Search for Eligible Expenses
Health care costs that result from the diagnosis, care, treatment, improvement, or prevention of a disease or illness are considered eligible expenses. Before you submit a claim, you can check if your expense is eligible for reimbursement.
The below search tool provides a list of health and wellness expenses. To use the search tool, search the name of the health care expense and review the information provided to see if it’s eligible for reimbursement. You can also download a full list of eligible expenses in the SF MRA Eligible Expense Guide.
For expenses that require a Provider Statement, ask your provider to fill out a Letter of Medical Necessity and submit this completed form with your claim.
HEALTH CARE EXPENSE TYPE | ELIGIBLE FOR REIMBURSEMENT | SPECIAL REQUIREMENTS |
---|---|---|
A | ||
AA, Alcoholism, Drug, or Substance Abuse Treatments
|
Yes | |
Abortion | Yes | |
Acne Treatment
|
Yes | |
Activity Tracker
|
Yes | Eligible if purchased on or after 12/1/2019. Data plans, accessories, and insurance for these products are not eligible for reimbursement. |
Acupuncture
|
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
|
Yes | Eligible if purchased on or after 12/1/2019. |
Allergy Relief (Equipment and Supplies)
|
Potentially Eligible | Provider’s statement required. |
Allergy Relief (Medicine and Shots)
|
Yes | |
Ambulance Services | Yes | |
Anti-Itch Lotions and Creams | Yes | |
Artificial Insemination
|
Yes | See also Fertility Treatments. |
Artificial Limb (prosthesis) or Teeth (dentures or implants) |
Yes | |
Asthma Medicines | Yes | |
Audio Books
|
Potentially Eligible | Documentation of a visual impairment or other disability that necessitates an audio/electronic version is required. |
Automobile
|
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:
|
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
|
Yes | |
Blood Storage | Yes | |
Body Scan
|
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
|
Yes | |
C | ||
Capital Modification (House)
A capital modification is an expense incurred for the primary purpose of accommodating a personal residence to a disability.
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
|
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
|
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
|
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
|
No | |
Cosmetic Surgery and Procedures<
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. |
Counseling
|
Yes | |
Cough Relief, Cough Medicine, and Cough Drops |
Yes | |
COVID
|
Yes | |
Crutches | Yes | |
D | ||
Dancing or Swimming
|
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
This list is not exhaustive. |
Yes | |
Dental Products
|
No | |
Dental Treatment – Cosmetic
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
This list is not exhaustive. |
Yes | |
Diabetic Supplies
|
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
This list is not exhaustive. |
Yes | Fees include the portion of the expense not paid for by other health insurance (the “outofpocket” 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
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
|
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
|
Yes | The following items are not eligible:
|
F | ||
Face Masks (for respiratory protection) | Yes | |
Facility Fees
|
Yes | |
Feminine Hygiene
|
Yes | |
Fertility Treatments
|
Yes | |
Fiber Supplements | Yes | |
First Aid Supplies/Wound Care
(e.g. Band-Aids, Neosporin) |
Yes | |
Fitness Tracking Device
|
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 | Yes | Provider’s statement required. Eligible if purchased on or after 12/1/2019. |
Funeral Expenses | No | |
G | ||
Gender Re-Assignment
|
Yes | |
Genetic Counseling and Testing (for a medical condition) | Yes | Eligible if purchased on or after 12/1/2019. |
Guide Dogs
|
Potentially Eligible | Provider’s statement required. |
Gym Fees
|
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. |
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 | Eligible | |
Hearing Aids
|
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
|
Yes | |
House Modification | Potentially Eligible | See Capital Modification. |
Household Help
|
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 | The flat dollar amounts paid for medical services by the program participant. |
Insurance Co-Pays | 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 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
|
Yes | |
J | ||
Joint Supplements | Yes | |
L | ||
Laboratory Fees
This list is not exhaustive. |
Yes | |
Lactose Intolerance Supplements | Yes | |
Lead-based Paint
|
Potentially Eligible | Provider’s statement required. The cost of repainting the scraped area is not an eligible expense. |
Learning Disability Treatments | Potentially Eligible | Provider’s statement required. Eligible if purchased on or after 12/1/2019. |
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)
|
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)
|
Potentially Eligible | The cost of lodging not provided in a hospital or similar institution while away from home is an eligible medical expense if:
|
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
|
Yes | Eligible if purchased on or after 12/1/2019. |
Maternity
|
Yes | |
Mattress | Potentially Eligible | Provider’s statement required. |
Meals
|
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
|
Yes | |
Medical Conferences | Potentially Eligible | Provider’s statement required. |
Medical Information
|
Yes | |
Medical Supplies
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
|
Yes | |
Nutritional Supplements
|
Yes | |
Nutritional Supplements
|
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
|
Yes | |
P | ||
Pain Relief
(e.g. Advil, Aleve, Aspirin, Ibuprofen, Motrin, Naprosyn, Naproxen) |
Yes | |
Pedometer | Yes | |
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
|
Potentially Eligible | Provider’s statement required. Eligible if purchased on or after 12/1/2019. |
Personal Hygiene Products
|
No | |
Pest 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
|
No | |
Prosthesis | Yes | |
Psychiatric Care | Yes | |
Psychoanalysis | Yes | |
Psychologist | Yes | |
R | ||
Radiology Fees
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
|
Potentially Eligible | Provider’s statement required. |
Sinus Products
(e.g. 4-Way, Vicks, Allergy Buster) Yes |
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
|
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
|
Yes | |
Stop-Smoking Program or Tools | Yes | |
Sunburn Relief | Yes | |
Sunscreen | Yes | |
Surrogate Pregnancy
|
Yes | |
Swimming Pools or Whirlpools | Potentially Eligible | Provider’s statement required. |
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
|
||
Telephone for Disabled Persons
|
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. |
Therapy
|
Yes | |
Toothache/Teething Relief | Yes | |
Topical Steroids
(e.g. Hydrocortisone) |
Yes | |
Transcutaneous Electrical Nerve Stimulation (TENS) Unit | Yes | |
Transplants, Organ or Tissue
|
Yes | |
Transportation for Medical Care
|
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.
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.
The following are not eligible transportation expenses:
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 | |
V | ||
Vacations | No | |
Vaccinations | Yes | |
Vitamins and Minerals | Yes | |
W | ||
Wart Removal
|
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
|
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 |