Contact lenses or replacements needed for medical reasons Eye exams
Contact lenses solution LASIK surgery, radial keratectomy and photorefrac-
Eyeglasses (including non-prescription reading glasses and tive keratectomy (PRK) to correct or promote the
prescription sunglasses) proper function of the eye
PAGE 16 • 1100 – Nontaxable Benefit Plan NHC BENEFITS HANDBOOK
EQUIPMENT AND SUPPLIES
Abdominal supports Hearing aids
Air filters prescribed by a physician for allergies Home improvements or special home equipment
Ambluance hire whose main purpose is medical care
Arches Mattress for treatment of arthritis
Artificial eyes or limbs Orthopedic shoes
Autoette (auto device for handicapped person), but not if Oxygen or oxygen equipment purchased to alleviate
used to travel to job or business breathing problems caused by a medical condition
Automobile related expenses for special hand controls or Retin-A when prescribed by a physician for a specific
other special equipment installed in a car for the use of a medical condition (such as acne), but not for cosmetic person with disabilities and the amount by which the cost purposes (such as wrinkles)
of a car specifically designed to hold a wheelchair exceeds Rogaine when prescribed by a physician for a specific
the regular car cost medical condition (such as hypertension), but not for
Back supports cosmetic purposes (such as to stimulate hair growth)
Birth control devices or pills prescribed by a physician Sacroiliac belt
Braille books and magazines (but only to the extent the Splints
price exceeds that of regular books and magazines) Telephone/teletype equipment or repair that allows
Chair that reclines purchased on advice of physician to hearing impaired person to communicate over the
alleviate a heart, back or other medical condition telephone
Crutches (whether bought or rented) Television adapter equipment or repair that allows
Diapers or similar products used to mitigate incontinence a hearing impaired person to view audio as subtitles
Elastic hosiery Truss
Extra cost of private hospital room Wigs purchased at advice of a physician for the mental health of a patient who has lost all of his or her hair from
disease
MEDICAL TREATMENTS Alcohol or drug abuse center treatment and inpatient care Insulin Treatments
costs, including meals and lodging provided by center Lasik eye surgery
during treatment Legal Abortion
Blood transfusion Nursing home expenses
Cosmetic surgery, but only if necessary to improve a Organ transplants
deformity arising from or related to, a congenital abnormality, Physical exams not required for employment
a personal injury resulting from an accident or trauma, or a Pre-natal; post-natal treatments
disfiguring disease, or to promote the proper function of the Psychotherapy
body or prevent or treat an illness or disease (physician Radium therapy
certificate necessary) Reconstructive breast surgery (but not breast surgery
Diathermy relating to cosmetic purposes- whether augmentation
Electric shock treatments or reduction) or the reversal of cosmetic breast surgery
Fertility treatments, including in vitro fertilization (including prescribed due to defects or medical problems caused
storage of eggs or sperm) and surgery (including an operation thereby
reversing sterilization surgery or medical expenses related to Sterilization
the treatment of Impotence) Ultra-violet ray treatments
Healing services Vasectomy
Hydrotherapy (water treatments) Whirlpool baths
Injections X-ray treatments
MEDICINES Cost of prescriptions, including birth control pills prescribed by a physician and prescription drugs for dieting programs for people who are obese by government standards or smoking-cessation programs. Over-the-counter medications are allowed only when purchased with a doctor’s prescription, with the exception of insulin. Over-the-counter medical devices, such as bandages, crutches, and eyeglass repair kits are allowable. LABORATORY EXAMINATIONS AND TESTS Blood test “Seeing-eye” dog or other animal used by visually or
Cardiograph hearing impaired and its maintenance, or the wages of a
Electromagnetic imaging (EMI) human guide
Metabolism tests Stool examination
Spinal fluid tests X-ray by an x-ray technician
Ambulance service Lead-based paint removal to prevent child who has, or
Childbirth classes incurred by the mother-to-be has had, lead poisoning
(but not a “coach” - even if it is the father-to-be) Nurse's board and wages necessary for medical care,
which address specific medical issues such as labor, including Social Security taxes you pay on wages
delivery procedures, breathing techniques and nursing Remedial reading for child suffering from dyslexia
Computer medical data bank expenses for retrieval on physician recommendation
of medical information Sanitarium or similar institution
Convalescent home – for medical treatment only Special school costs for physically and mentally
Exercise programs, but only if prescribed by a physician handicapped children on physician’s recommendation
for a specific medical condition
Hospital or similar institution charges including lodging
and medications if there to receive medical care, subject
to any federal limitations PREMIUMS, CO-PAYS, DEDUCTIBLES, COINSURANCE AND AMOUNTS NOT PAID OR
REIMBURSED BECAUSE OF PREEXISTING CONDITION LIMITATIONS OR BECAUSE MEDICAL
EXPENSES ARE IN EXCESS OF REASONABLE AND CUSTOMARY CHARGES UNDER THE HEALTH BENEFIT PLAN, THE DENTAL PLAN AND/OR THE VISION PLAN SPONSORED BY YOUR EMPLOYER FOR YOUR OR YOUR LEGAL FAMILY’S COVERAGE EXPENSES NOT COVERED BY MEDICAL CARE EXPENSE REIMBURSEMENT ACCOUNT Antiseptic diaper service Illegal operations and drugs
Babysitting or child care fees to enable you to make Marriage counseling fees
doctor's visits or receive medical care Maternity clothes
Boarding school fees paid for healthy children while Medical alert devices or personal emergency parent is recuperating from illness. It makes no difference transmitters worn as a bracelet or necklace that this was done on a doctor's advice Medical savings accounts
Bottled water bought to avoid drinking fluoridated city water Medicare Part A or Part B
Breast pumps, even if prescribed (unless prescribed to alleviate Personal use items, unless used primarily to prevent
a special medical condition affecting either the mother (such as or alleviate a physical or mental defect or illness, but
a cyst, for example) or the child (such as an ailment preventing only to the extent its cost exceeds the normal cost
nursing, for example) for such items
Cosmetic surgery for appearance purposes, including liposuction Pregnancy tests even if prescribed by a physician
Cost of moving away from an airport due to noise by a Premiums for dental or vision care insurance, or
person suffering from a nervous breakdown cancer or other specific disease insurance, hospital
Cost of trip for a “change of environment” to boost morale confinement or intensive care insurance, or contact
of ailing person, even if a physician prescribed the trip lens replacement insurance, or life insurance, or
Dancing or swimming lessons (even if prescribed by a long-term care insurance, or wage continuation
physician) insurance
Deductions from your wages for sickness insurance under Scientology “audits”
state law Special food or beverage substitutes, but only
Dietary Supplements, used for good health excess cost of chemically uncontaminated foods
Diaper services (unless to relieve effects of a particular over what would have ordinarily been spent on normal
disease) food is a covered expense for allergy patients
Domestic help, even if recommended by a physician Tattooing; ear or other body piercing
because of illness. But the part of domestic help cost Toothpaste
directly attributable to any nursing duties performed by Transportation costs of a disabled person to and
the domestic is a covered expense from work
Face lift operation, even if recommended by a physician Travel costs to a favorable climate where one will
(unless necessary for a medical reason as described under live there permanently
“Medical Treatments”) Traveling costs to look for a new place to live, even
Fitness programs, athletic club, gym or YMCA fees and if on a physician's advice
expenses and the like for general health or to keep Veterinary fee for a pet (pets are not dependents for
physically fit federal tax purposes)
Funeral, cremation, burial, cemetery plot, monument or Weight reduction or stop-smoking programs
mausoleum expenses undertaken for general health
Hair removal or transplants Your divorced spouse's medical bills
PAGE 18 • 1100 – Nontaxable Benefit Plan NHC BENEFITS HANDBOOK
If you have any questions about coverage, IRS Publication 502 explains medical, dental and/or vision expenses that are deductible to you when you itemize expenses on your annual federal income tax Form 1040.
Only deductible expenses can be paid for on a before-tax basis under your Medical Care Expense Reimbursement Account. However, not all deductible medical, dental and/or vision expenses listed in IRS Publication 502 are covered expenses under the Nontaxable Benefit Plan which can be paid on a before-tax basis from your Medical Care Expense Reimbursement Account. For instance, premiums for medical, dental or vision care insurance, or cancer or other specific disease insurance, hospital confinement or intensive care insurance, or contact lenses replacement insurance, or life insurance, or long-term care insurance, or wage continuation insurance are not covered expenses eligible for before-tax payment or reimbursement from your Medical Care Expense Reimbursement Account under the Nontaxable Benefit Plan. All questions concerning what are covered expenses will be decided by the Plan Administrator. You may appeal if you disagree with the Plan Administrator’s decision. However, if there is any question as to whether an expense is covered which you wish to pay for on a before-tax basis under your Medical Care Expense Reimbursement Account, you should ask about such coverage in advance.
You should note that the above-description of medical expenses which may be reimbursed from your Medical Care Expense Reimbursement Account does not describe those employer self-insured medical benefits, or insured dental and/or vision benefits. Those benefits are described in their own summary plan description sections of this Handbook.
Also, you should note that, like premiums you pay for medical coverage through an insurance company, even if you never use your coverage, you don't get back the money you paid for that coverage. Likewise, under federal tax law, the balance in your Medical Care Expense Reimbursement Account at the end of the Plan Year consisting of before-tax contributions of your pay made to the Nontaxable Benefit Plan will not be repaid to you except in those cases where reimbursement is requested by March 31 for services received by December 31 of the prior year. You are urged to limit contributions from your pay to your Medical Care Expense Reimbursement Account to that amount you think you will use as covered expenses during the upcoming Plan Year. This is very important: this “use it or lose it” rule is required by federal tax law.
The amount you may wish to contribute to your Medical Care Expense Reimbursement Account might be limited, for instance, to the amount of your co-pay, deductible and coinsurance payments for the Health Benefit Plan, dental and/or vision plan. For instance, after the co-pay and any applicable deductible is paid by you, you and your employer share in paying medical costs as coinsurance. You might elect to put money into your Medical Care Expense Reimbursement Account for your medical co-pays, deductibles and your share of coinsurance you reasonably expect to pay so you will be paying these on a before-tax basis. (The sections in this Handbook on the Health Benefit Plan, dental plan and vision plan give you the current co-pays, deductibles and coinsurance payments ).
But remember, you lose what you don't use in the Medical Care Expense Reimbursement Account by the end of the Plan Year on December 31. So unless you reasonably know you are going to have medical expenses, don't contribute to cover expenses that may not happen. On the other hand, don't forget to contribute for expenses that are routine, like dental checkups, braces or eyeglasses.
6. Are there any limits to covered expenses under, or contributions to, the Medical Care Expense Reimbursement Account?
You will not be reimbursed for expenses covered by any insurance or employer self-insured plan which reimburses you or directly pays such expenses. In other words, you cannot be reimbursed twice, and trying to do so may be a crime under the law.
Effective Plan Year 2013, there is a $2,500.00 overall cap on your contributions under the law. Also, you cannot be reimbursed for expenses in excess of the limit set out in the Nontaxable Benefit Plan Election Form. You may make a withdrawal at any time up to this limit if you first certify the covered expenses. Your employer will be reimbursed by you out of future payroll contributions you make to your Medical Care Expense Reimbursement Account, or will offset other amounts it owes to you where permitted by law. Tax laws may further limit the before-tax contribution or reimbursement of medical expenses for highly compensated partners. Effective Plan Year 2013, beginning January 1, the maximum for before-tax contributions is $2,500 for the Medical Care Expense Reimbursement Account.
7. Can I, as a plan participant, also deduct reimbursed medical expenses when I prepare my income tax return at year end?
No, you should not deduct any of these reimbursed medical expenses since you have already received the “tax benefit” at the time your pay was adjusted to pay the reimbursed expenses. In effect, a tax deduction has already been taken by you.
Actually, in all cases you are better off from a tax viewpoint under the Nontaxable Benefit Plan when you get a dollar for dollar “tax benefit”. Otherwise you get only a deduction for medical expenses (other than prescriptions) in excess of seven and one- half percent of your adjusted gross income when you itemize deductions on your tax return.