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Fillable Fsa Medical Expense Reimbursement Claim Form A1hr printable pdf download The irs determines which expenses can be reimbursed by an. 6 examples of fsa eligible expenses 1. Ace bandages acne treatments acupuncture. Unfortunately, insurance premiums are not covered by an fsa. The complete fsa eligibility list. Fsa eligible expense list health fsa eligible expenses new: You can include medical expenses you paid for your spouse. Get details from the irs in this publication (pdf, 1.22 mb). 16 rows various eligible expenses. Ineligible expenses contact lens or eyeglass insurance (fsa ineligible only)cosmetic surgery/procedures electrolysis insurance premiums and interest long term care premiums.
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