,
or bus fare, the following information must
be included with the request:
• Dates of travel
• Provider’s name
• Provider’s address
• Receipt or invoice for medical services
corresponding to dates of travel
• For international travel or travel outside your
home state: Provider’s statement required
The following are not eligible transportation
expenses:
• General repair, maintenance, depreciation,
or insurance expenses for personal
automobile
• Transportation to and from work
• Travel to another city if the primary purpose
for the travel is not related to medical care,
such as a vacation or trip to visit relatives.
See Ambulance Service for separate eligibility rules.
Tuition Fees Potentially Eligible See Special Education for Disabled.
Tuition fees paid to a private school as a
personal preference over public schooling
for general education are not eligible
medical expenses
U
Umbilical Cord Storage Yes
V
Vacations No
Vaccinations Yes
Vitamins and Minerals Yes
W
Wart Removal
• Wart removal treatment performed in a
provider’s office
• Over-the-counter wart removal
treatments (e.g. Compound W)
Yes
Water Bed Potentially Eligible Provider’s statement required.
Weight Loss Products Potentially Eligible Provider’s statement required.
Any weight loss product purchased for
purposes of improving one’s general health
(without obesity or medical condition), and
food or beverage products purchased for
weight control or reduction are not eligible.
Weight Loss Program Potentially Eligible Provider’s statement required.
The weight loss program must treat a medical
condition diagnosed by a health care provider
(e.g., obesity, diabetes, high blood pressure).
Only program fees are eligible. The cost
of food for use in weight loss treatment
programs is not an eligible expense. The cost
of a weight loss program to improve your
general health and appearance is not an
eligible expense.
Wheelchair
Purchase price of wheelchair

• Operating cost of wheelchair
• Wheelchair cushions
Yes
Wigs or Toupees Potentially Eligible Provider’s statement required.
A wig or toupee can be an eligible expense
if it is necessary to treat a medical condition
or improve a deformity that arises from, or is
directly related to, a birth defect, a disfiguring
disease or an injury resulting from an accident
or trauma. Treatment for hair loss that occurs
as a normal part of aging or inherited or
genetic baldness, or for cosmetic purposes,
would not be covered.
X
X-Ray Fees Yes