FSA funds cover medical expenses your insurance doesn't pay for, plus some preventive care your plan already covers
A Flexible Spending Account (FSA) lets you pay for may have access to medical, dental, and vision expenses with pre-tax money. That means you set aside money before taxes are taken out of your paycheck, reducing your taxable income for the year. You can use FSA funds to cover costs your health insurance doesn't pay for — copays, deductibles, coinsurance — and also for certain preventive services your plan covers but you'd otherwise pay out of pocket.
The IRS maintains a specific list of what counts as a may have access to medical expense. If it's not on that list, you cannot use FSA money for it, even if it seems health-related. The rules are strict because FSA money is pre-tax, so the government limits what qualifies.
Key Takeaways
- FSA money covers copays, deductibles, coinsurance, and out-of-pocket costs for doctor visits, prescriptions, dental work, and vision care.
- You can use FSA funds for preventive care services — like annual physicals and screenings — even if your insurance covers them at no cost.
- Over-the-counter medicines and medical supplies require a prescription or doctor's note to count as may have access to expenses.
- FSA funds cannot be used for cosmetic procedures, gym memberships, vitamins without a medical condition, or most wellness products.
- Unused FSA money at the end of the plan year is forfeited — you cannot carry it over to the next year.
Medical expenses you can pay with FSA funds
FSA money covers the out-of-pocket costs of medical care: copays when you see a doctor, coinsurance (your share of the cost after insurance pays), and deductibles (the amount you pay before insurance kicks in). It also covers prescription medications, even if your insurance plan covers them — you can use FSA funds to pay your copay or the full cost if you're paying out of pocket.
Urgent care visits, emergency room visits, hospital stays, and surgery costs all may have access to. If your insurance requires you to pay a portion, FSA funds can cover your share. Mental health and substance abuse treatment expenses also count, including copays for therapy sessions and psychiatric medications.
Medical equipment and supplies are covered if they treat or monitor a medical condition: blood glucose monitors and test strips for diabetes, blood pressure cuffs, thermometers, crutches, wheelchairs, and hearing aids all may have access to. Bandages, gauze, and first-aid supplies count. Over-the-counter medical items like pain relievers, allergy medications, and cold medicines may have access to only if you have a prescription or a doctor's note stating medical necessity.
Dental and vision expenses FSA covers
Dental expenses covered by FSA include copays for routine cleanings and exams, fillings, root canals, crowns, extractions, and orthodontia (braces). If your dental insurance has a copay or coinsurance, FSA funds can cover your share. Dental work your insurance doesn't cover — like cosmetic bonding or whitening — does not count as a may have access to expense.
Vision expenses include copays for eye exams, prescription glasses, contact lenses, and contact lens solution. Laser eye surgery (LASIK) qualifies if it corrects a vision problem, not if it's purely cosmetic. Sunglasses do not count, even if they have a prescription, because they are not medically necessary.
Preventive care and screenings you can fund with FSA
Many health insurance plans cover preventive services at no cost to you — annual physicals, cancer screenings, vaccinations, and cholesterol checks. You can still use FSA funds to pay for these services. This is useful if you want to pay out of pocket to preserve your FSA balance for other expenses, or if your plan covers the service but charges a copay.
Preventive dental cleanings and exams, even if your dental plan covers them fully, can be paid with FSA funds. The same applies to routine eye exams. If your plan covers a screening but you choose to go to an out-of-network provider and pay more, only the amount your plan would have covered counts as a may have access to expense.
What FSA money cannot cover
Cosmetic procedures — including teeth whitening, Botox, hair removal, and plastic surgery — do not count as may have access to expenses unless they treat an injury or medical condition. Teeth whitening for appearance does not may have access to; whitening to treat staining from medication might.
Gym memberships, fitness classes, and general wellness products do not count, even if they improve your health. Vitamins and nutritional supplements do not count unless a doctor prescribes them to treat a specific medical condition and provides written documentation. Weight-loss programs and diet plans are not covered.
Over-the-counter items like pain relievers, antacids, allergy medications, and cold medicines do not count without a prescription or doctor's note. Toiletries, sunscreen, and personal care items are not covered. Maternity clothes, even though they are pregnancy-related, do not count. Childcare and dependent care are handled through a separate account (a Dependent Care FSA), not a medical FSA.
How to know if something qualifies before you buy it
Your FSA plan administrator — usually your employer's benefits department or the third-party company managing the account — can tell you whether a specific expense qualifies. Many FSA providers have a searchable database of may have access to expenses on their website or app. You can search by product name or category to see if it's approved.
If you are unsure, ask your doctor or dentist whether they will provide a prescription or letter of medical necessity for an over-the-counter item. Keep receipts and any documentation (prescriptions, doctor's notes, explanation of benefits from your insurance) in case your FSA administrator asks for proof that an expense was may have access to.
When you submit a claim to your FSA, the administrator reviews it against the IRS rules. If they deny a claim, they will tell you why and may ask for additional documentation. You can appeal a denial if you believe the expense qualifies.
The "use it or lose it" rule and planning your FSA spending
FSA funds must be spent by the end of your plan year — usually December 31 — or they are forfeited. You cannot carry unused money into the next year. This is why FSA planning matters: you need to estimate your medical, dental, and vision expenses for the coming year and set aside only what you expect to spend.
Some employers offer a grace period of up to 2.5 months into the next year to spend the previous year's FSA funds, but this is optional and not all plans include it. A few plans allow you to carry over up to $610 (the amount changes yearly) into the next year, but most do not. Check your plan documents to see what applies to your account.
If you have money left in your FSA near the end of the year, consider scheduling dental cleanings, eye exams, or other routine care you have been putting off. Stock up on prescription medications or over-the-counter items you use regularly (if they may have access to). Do not spend money on things you do not need just to avoid forfeiture — that defeats the purpose of the tax savings.
Frequently Asked Questions
Can I use my FSA to pay for my spouse's or child's medical expenses?
Yes, if they are covered under your health insurance plan or are your tax dependents. You can use your FSA funds to pay for their copays, deductibles, prescriptions, and other may have access to medical expenses. The expense must be for someone you can claim on your taxes or someone covered by your insurance.
Do I need a receipt to use my FSA debit card?
Your FSA provider may require a receipt or explanation of benefits to verify that the expense was may have access to. If you use an FSA debit card at a pharmacy or doctor's office, the system sometimes automatically approves the transaction. Other times, the provider will ask you to submit documentation later. Keep all receipts for at least three years in case of an audit.
Can I use FSA funds for prescription glasses or contacts without a copay?
Yes. Even if your vision insurance covers glasses or contacts at no cost, you can use FSA funds to pay for them. This is useful if you want to buy multiple pairs or upgrade to a more expensive frame, and you can use pre-tax FSA money to cover the cost.
What happens to my FSA if I leave my job?
You typically lose access to your FSA when you leave your employer. You may be able to continue coverage under COBRA, but you would pay the full premium yourself (no longer pre-tax). Any unused FSA funds are forfeited — you cannot take them with you. Spend down your FSA before you leave, or plan your resignation timing around your plan year.
Can I use FSA money for pet medical expenses?
No. FSA funds are for human medical expenses only. Veterinary care and pet medications do not count as may have access to expenses, even if the pet is a service animal. Service animal training and equipment also do not may have access to under FSA rules.