consumer Employer SBEC/FBD EE Access


Featuring The Benny™ Prepaid Benefits Card


Address:

PO Box 800518
Houston, TX
77280-0518

Phone: (713) 460-FLEX (3539)
Toll-Free: (888) 732-8125
Fax: (713) 460-3550
Email:
claims@fbaflex.com

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.


Copyright 2018 Flex Benefit Administrators