Limited Purpose Account Eligible Expenses

• Dental plan deductible
• Dental aligners (like Invisalign)
• Dental care, including:
  • Cleanings and exams
  • Crowns and bridges
  • Dental reconstruction, implants
  • Dentures and denture care products
  • Diagnostic services
  • Fillings
  • Root canals
  • Sealants
  • X-Rays
• Diagnostic services
• Medicated toothpaste* (cost difference between standard and medicated toothpaste is covered)
• Occlusal guards (to prevent teeth grinding)
• Orthodontia
• Sales tax, shipping and handling fees (for any eligible expense)
• Toothache or teething pain reliver (over-the-counter)

*May be eligible with letter of medical necessity

• Braille books and magazines (cost difference between standard and Braille versions is covered )
• Contact lenses and solutions
• Vision plan deductible
• Diagnostic services
• Eye drops and treatments (over-the-counter)
• Eye glass repair kit
• Guide dog*
• Lasik surgery
• Ortho keratotology
• Prescription eyeglasses – regular and sunglasses
• Radial keratotomy
• Reading glasses (over-the-counter)
• Sales tax, shipping and handling fees (for any eligible expense)
• Vision correction treatment/surgery (not covered by health plan)
• Vision exams
• Vision eye patch
• Vision lens wipes

*May be eligible with letter of medical necessity

• Eye serums or wrinkle creams
• Dental veneers*
• Non-prescription sunglasses
• Prescription goggles and masks
• Teeth bleaching or whitening
• Toothpaste, toothbrush, floss, mouthwash
• Waterpik/flosser*

*May be eligible with letter of medical necessity