For Employees
ESTIMATE YOUR SAVINGS
FSA Eligible Expenses and Items
Use these buttons to see how average families save using the plan:
1 - HEALTH CARE EXPENSES   2 - DEPENDENT CARE EXPENSES
Co-pays to doctor & pharmacies   Nanny & babysitter through age 12
Over-the-counter 1.2   Pre-K or nursery school
Prescription drugs   Before/after school care through age 12
Office visits & Checkups   Day camp through age 12
Prescribed sunglasses & eyeglasses   Day car for disabled adult or child
Contact lenses & solutions   Elder care for parent or dependant
Eye exam's, surgery & LASIK  
3 - PARKING EXPENSES
Dental cleanings, fillings & X-rays  
Sealants, crowns, bridges & dentures   Parking located near work
Braces, spacers & retainers   Parking for which you take mass transit
Wisdom teeth, implants & oral surgery      
Psychologist & psychiatrist fees  
4 - TRANSIT EXPENSES
Obstetrics & fertility  
Lab tests & body scans   Transit passes for bus, subway or train
Chiropractic & podiatrist fees   Vanpooling expenses
Oxygen. insulin, syringes & supplies  
5 - ADOPTION EXPENSES
Hearing aids, batteries & exams  
Artificial limbs & braces   Home study & application fees
Arches & orthopedic shoes   Court costs & attorney fees
Walkers, canes & wheelchairs   Agency fees
Physical & speech therapy   Medical services & counseling
Wheight-loss programs (for specific diseases)   Travel lodging expenses
Quite-smoking programs & medications 2  
6 - INSURANCE PREMIUMS
Deducted from my paycheck
Alcoholism & drug treatment  
Medical alert bracelet & fees   Health Insurance (my share only)
Special school for disabled child   Other (my share only)
Travel & milage to doctor or hospital      
Reconstructive surgery (birth defect, disease)      
Wigs for hair loss caused by disease      

*Plan restrictions may apply. Check with your plan administrator.

**Prescription (Rx) required beginning 1/1/2011

       
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Please select your family's income range:
YOU SAVE
GRAND TOTAL
   
FSA Eligible Expenses and Items
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