mbraun benefits summary-Updated 8-19

Ineligible FSA/HSA Expenses and Over-the-Counter Products

Ineligible FSA/HSA Healthcare Expenses

Advance payment for services to be rendered Automobile insurance premium allocable to medical coverage Boarding school fees Body piercing Bottled water Chauffeur services Controlled substances Cosmetic surgery and procedures Cosmetic dental procedures Dancing lessons Diapers for Infants Diaper service Ear piercing Electrolysis Fees written off by provider Food supplements Funeral, cremation, or burial expenses Hair transplant

Health programs, health clubs, and gyms Illegal operations and treatments Illegally procured drugs Insurance premiums Long-term care services Maternity clothes Medical savings accounts Premiums for life insurance, income protection, disability, loss of limbs, sight, or similar benefits Personal items Preferred provider discounts Social activities Special foods and beverages Swimming lessons Tattoos/tattoo removal Teeth whitening Transportation expenses to & from work Travel for general health improvement Uniforms Vitamins & supplements without prescription

Herbs & herbal supplements Household & domestic help

Ineligible FSA/HSA Over-the-Counter Products The following are examples of OTC medications & products which are NOT eligible for FSA/HSA reimbursement.

Aromatherapy Baby bottles & cups Baby Oil Baby wipes Breast enhancement system Cosmetics (including face creams & Moisturizers) Cotton swabs Dental floss Deodorants & anti-perspirants Dietary supplements Fiber supplements Food Fragrances

Hair regrowth preparations Herbs & herbal supplements Hygiene products & similar items Lip Balm Low carb & low-fat foods Low calorie foods Medicates shampoos & soaps Petroleum jelly Shampoo & conditioner Spa salts Suntan lotion

Toiletries (including toothbrushes & toothpaste) Vitamins & supplements without a prescription Weight loss drugs for general well-being

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