Cafeteria Plan Tax Savings Calculator | FSA, Dependent Care, 125

Gross Annual Pay
Estimate your monthly expenses
*Health Insurance Premiums
Medical expenses	(click here for a list of eligible expenses)

Partial List of Deductible Medical Expenses
- Enter the total monthly amount next to expenses listed below -

Acupuncture
Alcoholic/Drug treatment
Ambulance fees
Birth control pills
Chiropractic
Co-payments
Counseling (for a medical condition)
Deductibles
Dental fees
Dentures
Diabetic supplies
Diagnostic fees
Dr Fees
Qualified over the counter medications (used for specific illness or injury)
Hospital bills (Emergency Room Fees)

Laboratory fees
Medical Equipment
Medical Mileage
Medical Tests
Prescription medication
Nurse's fees (in home)
Obstetrical
Operations/Surgery
Office calls
Orthodontia/Braces
Physical therapy
Physical exam (routine)
Radiology/X-rays
Vaccines/Allergy/Flu Shots
Vision (contacts/supplies, eyeglasses, Lasik surgery)
Other

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**Dependent care expenses

*Health insurance premiums must be run through premium only or HCPR for the tax savings

**$5000 annual maximum if filing married, $2500 annual maximum if married filing separately