United States Office of 

Personnel Management

The Federal Government’s Human Resources Agency

Benefits Administration Letter

 

Number: 20-802 Date: May 15, 2020 

Subject: Update on Qualified Medical Expenses under CARES Act and Reminder 

about Dependent Care Flexible Spending Account Qualifying Life Event

Purpose

We write with an update to qualified medical expenses for use with health care flexible spending 

accounts (FSAs), health savings accounts (HSAs), health reimbursement arrangements (HRAs)

under certain FEHB plan options and a reminder about the Federal Flexible Spending Account 

(FSAFEDS) Program. 

Update: Certain over-the-counter (OTC) drugs and medications, as well as menstrual care 

products, are now considered qualified medical expenses, without the need for a physician 

prescription. You may use HSA, FSA or HRA funds to pay for these products. For more 

information on OTC products and other eligible health care expenses, refer to IRS Publication 

969 or go to the IRS website at www.irs.gov. 

Reminder: Dependent Care Flexible Spending Account (DCFSA) participants may increase or 

decrease their election, if they experience an eligible Qualifying Life Event (QLE). 

Background 

Public Law 116-136, the Coronavirus Aid, Relief, and Economic Security (CARES) Act, 

includes two significant changes that affect participants with an FSA, HSA or HRA and apply to

expense amounts incurred after December 31, 2019. 

• Over-the-counter drugs and medications can be reimbursed through a healthcare FSA, 

HSA or HRA without a doctor’s prescription. 

• HCFSA, HSA and HRA funds can now be used for menstrual care product purchases. 

Since inception of FSAFEDS, DCFSA participants have had the option to increase their election

due to an eligible QLE through September 30 of the calendar year and decrease their election

due to an eligible QLE throughout the year. The closing of a child/elder care facility or program, 

as a result of the call for social distancing, meets one of the program's qualifying life events: a 

childcare/elder care provider’s cost or coverage changes. 

• Note: The request must be consistent with the reason for the change. For example, if the 

dependent care provider is no longer providing care, the election can be reduced. 
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Similarly, if the participant needs supplemental child or adult care, due to an increase in 

hours worked, the participant can increase the DCFSA election. 

Decreasing DCFSA Election

If a participant who is paying for childcare/elder care experiences a decrease in cost, a request to 

decrease the DCFSA election can be submitted. The new election cannot be less than the 

expenses for which the participant has already been reimbursed or less than the amount already 

contributed to the DCFSA account. The participant can submit a QLE anywhere from 31 days 

before to 60 days after the date of the event. If this situation changes, he or she can again submit 

a QLE to increase that election for the rest of the plan year on or before September 30th. 

Increasing DCFSA Election

If the cost for dependent/elder care increases, an employee may elect to participate or a 

participant may increase their DCFSA election for the plan year. This election or change must 

be made on or before September 30th. 

Participants may submit a QLE in their online account at www.FSAFEDS.com or by calling 1-

877-FSAFEDS (372-3337). Please also call 1-877-FSAFEDS (372-3337) for questions and 

additional information regarding these FSAFEDS Program changes. 

For questions concerning this Benefits Administration Letter, please email FSA@opm.gov 

Sincerely, 

 Laurie Bodenheimer

Acting Director 

Healthcare and Insurance