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The following lists provide a brief summary of the information described in the Internal Revenue Code and IRS publication. The lists are intended to serve as a quick reference to help determine whether or not an expense may be eligible for HSA reimbursement. This information is provided with the understanding that Henderson State Bank is not providing tax advice. Tax advice should be obtained from a professional tax advisor. IRS Publication 502 can be ordered from the IRS by calling 1-800-TAX-FORM (1-800-829-3676). http://www.irs.gov/

Qualified Medical Expenses Eligible For Reimbursement
Acupuncture
Air conditioner (when necessary for
relief from an allergy or for relief from
difficulty in breathing)
Alcoholism treatment
Ambulance
Anesthetists
Artificial limbs
Autoette (when used for relief
of sickness or disability)
Birth control pills (by prescription)
Blood tests
Braces
Cardiographs
Chiropractor
Contact lenses
Contraceptive devices
Convalescent home (for medical treatment only)
Crutches
Dental treatment
Dental x-rays
Dentures
Dermatologist
Diagnostic fees
Diathermy
Drug addiction therapy
Drugs (prescription)
Eyeglasses
Fees paid to health institute
prescribed by a doctor
FICA and FUTA tax paid for medical
care service
Fluoridation unit
Guide dog
Gynecologist
Healing services
Hearing aid and batteries
Hospital bills
Hydrotherapy
Insulin treatments
Lab tests
Lead paint removal
Legal fees (to authorize treatment for
a mental illness)
Lodging (away from home for outpa-
tient care)
Metabolism tests
Neurologist

Nursing (including board and meals)
Obstetrician
Operating room costs
Ophthalmologist
Optician
Oral surgery
Organ transplant (including
donor's expenses)
Orthopedic shoes
Orthopedist
Osteopath

Oxygen and oxygen equipment
Pediatrician
Physician
Physiotherapist
Postnatal treatments
Practical nurse for medical
services
Premiums for long-term care
insurance
Premiums for continuation coverage required by Federal law (COBRA)
Premiums for insurance received while receiving unemployment compensation.
Prenatal care
Prescription medicines
Psychiatrist
Psychoanalyst
Psychologist
Psychotherapy
Radium therapy
Registered nurse
Special school costs for the handicapped
Spinal fluid test
Splints
Sterilization
Surgeon
Telephone or TV equipment to assist the hearing impaired
Therapy equipment
Transportation expenses

Ultra-violet ray treatment
Vaccines
Vasectomy
Vitamins (if prescribed)
Wheelchair
X-rays

 

Expenses Not Eligible For Reimbursement
Advance payment for services to
be rendered next year
Athletic club membership
Automobile insurance premium
allocable to medical coverage
Boarding school fees
Bottled water
Commuting expenses of a disabled
person
Cosmetic surgery and procedures
Cosmetics, hygiene products and
similar items
Diaper service
Domestic help
Funeral, cremation or burial expenses
Health programs offered by resort
Hotels, health clubs and gyms
Illegal operations and treatments
Illegally procured drugs
Maternity clothes
Premiums for life insurance, income
Protection, disability, loss of limbs,
sight or similar benefits
Scientology counseling
Social activities
Special foods or beverages
Specially designed car for handicapped
other than autoette or special equipment
Stop smoking programs
Swimming pool
Travel for general health improvement
Tuition and travel expenses for sending a
problem child to a particular school
Weight loss programs
Contact us
1040 N Main St
PO Box 605
Henderson, NE 68371

 

 

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Henderson State Bank is not
responsible for its accuracy or its content.

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