FSA money can only be spent on medical expenses that the IRS considers may be able to access, and you cannot use it for insurance premiums, over-the-counter drugs without a prescription, or cosmetic procedures.
Your Flexible Spending Account holds pre-tax dollars your employer set aside for healthcare costs. The catch is strict: you can spend it only on things the IRS has approved. Spend it on the wrong thing and you lose that money — there is no refund, no exception, no appeal. The list of what counts is longer than most people think, but it has real boundaries.
The easiest way to know if something is may be able to access is to check the IRS Publication 502 list or ask your FSA plan administrator before you buy. Many FSA debit cards will reject ineligible purchases at the register, which saves you from the mistake. But some won't, which means the burden falls on you to know the rules.
Key Takeaways
- may be able to access FSA expenses include copays, deductibles, prescription medications, dental work, vision care, and medical equipment like crutches or blood pressure monitors.
- Over-the-counter drugs like cold medicine and pain relievers are not may be able to access unless you have a prescription from your doctor.
- Health insurance premiums, cosmetic procedures, and gym memberships are never may be able to access, even if they improve your health.
- You must spend FSA money by the end of your plan year or lose it — there is no carryover, though some plans offer a grace period of up to 2.5 months.
- Keep receipts for everything you buy with FSA money in case your plan administrator asks for proof later.
Medical visits, prescriptions, and devices you can pay for
Copays and coinsurance at doctor's offices, urgent care, and emergency rooms are may be able to access. So are deductibles you owe before insurance kicks in. If your plan requires you to pay $500 before coverage starts, FSA money covers that $500.
Prescription medications are always may be able to access. Over-the-counter drugs are not — unless your doctor writes a prescription for them. That means you cannot buy ibuprofen, allergy medicine, or cold medicine with FSA funds unless your doctor has written a prescription specifically for that medication. Some people get their doctor to write a prescription for common OTC drugs for exactly this reason.
Medical equipment and supplies are may be able to access if they treat or monitor a condition. This includes blood pressure monitors, glucose meters, crutches, wheelchairs, hearing aids, and orthopedic braces. Bandages, gauze, and first-aid supplies count. Thermometers count. Pregnancy tests count. Condoms do not — they are considered contraception for prevention, not treatment.
Mental health and therapy visits are may be able to access. So are prescriptions for psychiatric medications. Substance abuse treatment programs are may be able to access too.
Dental and vision care that FSA covers
Dental work is may be able to access: cleanings, fillings, root canals, crowns, extractions, and orthodontia. You can use FSA money for braces, retainers, and the dentist's portion of implants. Teeth whitening is not may be able to access because it is cosmetic.
Vision care includes eye exams, glasses, contact lenses, and contact lens solution. Laser eye surgery (LASIK) is may be able to access. Sunglasses are not, even if you need them for a medical condition — the IRS does not cover them.
What is not may be able to access, even if it seems medical
Health insurance premiums are never may be able to access — not your monthly premium, not your deductible, not your copay. Wait, you just read that copays are may be able to access. The difference: you pay the copay at the doctor's office after you are already insured. The premium is what you pay to have insurance in the first place. FSA money cannot go toward that.
Cosmetic procedures are not may be able to access. This includes teeth whitening, hair removal, wrinkle treatments, and plastic surgery. If the procedure is done purely to improve appearance rather than treat a medical condition, it does not may have access to. Reconstructive surgery after an injury or illness is may be able to access; elective cosmetic surgery is not.
Gym memberships and fitness classes are not may be able to access, even if your doctor recommends exercise. Weight loss programs are not may be able to access unless they treat a specific disease diagnosed by a doctor — and even then, only the medical portion counts, not the membership fee.
Vitamins and supplements are not may be able to access unless your doctor prescribes them to treat a specific condition. A multivitamin you buy for general health does not count. Herbal remedies are not may be able to access.
How to actually spend the money before the year ends
FSA money operates on a use-it-or-lose-it schedule. Your plan year runs on your employer's calendar — often January through December, but sometimes July through June or another cycle. Any money left in your account at the end of that year is forfeited. You cannot roll it over to next year, and you cannot get it back as a refund.
Some employers offer a grace period of up to 2.5 months after the plan year ends. If your plan has this, you can spend money from the previous year during that grace period. Check your plan documents or ask your HR department whether yours does.
The practical move is to estimate conservatively how much you will spend on may be able to access expenses in the coming year, then contribute that amount. If you contribute $2,500 and spend only $1,800, you lose $700. If you contribute $1,500 and spend $2,000, you pay the extra $500 out of pocket. Most people aim to spend 80 to 90 percent of what they contribute.
Track your spending throughout the year. Keep receipts. Many FSA debit cards let you check your balance online. If you are halfway through the year and have spent very little, start scheduling dental work, vision exams, or other may be able to access care before the year ends.
Using your FSA debit card versus paying out of pocket and reimbursing yourself
Most FSA plans issue a debit card that works like a regular card at pharmacies, doctor's offices, and medical suppliers. Swipe it, and the may be able to access amount comes out of your FSA. The card is convenient, but it does not always work perfectly — some medical offices do not accept FSA cards, and some cards decline may be able to access purchases by mistake.
The backup method is to pay out of pocket with your own money, then submit a receipt to your FSA plan administrator for reimbursement. This takes longer — usually one to two weeks — but it works everywhere. You can also do this if your FSA card declines an may be able to access purchase.
Keep every receipt, whether you use the card or pay out of pocket. Your plan administrator can ask for proof that an expense was may be able to access, and the receipt is your proof. Take a photo of receipts or scan them so you have a backup copy.
Frequently Asked Questions
Can I use FSA money to pay for my spouse's or child's medical expenses?
Yes, as long as they are claimed as dependents on your tax return. You can use your FSA to pay for their copays, prescriptions, dental work, and other may be able to access expenses. The money in your account belongs to you, so you decide how to spend it on may be able to access care for yourself or your dependents.
What happens to FSA money I do not spend by the end of the year?
You lose it. The money does not roll over to the next year, and you cannot withdraw it or get it back. This is why it is important to estimate carefully how much to contribute. If your plan offers a grace period, you have a few extra months to spend it, but after that, it is gone.
Can I use FSA money to buy a fitness tracker or smartwatch that monitors my health?
No. Fitness trackers and smartwatches are not may be able to access, even if they monitor heart rate or steps. They are considered general wellness devices, not medical equipment. However, if your doctor prescribes a specific medical device like a continuous glucose monitor or heart rate monitor for a diagnosed condition, that device may be may be able to access.
Is pet medication or veterinary care may be able to access?
No. FSA money can only be used for human medical expenses. Veterinary care, pet medications, and pet health supplies are not may be able to access, even if the pet is a service animal.
Can I change how much I contribute to my FSA during the year?
Only if you have a may have access to life event: marriage, divorce, birth or adoption of a child, loss of other health coverage, or a significant change in your spouse's benefits. Outside of these events, your contribution amount is locked in for the plan year. This is another reason to estimate carefully at enrollment time.