The IRS requires that you demonstrate that your purchase is an eligible use of FSA funds.
This may take the form of a receipt, invoice, or Explanation of Benefits.
Your receipt must show:
- Patient's Name. Your (or your dependent's) name. For retail store purchases, this information may be omitted.
- Provider's Name or Merchant Name.
- Itemized List of Products and/or Services.
- Cost per Item. The amount paid for the service or product and/or the portion that is not reimbursed through your insurance carrier.