Examples of Eligible Medical Care Expenses



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Examples of Eligible Medical Care Expenses

Please review the benefits in each category and make an estimation of how you currently spend money in each category. This list is not inclusive of all eligible expenses. Refer to IRS Publications 502 & 969 for more examples.

Medical $ ____________/month		Special Care Needs $ ___________/month



Well Baby Care HMO/PPO Co-payments Deductible Expenses Co-insurance Expenses Pap Smear Obstetrical Expenses (excludes pre-payments) Immunizations Routine Physical Exams Transportation Expenses (primarily for rendition of medical services, i.e. ambulance, cab fare, parking fee)		Braille Handicapped persons special school Home improvements motivated by medical consideration (i.e., ramps) “ Seeing Eye Dog” and its upkeep Special Education for the blind Special communication equipment for the deaf Special plumbing for the handicapped Orthopedic shoes

Dental $_____________/month		Specialty Medical $ _________/month



Fillings Braces (orthodontia) Crowns Dentures Deductibles Exams		Acupuncture Chiropractors Psychologist and Psychiatric fees Therapy*

Drugs $ ______________/month		Miscellaneous $ ____________/month



Birth control pills¹ Prescription co-payments¹ Insulin and syringes OTC Prilosec, Claritin, Zyrtec (until 12/31/2010)		Until 1/1/2011, Certain “Medical Care” expenses under Code § 105 Wigs (Radiation/Chemotherapy treatments) Smoking cessation programs, drugs and supplies Weight loss programs and prescriptions (by doctor’s recommendation only)

Hearing $ ______________/month		Vision $ ______________/month



Hearing devices and batteries Exams		Eyeglasses and exams Contacts Corrective eye surgery (Lasik surgery) Prescription sunglasses

*Items NOT Covered:*



Elective cosmetic expenses Hair Loss prescriptions and medications Health Insurance Premiums cannot be reimbursed Prepayments or estimates of future expenses		Prescription Drugs purchased outside the US Teeth bleaching, toothpaste, toothbrushes Vitamins for health Weight loss foods



¹ Drug name is required. * Proper license and diagnosis required.