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Eligible health care expenses are defined by the IRS as amounts paid for the diagnosis, cure, mitigation or treatment of a disease and for treatments affecting any part or function of the body. The expenses must be primarily to alleviate a physical or mental defect or illness.
With this definition in mind, we have listed below many of the medical expenses eligible for payment under Horizon MyWay to the extent such expenses are not covered by your medical or dental insurance. This list is not meant to be all inclusive. Other expenses not specifically mentioned may also qualify. For additional information, please refer to Medical and Dental Expenses, or Section 213(d) of the Internal Revenue Code.
DENTAL SERVICES
Crowns/Bridges
Dental X-Rays
Dentures
Exams/Teeth Cleaning
Extractions
Fillings
Gum Treatment
Oral Surgery
Orthodontia/Braces
INSURANCE-RELATED ITEMS
Insurance Premiums
Pre-existing Condition Expenses (medical)
Private Hospital Room Differential
LAB EXAMS/TESTS
Blood Tests
Cardiographs
Diagnostics
Laboratory Fees
Metabolism Tests
Spinal Fluid Tests
Urine/Stool Analyses
X-Rays
MEDICATION
Insulin
Over-the-Counter Medicine (to treat illness or medical condition)
Prescribed Birth Control
Prescribed Vitamins (to treat a specific disease and not available over the counter)
Prescription Drugs*
OBSTETRIC SERVICES
Midwife Expenses
Ob/Gyn Exams
Ob/Gyn Prepaid Maternity Fees (reimbursable after date of birth)
Postnatal Treatment
Prenatal Treatment
Prescribed Prenatal Vitamins
PRACTITIONERS
Allergist
Chiropractor
Christian Science
Dermatologist
Homeopath
Naturopath
Osteopath
Physician
Psychiatrist
Psychologist
OTHER MEDICAL TREATMENTS/PROCEDURES
Acupuncture
Alcoholism (inpatient treatment)
Biofeedback Therapy (in medically necessary situations)
Cosmetic Surgery (if medically necessary due to a congenital defect)
Drug Addiction
Hearing Exams
Hospital Services
Infertility
In-Vitro Fertilization
Norplant Insertion or Removal
Patterning Exercises
Physical Examination (not employment related)
Physical Therapy
Speech Therapy
Sterilization
Transplants (includes organ donor)
Vaccinations/Immunizations
Vasectomy and Vasectomy Reversal
Well Baby Care
OTHER MEDICAL EQUIPMENT, SUPPLIES AND SERVICES
Abdominal/Back Supports
Ambulance Services
Arches/Orthopedic Shoes
Contraceptives, Prescribed
Counseling
Crutches
Guide Dog (for visually/hearing impaired person)
Hearing Aids and Batteries
Hospital Bed
Lead Paint (if not capital expense and incurred for a child poisoned)
Learning Disability (special school/teacher)
Medic Alert Bracelet or Necklace
Oxygen Equipment
Prescribed Medical and Exercise Equipment
Prosthesis
Splints/Casts
Support Hose (if medically necessary)
Syringes
Transportation Expenses (essential to medical care)
Tuition Fee at Special School for Disabled Child
Wheelchair
Wigs (hair loss due to disease)
VISION SERVICES
Artificial Eyes
Contact Lenses
Contact Lens Solution
Eye Examinations
Eyeglasses
Laser Eye Surgeries
Ophthalmologist
Optometrist
Prescription Sunglasses
Radial Keratotomy/LASIK
INELIGIBLE EXPENSES
The following expenses are not allowed by the IRS to be reimbursed under Horizon MyWay to promote general health and are not eligible expenses unless prescribed by a physician for a specific medical ailment. This is not an all-inclusive list.
Baby-Sitting and Child Care
Calcium Supplements
Canceled Appointment Fees
Contact Lens Insurance
Cosmetic Surgery/Procedures
Dancing/Exercise Programs
Diaper Service
Discounts/Write-Offs
Electrolysis
Exercise Equipment*
Eyeglass Insurance
Fitness Programs*
Hair-Loss Medication
Hair Transplant
Health Club Dues
Herbs and Herbal Medicines
Homeopathic Drugs
Illegal Operations or Treatments
Insurance Premiums
Interest Charges
Lamaze Classes
Marriage Counseling
Massage Therapy**
Maternity Clothes
Personal Trainer
Pregnancy Test (over the counter)
Prenatal Vitamins (over the counter)
Prescription Drug Discount Program Premiums
Retin A*
Rogaine*
Smoking Cessation Products (over the counter)
Special Foods* (cost difference of common product)
Student Health Fees
Supplements
Swimming Lessons
Teeth Whitening/Bleaching
Toiletries, Toothpaste, etc.
Vision Discount Program Premiums
Vitamins
Weight Loss Programs**
* Generally ineligible; in limited situations, eligible only with doctor's certification identifying a qualifying medical diagnosis, medical necessity and length of treatment program.
** Eligible only with doctor's certification identifying the physical nature of the medical condition and length of treatment program. Massage therapy for the sole purpose of tension/stress relief does not qualify as an eligible expense. Over-the-counter products/medications deemed for "medical care" will be considered reimbursable. "Medical care" includes amounts paid for the diagnosis, cure, mitigation, treatment or prevention of disease. Amounts paid for medicines and drugs are expenditures for medical care, but expenditures that are merely beneficial to the general health of an individual are not.
This list is subject to change. For an updated list, please check with the person in charge of benefits at your company.
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