SF MRA Eligible Expenses

Search for Eligible Expenses

Eligible health care costs are costs that come from the: diagnosis, care, treatment, improvement, or prevention of a disease or illness.

Before you send in a claim, you can check if your health care cost is covered.

The search tool below shows a list of health care costs. To use the search tool, search the name of the health care cost. Then, check the info given to see if you can get money back.

For health care costs that need a Provider Statement, ask your provider to fill out a Letter of Medical Necessity. Then, send in the filled-out form with your claim.

SF City Option and SF MRA is not affiliated with SF MRA Store website.

Move ←, →, ↑, ↓ to see more

HEALTH CARE EXPENSE TYPE	ELIGIBLE FOR REIMBURSEMENT	SPECIAL REQUIREMENTS
A
AA, Alcoholism, Drug, or Substance Abuse Treatments Alcohol or substance abuse treatment center, including meals and lodging	Yes	Treatment and transportation to treatment are eligible. Donations, contributions (i.e., voluntary, no charge associated with treatment) are not eligible for reimbursement.
Abortion	Yes
Acne Treatment Acne medication Light Therapy Treatment for acne	Yes
Acne Treatment Acne peels Cryosurgery Microdermabrasion Laser Treatment Retinol	Potentially Eligible	Letter of Medical Necessity needed. Over-the-counter acne treatments and kits are usually eligible. However, in office treatments require a Letter of Medical Necessity.
Activity Tracker Fitness Tracker Pedometer Smart Watch	Potentially Eligible	Letter of Medical Necessity needed. Data plans, accessories, and insurance for these products are not eligible for reimbursement.
Acupuncture Acupressure Mat Acupressure seat cushion Chirp Wheel Flents Ezy-Travel Band Hyperice Normatec Go Sea-Band	Yes
Acupressure Treatment Calming or relaxation Daith Piercing (AcuStaple) Keloids Pressure Earrings Weight loss related	Potentially Eligible	Letter of Medical Necessity needed.
Adoption Fees	No	You may submit health care costs for an adopted child once they become your qualified dependent. This includes health care costs from the adoption process, like physical exams.
Affordable Care Act (ACA) Penalties	No	Tax penalties for not following the individual mandate of the Affordable Care Act (also known as the ACA or “Obamacare”) are not eligible for reimbursement.
Air Conditioner	Potentially Eligible	Letter of Medical Necessity needed.
Air Purifier Including Air Filter	Potentially Eligible	Letter of Medical Necessity needed.
Allergy Relief (Equipment and Supplies) Humidifier Special pillows, mattress covers, etc. to alleviate an allergic condition Special vacuum cleaners Vaporizer	Potentially Eligible	Letter of Medical Necessity needed.
Allergy Relief (Medicine and Shots) Allergy shots Nasal irrigation supplies (e.g. NetiPot) Nebulizer 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. Storage Fees: allowed for Immediate Conception (within the same year). Egg Donor Fees: only if the recipient is a tax dependent. Surrogate Pregnancy: only if the recipient is a tax dependent. Gender reveal kits are not eligible.
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	You must provide record of a visual impairment or other disability that requires an audio/electronic version.
Automobile Equipment such as hand controls, lifts, or ramps	Potentially Eligible	Letter of Medical Necessity needed. Buying a vehicle is not a covered cost.
B
Baby Formula Donor Breast Milk Freezing/Storage/Freeze Dry Services Storage fees are eligible for immediate use (within the same plan year)	Yes	Allowed for immediate use within the same year.
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	Letter of Medical Necessity needed. Does not include the rental of electric scooter. May be eligible as part of a recommended exercise program with a Letter of Medical Necessity.
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 Blood Cord Storage Umbilical Cord Storage	Yes	Letter of Medical Necessity needed. Allowed for immediate use within the same year.
Body Scan CAT Scan or CT Scan CT body scanning Full body scanning MRI Radiology Fees	Yes
Botox Treatment Collagen Injections Daxxify Dysport Jeuveau Xeomin	Potentially Eligible	Letter of Medical Necessity needed. Botox used to improve a deformity that comes from, or is directly related to, a birth defect, a disfiguring disease or an injury resulting from an accident or trauma is a covered cost. Botox used for the treatment of migraines is also a covered cost.
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	See Baby Formula Storage fees are eligible for immediate use (within the same plan year)
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 Inclinator 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 Lactation consultants	Yes
Childbirth-Related Doula fees	Potentially Eligible	Letter of Medical Necessity needed. Only medical care (prenatal & delivery support) is eligible. Postnatal visits are only eligible if medical care is provided. Child or newborn care instruction are NOT eligible.
Chiropractor Fees	Yes
Christian Science Practitioners	Yes
Church of Scientology Practitioners	No
Circumcision	Yes
Classes, Health-Related	Potentially Eligible	Letter of Medical Necessity needed. The training must be for the treatment of a specific medical condition and not for 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	Letter of Medical Necessity needed.
Concierge (Boutique) Fees Office visit	Yes	Eligible with Proof of Eligible Services. Proof of eligible medical services rendered is required. Only the specific amounts applied to the specific services are reimbursable. Documentation must be from a 3rd party and contain the Date of Service, Service Description, and amount charged/applied for that service.
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 Creams Face soaps Hair removal Makeup Perfumes	No
Cosmetic Surgery and Procedures Blepharoplasty Botox or Collagen injections Breast reconstruction surgery Dental veneers, bonding, tooth whitening/bleaching Dermo Corrective Collagen Therapy (micro needling) Facelifts Sclerotherapy This list is not exhaustive.	Potentially Eligible	Letter of Medical Necessity needed. A cosmetic surgery or procedure can be an covered cost if it is needed to improve a deformity that comes from, or is directly related to, a birth defect, a disfiguring disease or an injury resulting from an accident or trauma.
Counseling Bereavement and grief counseling Genetic Counseling Psychotherapy and psychoanalysis	Yes
Counseling (Dual-Purpose) Life Coaching Marriage Counseling Sex Therapy	Potentially Eligible	Letter of Medical Necessity needed.
Cough Relief, Cough Medicine, and Cough Drops	Yes
COVID COVID Antigen and PCR tests Face masks Rapid COVID test	Yes
D
Dancing or Swimming Lessons, etc.	Potentially Eligible	Letter of Medical Necessity needed to show exercise program was recommended to treat medical condition.
Decongestants (e.g. Claritin-D, Neo-Synephrine, Sudafed)	Yes
Deductibles	Yes	See Insurance Deductibles.
Dehydration/Rehydration It contains only medically necessary electrolytes (typically sodium, potassium) and carbohydrates (like glucose) that support absorption. Products with added dietary supplements beyond electrolytes are not eligible. Examples of Eligible Rehydration Products: Pedialyte electrolyte solutions and powders Cure Hydration electrolyte mixes CVS brand electrolyte solutions DripDrop ORS packets	Potentially Eligible	Letter of Medical Necessity needed. A rehydration product is not eligible if it: Is marketed as a sports drink or performance beverage Contains supplements beyond electrolytes (e.g., herbal blends, amino acids) Is intended for general hydration, fitness, or lifestyle use rather than medical dehydration
Dental Care and Prevention Bonding and sealants for dentures Braces or other orthodontics Cleaning Crowns Dentures Extractions Filings Occlusal guard Porcelain veneers (if not cosmetic) Sealants (non-denture) X-rays This list is not exhaustive.	Yes
Dental Treatment – Cosmetic Teeth whitening or bleaching Porcelain veneers This list is not exhaustive.	Potentially Eligible	Letter of Medical Necessity needed. A cosmetic surgery or procedure can be an covered cost if it is necessary to improve a deformity that comes 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 Dexcom Sensor Glucose tablets Glucometer and test strips Insulin Insulin Cooler Ketone test strips Needles (lancets) Syringes	Yes
Diapers or Diaper Service	Potentially Eligible	Diapers for disabled people (other than a newborn) are eligible, but only if needed to relieve the effects of a certain disease.
Disabled Dependent Care Expenses	Potentially Eligible	Letter of Medical Necessity needed.
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 part of the cost not paid for by other health insurance (the “out-of-pocket” portion). Late fees, finance fees, fees for missed appointments, etc., are not covered health costs.
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
Drugs/Medicines – Prescriptions	Yes	Imported drugs are not eligible. If prescribed while traveling, and legal in both the foreign country and the U.S., prescription medications can be considered eligible if obtained and consumed while traveling.
Drug Addiction Treatment	Yes
E
Educational Material (related to a diagnosed illness)	Potentially Eligible	Letter of Medical Necessity needed.
Electrolysis or Hair Removal	Potentially Eligible	Letter of Medical Necessity needed. Electrolysis or hair removal can be a covered cost, but only if it is needed to improve a deformity that comes 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	Letter of Medical Necessity needed. The exercise equipment and program must treat a health 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 a covered cost. See also Weight Loss Program.
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) N95 KN95 Disposable face mask 3M daily face mask	Yes
Face Masks (for respiratory protection) Gaiters & Face Shields 3M Cool flow valve Q mask	Potentially Eligible	Letter of Medical Necessity needed.
Facility Fees Hospital Nursing home Rehabilitation facility Home for mentally or physically disabled	Yes
Feminine Hygiene Maxi pads Menstrual cups Tampons	Yes	Feminine Cleansing/Moisturizing Products are dual-purpose/require a Letter of Medical Necessity. Deodorant, cleansers, moisturizing products such as Replens.
Fertility Treatments Artificial insemination Donated Embryos or Donated Sperm 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	Treatment for multiple (twins/triplets) pregnancy: Letter of Medical Necessity needed. Egg Donor: Recipient’s medical expenses are eligible if the recipient is a tax dependent. Surrogate Pregnancy: only if the recipient is a tax dependent. Gender reveal kits are not eligible.
Fiber Supplements	Yes
First Aid Supplies/Wound Care (e.g. Band-Aids, Neosporin)	Yes
Fitness Tracking Device Pedometer Smart watch	Potentially Eligible	Data plans, accessories, and insurance for these products are not eligible for reimbursement. Letter of Medical Necessity needed.
Fluoride Treatments	Yes	Fluoride Treatments Performed at Providers Office (e.g., fluoride rinses) are eligible. Prescriptions fluoride is eligible. Over-the-counter products such as Gel-Kam are dual purpose and require a letter of medical necessity
Food Supplements	Potentially Eligible	Only those specifically listed on IIAS are eligible. Letter of Medical Necessity needed.
Founder’s Fee/Lifetime Care Advance Payments	Potentially Eligible	Letter of Medical Necessity needed.
Funeral Expenses	No
G
Gender Re-Assignment Surgery Counseling Hormone therapy	Yes
Genetic Counseling and Testing (for a medical condition)	Yes
Guide Dogs Cost of the animal Care of the animal	Potentially Eligible	ESA Certification letter, ADA Certification or official documentation noting the animal is a service/guide dog are eligible.
Gym Fees Gym Membership Fees Fitness Class Trainer Fees Yoga Class	Potentially Eligible	Letter of Medical Necessity needed. Gym fees paid for your general health, that are not related to a specific health condition, are not covered costs.
H
Hair Loss Treatment Rogaine Minoxidil	Potentially Eligible	Letter of Medical Necessity needed. Hair loss treatments are eligible if needed to improve a deformity that comes 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 happens as a normal part of aging, or because of inherited or genetic baldness, or for cosmetic purposes, is not covered. See also Wigs or Toupees.
Hair Transplant	Potentially Eligible	Letter of Medical Necessity needed. Surgical hair transplants are eligible if needed to improve a deformity that comes 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 happens as a normal part of aging, or because of inherited or genetic baldness, or for cosmetic purposes, is not covered. See also Wigs or Toupees.
Health Club Dues	Potentially Eligible	Letter of Medical Necessity needed. Amounts paid for health club dues or steam baths for your general health are not covered costs. They must be related to the treatment of a specific health condition.
Health Expenses Incurred Outside of the United States	Yes	When traveling medical care is eligible. See prescription drugs for information regarding imported medications.
Health Institute Fees	Potentially Eligible	Letter of Medical Necessity needed. Health institute fees are the costs associated with going to health-related courses, retreats, workshops, room & board, and wellness coaching.
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	Yes
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 is not eligible. A covered cost would only include special changes needed for a disabled person to use the television or telephone.
Hearing Aids AirPods Pro 2 Personal amplification devices	Potentially Eligible	Letter of Medical Necessity needed. The iPhone is not eligible.
Hearing Exams	Yes
Heart Monitors OURA Ring RingConn Ultrahuman Ring WHOOP	Yes	Data plans, accessories, and insurance for these products are not eligible for reimbursement.
Hemorrhoidal Preparations	Yes
Hippotherapy Therapeutic horseback riding Equine Therapy	Potentially Eligible	Letter of Medical Necessity needed. Recreational horseback riding is not a covered cost.
Home for Mentally Disabled Persons	Yes
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	Letter of Medical Necessity needed. HCG injections may be eligible for infertility treatment or to test for tumors.
Hypnosis	Potentially Eligible	Letter of Medical Necessity needed. Hypnosis may qualify if performed by a licensed professional to treat a medical condition (e.g., quitting smoking or weight loss due to a diagnosed health condition). Hypnosis does not qualify if performed for personal well-being, such as general stress relief.
I
Incontinence Supplies	Yes	The flat dollar amounts paid for medical services by the program participant.
Insurance Co-Pays	Yes	The flat dollar amounts paid for medical services by the program participant are eligible
Insurance Deductibles	Yes	The part of a medical claim that is not covered by a health insurance provider and must be paid by the program participant is covered.
Insurance Premiums Any medical, dental or vision insurance premium (HMO, DMO, PPO, etc.) COBRA premiums Disability insurance premiums Life insurance Long-term care insurance premium Medicare (parts A, B & D)	Yes	Acceptable documentation for employer sponsored insurance: submit individual paystubs for each pay period OR submit annual employer statements showing the total deductions made for the year. NOT Covered: Auto Insurance Critical Need Fund Legal Insurance Pet Insurance OPEBI/CREPT Deductible International Insurance Premium ABC Deduction
J
Joint Supplements Chondroitin Dextrose Glucosamine	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 Dairy Aid Caplets Dr. King Dairy Spray Ultra -Dairy Digestive	Yes	NOT Covered: Lactose Enzyme Supplements Lactaid
Lead-based Paint Removal of paint Covering of paint	Potentially Eligible	Letter of Medical Necessity needed. The cost of repainting the scraped area is not a covered cost.
Learning Disability Treatments	Potentially Eligible	Letter of Medical Necessity needed.
Legal Fees for Medical Care Authorizing Treatment for Mental Illness	Potentially Eligible	Letter of Medical Necessity needed. Fees related to guardianship or estate management are not covered costs.
Lice Treatment	Yes
Lodging (Hospital or Similar Institution) Hospital Nursing home Rehabilitation facility	Yes	Lodging at a hospital or similar place is a covered cost if the main reason for being there is to get health care.
Lodging (Non-Hospital) Hotel Motel	Potentially Eligible	Letter of Medical Necessity needed. The cost of lodging not provided in a hospital or similar place while away from home is an covered health cost if: The lodging happened at the same time as the medical treatment; The lodging is mainly 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 personal pleasure, recreation, or vacation in the travel away from home Standard reimbursement is limits apply ($50. per person per night). The expense must be primarily for medical care with no significant element of personal pleasure.
M
Marijuana	No	Payments for medications or treatments illegal in the United States are not eligible for reimbursements. State law does not supersede federal law (e.g., California marijuana dispensaries).
Massage Device Massage Gun Percussion Gun Therapeutic Massage Products	Potentially Eligible	Letter of Medical Necessity needed. NOT Covered: Massage Chairs
Mastectomy-related supplies Breast form cover Breast forms Removable liquid adhesive Special Bra for mastectomy	Yes
Maternity Childbirth prep classes (Lamaze) Midwife fees Maternity girdles (for back pain) or special support hose (for leg circulation) Home pregnancy tests Ovulation kits Lactation consultants	Yes
Maternity Newborn Childcare Classes Doula Fees	Potentially Eligible	Letter of Medical Necessity needed
Mattress Bed frame Waterbed Mattress (Specialty)	Potentially Eligible	Letter of Medical Necessity needed. Only specialty mattresses are allowed. The Letter of Medical Necessity must specifically state the exact specialty mattress recommended.
Meals Hospital Nursing home Rehabilitation facility	Yes	Meals at a hospital or similar institution are covered costs 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	Letter of Medical Necessity needed.
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 First aid kit Glucose kit Heating pad/pack, ice pack Orthopedic shoe inserts, or orthotics 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
Mobility Equipment Canes Crutches Walkers	Yes
Motion Sickness (e.g. Dramamine, Marezine)	Yes
N
Nursing Home	Yes
Nursing Services Wages and other fees paid for nursing services	Yes
Nutritional Supplements Body Building Supplements Protein Bar Protein Shakes	Potentially Eligible	Letter of Medical Necessity needed.
O
Optician/Optometrist Fees	Yes
Orthodontics	Yes
Orthopedic Shoes Crocs HOKA On Cloud (aka “ON”)	Potentially Eligible	Letter of Medical Necessity needed.
Over-the-Counter Drugs	Yes	See Drugs/Medicines – Over-the-Counter.
Over-the-Counter Hormone Therapy	Yes	Letter of Medical Necessity needed.
Oxygen Oxygen tanks Oxygen equipment	Yes
P
Pain Relief (e.g. Advil, Aleve, Aspirin, Ibuprofen, Motrin, Naprosyn, Naproxen)	Yes
Pedometer	Potentially Eligible	Letter of Medical Necessity needed.
Penile Implants	Potentially Eligible	Letter of Medical Necessity needed. A penile implant is a covered cost only if impotence is due to organic causes such as trauma, postprostatectomy, or diabetes.
Personal Care Services Adult Day Care Emergency Response Systems Home Health Care Homemaker Services Long-Term Care Personal Care Transportation Services	Potentially Eligible	Letter of Medical Necessity needed.
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	Letter of Medical Necessity needed.
Prescription Drug Additives Additives used to improve the taste of medicine	Yes
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	Potentially Eligible	Letter of Medical Necessity needed.
Rehydration Products (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 a covered cost; 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	Letter of Medical Necessity needed.
Sinus Products (e.g. 4-Way, Vicks, Allergy Buster)	Yes
Sleeping Aids (e.g. Unisom)	Yes
Smoke Detector for Disabled Persons	Potentially Eligible	Letter of Medical Necessity needed.
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	Letter of Medical Necessity needed. The cost of a school for a mentally impaired or physically disabled person is a covered cost if the main reason is to treat or relieve the disability. For example: 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 recovering from an illness is not a covered cost.
Speech Therapy	Yes
Sterilization/Sterilization Reversal Vasectomy Tubal ligation	Yes
Stop-Smoking Program	Potentially Eligible	Letter of Medical Necessity needed.
Student Health Fees	Yes	Only amounts applied to specific dates of eligible care are eligible for reimbursement.
Sunburn Relief	Yes
Sunscreen	Yes	SPF >15 is eligible
Surrogate Pregnancy Donor’s medical expenses Surrogate’s medical expenses	Yes	Expenses for an eligible tax dependent are allowed only.
Swimming Pools or Whirlpools	Potentially Eligible	Letter of Medical Necessity needed.
Surgery, Non-Cosmetic	Yes
Sun-Protective Clothing	No
T
Tanning Bed	Potentially Eligible	Letter of Medical Necessity needed.
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	Potentially Eligible	The cost of the telephone is not covered. A covered cost would only include special changes needed for a disabled person to use the telephone.
Therapy Chemotherapy Chiropractor fees Massage therapy Occupational therapy Physical therapy Radiation therapy Somatic Therapy including Feldenkrais and Alexander technique Speech therapy	Yes	NOT Covered: BetterHealth TalkSpace
Therapy (Dual-Purpose) Hydrotherapy Hypnotherapy Marriage Counseling (Emsella, Emsculpt, Emface, Emtone and other “BTL”) Medical Spa Halfway House (Sober Living and Residential Sober Living)	Potentially Eligible	Letter of Medical Necessity needed.
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 costs may be reimbursed when the transportation is mainly for, and essential to, medical care. You must submit documentation with your claim to support its relation to medical care. For reimbursement for mileage for personal automobile, this 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 Mileage is only reimbursable if you’ve traveled to receive care or traveled to pick up eligible products. Travel reimbursement is not eligible for the purchase of products or services delivered to your home. 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 irs.gov. For reimbursement for plane, train, taxi, ride- sharing (e.g. Uber, Lyft), metro/subway, ferry, or bus fare, this 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 The following are not eligible transportation expenses: General repair, maintenance, depreciation, or insurance expenses for personal automobile Transportation to and from work Gas Tips 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 Services 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	Letter of Medical Necessity needed. Allowed for immediate use within the same year.
V
Vacations	No
Vaccinations	Yes
Vitamins and Minerals	Potentially Eligible	Letter of Medical Necessity needed.
W
Wart Removal Wart removal treatment performed in a provider’s office Over-the-counter wart removal treatments (e.g. Compound W)	Yes
Weight Loss Products	Potentially Eligible	Letter of Medical Necessity needed. 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 covered. The cost of food for use in weight loss treatment programs is not a covered cost. The cost of a weight loss program to improve your general health and appearance is not a covered cost.
Weight Loss Program	Potentially Eligible	Letter of Medical Necessity needed. 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	Letter of Medical Necessity needed. 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