Pro-Tier now allows employees to use their funds towards approved medical expenses. What qualifies for this? That’s controlled by IRS guidelines, but we’ve provided some highlights below.
As a general rule, expenses must be:
➡️ Primarily for medical care (diagnosis, treatment, prevention, or mitigation of a disease or condition).
➡️ Not for general health or wellness unless prescribed (e.g., vitamins for a specific deficiency).
➡️ Not reimbursed by insurance or another source.
Examples of Eligible Expenses
✅ Medical & Dental Care – Doctor visits, hospital stays, surgeries, dental cleanings, orthodontics, and medically necessary procedures.
✅ Prescription Medications – Only those requiring a prescription (even over-the-counter drugs need a prescription to qualify).
✅ Over-the-Counter (OTC) Items – Pain relievers, allergy meds, and cold medicines (as of the CARES Act, no prescription needed).
✅ Vision & Hearing – Eye exams, glasses, contacts, LASIK, hearing aids, and batteries.
✅ Mental Health Services – Therapy, psychiatric care, and substance abuse treatment.
✅ Medical Equipment & Supplies – Crutches, wheelchairs, bandages, CPAP machines, and breast pumps.
✅ Fertility & Pregnancy Care – Fertility treatments, IVF, prenatal vitamins (if prescribed), childbirth classes.
Examples of Non-Eligible Expenses
❌ General Wellness & Personal Care – Gym memberships, fitness trackers, non-medical massages, cosmetic procedures.
❌ Cosmetic Surgery – Unless medically necessary (e.g., reconstructive surgery after an accident).
❌ Non-Prescription Supplements – Vitamins, herbal remedies, unless prescribed for a medical condition.
❌ Non-Medical Procedures – Teeth whitening, hair transplants, elective laser eye surgery for appearance.