CAPCO BENEFIT GUIDE

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 Ambulance  Breast Reconstruction  Eye Surgery (including laser
eye surgery)
 Orthotic Inserts
 Annual Physical  Christian Science (fees to
practitioners for care)
 Eyeglasses  Osteopath
 Artificial Limb  Cold/Hot Pack for medical
care
 Fertility Enhancement  Out-of-Network charges
 Artificial Teeth  Condoms  First Aid Supplies  Oxygen for medical
condition
 Nursing Home (for medical
care)
 Contact Lenses and
supplies
 Flu Shot  Physical Examination
 Thermometers  Contraceptives  Guide Dog (including
maintenance costs)
 Pregnancy Test Kit
 Abortion  Crutches  Gynecologist  Prosthesis
 Acupuncture  Dental Treatment  Hearing Aids (including
batteries and repair)
 Psychiatric Care
 Bandages  Dentures and cleaners  Homeopathic Care  Psychoanalysis
 Birth Control Pills  Dermatologist  Immunizations  Psychologist
 Blood Pressure Monitor  Diabetic Supplies  Laboratory Fees  Splints
 Blood Sugar Test Kit  Diagnostic Devices  Lactation Expenses  Sterilization
 Blood Tests  Doctor’s fees not covered
by insurance
 Medical Alert Bracelet  Therapy
 Body Scan  Drug Addiction (inpatient
treatment)
 Operations
(non cosmetic)
 Vasectomy
 Braille Books  Drugs (with prescription)  Optometrist  Wheelchair
 Breast Pump/Supplies  Eye Exams  Orthopedist  X-Ray
 Babysitting  Dental Floss  Funeral Expenses  Medigap Premiums
 Controlled Substances  Diaper Service  Health Club Dues  Swimming Lessons
 Cosmetic Surgery  Diet Foods  Household Help  Teeth Whitening
 Cosmetics  Electrolysis  Illegal Treatments  Veterinary Fees
 CPR Class  Exercise Equipment  Marijuana
 Dancing Lessons  Facial Tissues  Maternity Clothes
UNDERS TAND I NG
YOUR HSA