IBEW NECA Sound and Communications Trust Fund Health Reimbursement Account (HRA): What’s Eligible? The IRS defines eligible health care expenses as amounts paid for the diagnosis, cure, mitigation or treatment of a disease, and for treatments affecting any part or function of the body. The expenses must be primarily to alleviate a physical or mental condition or illness. This list is not meant to be all-inclusive. Eligible Expenses DENTAL SERVICES MEDICATION
Insurance Premiums and Interest (allowed for
Long Term Care Premiums (allowed for HSA)
PRACTIONERS
Over the Counter Medications (see reverse)
MEDICAL TREATMENTS/PROCEDURES
Alcoholism and Drug Addiction (inpatient
MEDICAL EQUIPMENT, SUPPLIES and SERVICES
Physical Examination (not employment-related)
Reconstructive Surgery (if medically necessary
Learning Disability (special school/teacher)
Weight Loss Programs (as prescribed by your
Prescribed Medical and Exercise Equipment
Splints/Casts or Support Hose (if medically
OBSTETRIC SERVICES
Lamaze Class (child rearing classes excluded)
Transportation Expenses (essential to medical
OB/GYN Prepaid Maternity Fees (reimbursable
Tuition Fee at Special School for Disabled Child
Weight Loss Drugs (to treat specific disease)
LAB EXAMS/TESTS Ineligible Expenses The IRS does not allow the following expenses to be reimbursed. This list is not meant to be all-inclusive. VISION SERVICES Section 213d governs the eligible expenses for HRA, FSA plans. Publications 502 and 503 are written to help taxpayers determine what qualified expenses can be deducted on their income tax returns FSAs and DCAP, respectively. They should not be used as the sole determinant for what is reimbursable under these plans. Over-The-Counter (OTC) Items Effective January 1, 2012 Eligible OTC Medical Supplies: Itemized Ineligible OTC Items: receipt with claim request Do not submit for
Adult incontinence products (e.g. Depends)
reimbursement
Birth control products (e.g. prophylactics) Contact lens solutions
Health monitors (e.g. blood pressure, cholesterol, HIV, thermometers)
Supports/braces (e.g. ankle, knee, wrist, therapeutic glove)
Please note that this is not a complete list, but is intended to provide Plan participants with examples of OTC items that may be eligible.
OTC Drugs and Medicines Requiring a Prescription
Acne medications Allergy & sinus medications (Benadryl, Claritin, Sudafed)
Anti-itch medications (Caladryl, Cortizone)
Gastrointestinal aids (antacids, anti-diarrhea medicines, laxatives – non-fiber, nausea
Nasal sprays for congestion (e.g. Afrin)
Pain relievers (e.g. aspirin, Excedrin, Tylenol, Advil, Motrin)
Please note that this is not a complete list, but is intended to provide Plan participants with examples of OTC items that may be eligible. To be reimbursed for these expenses, a completed claim form must be submitted to Dual-Purpose Items: Itemized receipt and UAS along with one of the following: Certification of Medical Necessity form A customer receipt identifying the required with claim request name of the person for whom the prescription applies, the date and amount of the purchase, and an Rx number; or A customer receipt that reflects the purchase, along with a copy of the prescription.
Nasal strips & snore relief (e.g. Breathe Right) Vaporizers/humidifiers Vitamins/minerals/supplements
ARESTIN® Table 3: Mean Pocket Depth Changes (SE) in Subpopulations, Studies 103A and 103B sites for 10 days after administration of ARESTIN®. Patients should be advised that (minocycline hydrochloride) Microspheres, 1 mgalthough some mild to moderate sensitivity is expected during the first week after SRP and DESCRIPTION administration of ARESTIN®, they should notify the dentis
bebe stores, Inc. EPO 90/0 Plan Welcome to WellNet! The information below is a general description of your plan benefits and is not meant to be a complete list or complete description of available services. Please contact WellNet at 800-442-1101 with specific questions about your program. PRESCRIPTION DRUG COPAYS RETAIL (up to 30 day supply) MAIL SERVICE (up to 90 da