MMC Benefits Handbook
Examples of Eligible Expenses
Expenses reimbursed by the Plan include:
  • medical services provided by medical practitioners and that are not covered by another plan
  • charges for medically necessary services not covered by another plan, including but not limited to the following:
    • deductibles
    • out-of-pocket expenses
    • copayments
    • coinsurance
    • charges exceeding reasonable and customary amounts
    • charges exceeding plan limits
    • prescription drug charges
    • other non-covered charges
    • all medically necessary prescription drugs and certain other prescription drugs permitted by the IRS (e.g., contraceptives and pre-natal vitamins)
    • eye exams, glasses (frames and lenses), contact lenses and solutions for contact lenses, lubricant eye drops, eye patches and reading glasses
    • LASIK eye surgery
    • dental implants
    • dental treatment, routine dental care (cleaning, X-rays, fillings, etc.), and over-the-counter products such as denture adhesive, temporary filling and temporary relief (if accompanied by a Letter of Medical Necessity)
    • orthodontia (braces)
    • mouth guards
    • hearing exams, hearing aids
    • cost differences between semi-private and private hospital rooms
    • cost for special medical equipment installed in your home, or for home improvements for purposes of medical care, e.g., ramps, support bars, railings, etc. (if accompanied by a Letter of Medical Necessity)
    • fees for special schools on the recommendation of a physician, including schools for the mentally impaired, physically disabled or individuals with severe learning disabilities
    • transportation (amounts paid for travel primarily for, and essential to, medical care)
    • personal use items if primarily used to prevent or alleviate a physical or mental defect or illness, e.g., Braille books, hearing aids
    • private nursing services rendered in your home or elsewhere
    • smoking cessation programs
    • weight loss programs (if you have a letter from your treating physician indicating medical necessity)
  • periodic health evaluations, including tests and diagnostic procedures ordered in connection with routine examinations, such as annual physicals
  • routine prenatal and well-child care
  • flu shots (if not covered by the Marsh & McLennan Companies $1,500 Deductible Plan, $2,850 Deductible Plan, or any other plan)
  • vaccinations
  • child and adult immunizations
  • screenings for conditions such as:
    • cancer
    • heart and vascular diseases
    • infectious diseases
    • mental health conditions
    • substance abuse
    • metabolic, nutritional, and endocrine conditions
    • musculoskeletal disorders
    • obstetric and gynecological conditions
    • pediatric conditions
    • vision and hearing disorders
  • preventive over-the-counter expenses, such as:
    • home diagnostic tests or kits for blood pressure, cholesterol screening, diabetes (e.g., glucose monitor), colorectal, HIV
    • smoking-cessation relief, such as patches and gum
    • pre-natal vitamins.
For examples of IRC Section 213 qualified medical expenses, see IRS Publication 502, which is available at www.irs.gov or by calling the IRS at +1 800 829 3676. Note that certain items listed in Publication 502 may not qualify for Health Care Flexible Spending Account reimbursement, such as premiums for dental or vision insurance. You may also contact the Claims Administrator for information about reimbursable qualified medical expenses.