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Eligible Expenses

This page outlines which items are approved expenses that can be paid from a health savings account (HSA), medical flexible spending account (FSA) or health incentive account (Blue Rewards).

Definitions

  • Eligible: This can be purchased or reimbursed from your medical spending account*.
  • Potentially Eligible: In order to determine eligibility for potentially eligible items, CareFirst requires a Letter of Medical Necessity (linked below) from your health care provider. 
  • Ineligible: These products and services are not eligible for HSA or FSA reimbursement. 
  • OTC: Over the counter. Items noted only with "OTC" are eligible without a prescription. 

Item List

This list does not apply for HRAs. For an HRA, the eligible products and services are determined by your group or employer. If you have eligibility questions about your HRA, check with your benefits administrator.

 Tips:

  • Avoid brand names and use generic terms for this search. If you have any questions about a product or service which is not in any of these lists please contact customer service: Toll Free: 866-758-6119.
Item Eligibility Notes

Abdominal supports

Binder, girdle, posture, lumbo-sacral, lumbar

Eligible  

Abortion

Eligible  

Acid Controllers/Antacids

Maalox, Tums, Pepto-Bismol, Pepto Bismol, Alka-seltzer, Prilosec, Pepcid, Omeprazole, Zantac, Nexium

Eligible  

Acne Treatment

Zit, salicylic

Eligible  
Acupuncture Eligible  
Air conditioner Potentially Eligible Capital Expense
Air purifier Potentially Eligible Capital Expense

Alcoholism treatment

Rehabilitation

Eligible  

Allergy medicine

Allegra, Benadryl, NSAIDs, Claritin, Zyrtec, Xyzal, Antihistamines, Alavert, Brompheniramine, Clarinex, Astelin, Optivar, Elestat, Patanol, Flonase

Eligible OTC

Analgesics (e.g., vaporizing rub)

Biofreeze, Vicks vaporub, Bengay, Capzasin, Icyhot, Solarcaine, chest rub

Eligible OTC
Anti-Arithritics Eligible  

Antibiotics

Neosporin, Polysporin

Eligible  

Anti-diarrhea medicine

Eligible OTC

Anti-gas, Antacid

Gax-x, Beano, Maalox, Prilosec, Zantac

Eligible OTC

Antihistimines

Claritin, Zyrtec

Eligible OTC

Anti-inflammatory

Ibuprofen, Advil, Motrin, Midol, Naproxen, Aleve, Naprosyn

Eligible OTC
Antiperspirant Ineligible  
Arch supports Eligible  
Artificial limbs Eligible  

Aspirin

Bayer, Ecotrin

Eligible OTC
Asthma treatments (e.g., inhaler, nebulizer) Eligible  

Athletic club membership

Gym

Potentially Eligible  
Automobile modifications Potentially Eligible Capital Expense

Bandaids/bandages

Band-aids, curad, OTC, over the counter

Eligible OTC
Bariatric surgery Eligible  
Behavioral modification programs Potentially Eligible  

Birth Control Pills

Potentially Eligible Valid Prescription Required
Birthing tubs Ineligible  
Blemish concealer Ineligible  
Blood pressure monitoring devices Eligible  
Body scans (e.g., MRI, CAT Scan) Eligible  
Bottled water Ineligible  
Brace (e.g., knee, back, wrist) Eligible  
Braille books/magazines Ineligible  
Breast pumps and supplies for pump only Eligible  
Breast reconstructive surgery Potentially Eligible  
Breast reduction surgery that is medically necessary Potentially Eligible  

Burn treatments

Eligible OTC

Calamine lotion

Caladryl

Eligible OTC
Chapsticks/lip balm Ineligible  
Childbirth/lamaze classes (related to birth) Eligible  
Chiropractic treatments (e.g., adjustments) Eligible  

Chondroitin

Eligible OTC
Circumcision Eligible  
Cleaning service Ineligible  
Coinsurance amounts (health, dental or vision) Eligible  

Cold and flu medicine

Comtrex, DayQuil, NyQuil, Motrin, Theraflu, Vicks, Sudafed

Eligible OTC

Cold Sore Remedies

Abreva, Releev

Eligible OTC

Cold/hot packs

OTC, over the counter

Eligible OTC

Condoms

contraceptive, contraceptives, OTC

Eligible OTC

Contact lens solutions/cleaners

OTC, over the counter

Eligible OTC
Contact lenses (corrective) Eligible  
Convalescent home (for medical treatment only) Eligible  
Copayments (health, dental or vision) Eligible  

Corn and callus removers

Eligible OTC
Cosmetic surgery Potentially Eligible For repair or reconstruction after accident or surgery or for correction of birth defect
Cosmetic surgery and procedures Ineligible  
Cosmetics, hygiene products and similar items Ineligible  

Cotton balls (sterile)

Eligible OTC

COVID testing

Coronavirus, COVID-19, Delta

Eligible OTC

Cough drops, cough suppressants

Pediacare, Robitussin

Eligible OTC
C-PAP machine and supplies Eligible  
Crutches (purchase or rental) Eligible  
Dancing lessons Ineligible  

Decongestants

Dimetapp, Sudafed

Eligible OTC
Deductibles (health, dental or vision) Eligible  
Dental floss Ineligible  
Dental procedures, non-cosmetic (e.g., X-rays, fillings, extractions, crowns, implants) Eligible  

Denture adhesive

OTC, over the counter

Eligible OTC

Denture care cleaning products

OTC, over the counter

Eligible OTC
Dentures Eligible  
Deodorant Ineligible  

Diabetic supplies (e.g., insulin, syringe, monitor, insulin pump)

OTC, over the counter

Eligible OTC

Diaper rash treatment

Balmex, Desitin

Eligible OTC
Diapers or diaper service Ineligible  
Diet foods Ineligible  
Dietary supplements Potentially Eligible  

Digestive relief (e.g.Tums, Pepto-Bismol)

Eligible  
DNA collection and storage Potentially Eligible  
Drug addiction/substance abuse treatment Eligible  
Drugs imported from other countries Ineligible  
Dust masks Ineligible  
Dyslexia testing and instruction Potentially Eligible  
Ear or body piercing Ineligible  
Ear plugs Potentially Eligible  

Ear wax removal kits

Eligible OTC

Elastic wraps

Eligible OTC
Electrolysis or hair removal Ineligible  
Elevator Potentially Eligible Capital Expense
Embryo, egg and sperm storage fees Eligible  
Ensure Ineligible  

Exercise equipment or programs

Gym, club, workout

Potentially Eligible  

Expectorants

Mucinex, Triaminic

Eligible OTC

Eye drops (non-medicated)

Opcon-A, Visine, OTC, over the counter

Eligible Vision
Eye exams Eligible  

Eye surgery (laser or radial keratotomy)

Lasik

Eligible  
Eyeglasses – prescription sunglasses/safety glasses Eligible  
Eyeglasses – reading Eligible  
Face creams Ineligible  

Feminine Anti-fungal / Anti-itch

Eligible OTC
Feminine hygiene products (e.g., tampons) Eligible  
Fertility treatments (e.g., artificial insemination, egg donor fees, in vitro) Eligible  

Fiber laxatives

Citrucel, Metamucil

Eligible OTC

First aid kits

OTC, over the counter

Eligible OTC
Flu shots Eligible  
Fluoridation device Potentially Eligible  
Fluoridation treatment at a dental office Eligible  

Fluoride rinses

Eligible Valid Prescription Required, OTC
Food thickeners Potentially Eligible  
Funeral, cremation or burial expenses Ineligible  
Gambling addiction treatment Eligible  
Genetic testing Potentially Eligible  

Glucosamine

Eligible OTC
Group therapy (for patient) Eligible  
Group therapy for family member Potentially Eligible  
Guide dog/service animal (purchase, care for, training) Potentially Eligible  
Hair colorants Ineligible  
Hair growth/removal products Potentially Eligible  
Hair transplants Ineligible  

Hand sanitizer – antibacterial

Germ-X, Purell

Eligible  
Hand/skin lotion Ineligible  
Head lice treatment Eligible  
Hearing tests and aids Eligible  

Heating pad

Eligible OTC

Hemorrhoid treatments

Preparation H, Tucks

Eligible OTC
Herbal treatment Potentially Eligible  
Holistic or natural healers consult Potentially Eligible  
Holistic remedies/medicines Potentially Eligible  
Home health care Eligible  
Home improvements (e.g., exit ramps, widening doorways) Potentially Eligible Capital Expense
Hormone replacement therapy (HRT) Potentially Eligible  
Hormone therapy Potentially Eligible  
Household help Ineligible  
Household products/improvements to treat allergies Potentially Eligible  
Illegal operations and treatments Ineligible  
Illegally obtained drugs Ineligible  
Immunizations Eligible  

Incontinence supplies

Eligible OTC
Individual counseling Eligible Counseling must be performed to alleviate or prevent a physical or mental defect or illness

Insect bite/sting medicine

Benadryl, Cortaid

Eligible OTC
Insurance premiums Ineligible
Certain health insurance premiums are eligible to be paid out of an HSA.
Qualified premiums include: COBRA health insurance, insurance premiums after you reach age 65 (including Medicare Parts A, B, C and D but not Medicare supplement plans), qualified long-term care insurance, health insurance premiums while receiving unemployment compensation under state or federal law and premiums for employer-sponsored retiree medical plans for account holders 65 and older.
Lab tests Eligible  
Lactation consultant Potentially Eligible  

Lactose intolerance pills

Lactaid

Potentially Eligible  
Late fees (e.g., for late payment of bills for medical services) Ineligible  

Laxatives

Ex-Lax, Miralax

Eligible OTC
Lead-based paint removal Potentially Eligible  
Learning disability treatment Potentially Eligible  
Lodging (away from home for outpatient care)  Potentially Eligible Special rules may apply
Lodging while attending a medical conference Ineligible  
Make-up Ineligible  
Manual therapy Potentially Eligible  
Marijuana or other controlled substances in violation of federal law Ineligible  
Marriage counseling Ineligible  
Massage therapy Potentially Eligible  
Mastectomy-related special bras Eligible  
Maternity clothes Ineligible  
Meals Ineligible  
Medical conference admission and transportation  Potentially Eligible Excludes meals and lodging
Medical grade face mask Eligible  
Medical newsletter Ineligible  
Medical records charges Eligible  

Medicated lip balm/cream

Eligible OTC

Menstrual pain relievers

Eligible OTC
Mentally handicapped residential or group home Potentially Eligible  
Missed appointment fees Ineligible  
Moisturizers Ineligible  
Mouthwash Ineligible  

Nasal sprays/strips for snoring

OTC, over the counter

Potentially Eligible OTC
New parent/newborn child care classes Ineligible  

Nicotine patches, gum, lozenges

Nicoderm, Nicorette

Eligible OTC
Non-prescription eyeglasses, sunglasses, safety glasses or contacts Ineligible  
Nutritional consultation Eligible  
Nutritional Counseling Potentially Eligible  
Occlusal guards to prevent teeth grinding Eligible  

Orajel pain relief

Eligible OTC
Orajel toothpaste Ineligible  
Oral surgery Eligible  

Oral wound treatments (cold sores)

Eligible OTC
Organ transplant (including donor’s expenses) Eligible  

Orthodontics

Braces, orthodontia, invisaligne

Eligible  

Orthopedic Inserts

OTC, over the counter

Eligible OTC
Orthopedic shoes Potentially Eligible  
Oxygen and oxygen equipment Eligible  

Oxygen equipment

OTC, over the counter

Eligible OTC

Pain relievers

Tylenol, Alieve, Biofreeze, Advil, Ibuprofen, Acetaminophen

Eligible OTC
Patient responsibilities Eligible Patient responsibilities under the medical, dental or vision plan solely because of the plan’s deductible, copay (coinsurance), reasonable and customary charge limit or benefit limit
Personal trainer fees Potentially Eligible  
Petroleum jelly Potentially Eligible  
Physical exams (routine, medical, well-child) Eligible  
Physical therapy Eligible  

Pregnancy test kits

Eligible OTC

Prenatal vitamins

Eligible OTC
Prenatal/postnatal exams Eligible  
Prepayments Ineligible  
Prescription drug discount program fees Ineligible  
Prescription drugs Eligible Prescription drugs imported from other countries are not covered
Prescription drugs and medicines imported from other countries Ineligible  
Prescription drugs that also have a cosmetic purpose (e.g., Retin-A, Rogaine, Botox, Propecia) Potentially Eligible  
Preventive care screenings (e.g., mammogram, colonoscopy) Eligible  

Probiotics

culterelle

Potentially Eligible  

Prosthesis

Eligible  

Psoriasis treatment

Eligible OTC
Psychiatric care Eligible  

Reading glasses

Eligible OTC

Respiratory Treatments

Eligible OTC

Rubbing alcohol

Eligible OTC

Sanitizing Wipes

Eligible OTC
Shampoo Ineligible  
Shaving cream Ineligible  
Shipping and handling fees for eligible expenses Eligible  
Skin irritation treatment Eligible  
Sleep aids and Sedatives Eligible  
Sleep study Eligible  
Smoking cessation medications/programs Eligible  
Special education costs for dependents with disabilities Potentially Eligible  
Special foods/beverages Ineligible  
Speech therapy Eligible  
Sports training and activities Ineligible  
St. John’s Wort Potentially Eligible  
Stem cell, harvesting and/or storage of Potentially Eligible  

Stomach Remedies

Eligible OTC

Sunburn treatments

Solarcaine

Eligible OTC

Sunscreen 

Eligible Must be broad spectrum and at least SPF 15, OTC
Support stockings (e.g., Jobst stockings) Potentially Eligible  
Surrogate expenses Ineligible  
Swimming lessons Ineligible  
Swimming pool and maintenance Ineligible  
Tanning salons and equipment Ineligible  
Taxes paid for eligible expenses Eligible  
Teeth whitening Ineligible  
Telephone/television equipment for hearing impaired persons Potentially Eligible  

Thermometers

Eligible OTC

Throat lozenges/cough drops

Cepacol, Chloraseptic

Eligible OTC

Toothbrush

Crest

Ineligible  
Transportation costs of disabled individual commuting to and from work Ineligible  
Transportation expenses relative to health care  Eligible Corresponding medical documentation requested
Travel for general health improvement Ineligible  
Tubal ligation/tubal ligation reversal Eligible  
Umbilical cord, freezing and storing of Potentially Eligible  
Vaccinations Eligible  
Varicose veins, treatment of Eligible  
Vasectomy/vasectomy reversal Eligible  
Veneers Ineligible  
Vitamins and minerals Potentially Eligible  
Walkers/canes (purchase or rental) Eligible  

Wart remover products

Eligible OTC
Weight loss program, medications and treatments Potentially Eligible Must be prescribed by a physician for a specific medical condition - excludes food
Wheelchair (purchase or rental) Eligible  
Wigs Potentially Eligible  

Wrist/joint supports

Eligible OTC
X-rays Eligible  

Yeast infection medication

Eligible OTC

*Medical expenses that can be reimbursed through your medical spending account include services and supplies incurred by you or your eligible dependents for the diagnosis, treatment or prevention of disease or for the amounts you pay for transportation to get medical care. In general, deductions allowed for medical expenses on your federal income tax according to Internal Revenue Code Section 213 (d) may be reimbursed through your HSA. You cannot deduct medical expenses on your federal income tax that have been reimbursed through your HSA. It is possible that changes in the IRS rules can affect the eligible, potentially eligible, and/or ineligible expense categories.