FSA funds cover specific medical and dental costs, not groceries or general health products
Your Flexible Spending Account (FSA) money can only pay for items the IRS classifies as may have access to medical expenses. This means you can use it for doctor visits, prescriptions, and dental work — but not for vitamins, gym memberships, or most over-the-counter items unless they treat a specific condition. The IRS publishes a list of what counts, and your FSA plan administrator has the final say on borderline items.
The key rule: the expense must be for diagnosis, treatment, or prevention of a disease or condition. Cosmetic procedures do not count. Improving general wellness does not count. But paying to fix a problem does.
Key Takeaways
- FSA money covers doctor visits, prescription drugs, dental and vision care, and medical equipment like crutches or glucose monitors.
- Most over-the-counter medicines and supplies now require a prescription or doctor's note to be covered, even if they treat a real condition.
- You cannot use FSA funds for cosmetic procedures, gym memberships, vitamins, or general wellness products.
- Your plan administrator can deny a purchase even if it seems medical, so ask before you pay if you are unsure.
- Unused FSA money does not roll over to next year — you forfeit it unless your plan offers a grace period or carryover option.
Medical visits and procedures you can pay for
Doctor office visits are covered, including the copay and any portion your insurance does not pay. This includes primary care, specialists, mental health counselors, and physical therapists. Urgent care and emergency room visits count. Preventive care like annual checkups and screenings is covered.
Procedures and treatments covered by FSA include surgery, dental work (fillings, root canals, crowns, orthodontia), vision correction (glasses, contacts, LASIK), hearing aids, and medical equipment. If your doctor prescribes it to treat a condition, it usually qualifies. Fertility treatments and related procedures are covered. Chiropractic care is covered if your doctor refers you or if your plan includes it.
Prescription and over-the-counter drugs
Prescription medications are always covered, whether for chronic conditions or short-term treatment. This includes birth control prescribed by a doctor.
Over-the-counter drugs have stricter rules now. Aspirin, cold medicine, allergy pills, and antacids require a prescription or written doctor's note to be FSA-may be able to access, even though you can buy them without one at the pharmacy. Insulin is the major exception — it is covered without a prescription. If your doctor writes a note saying you need an over-the-counter item to treat your condition, keep that note with your receipt.
Medical supplies and equipment
FSA covers bandages, first aid supplies, crutches, wheelchairs, walkers, and other durable medical equipment your doctor says you need. Blood pressure monitors, thermometers, and pulse oximeters count. Glucose monitors and test strips for diabetes are covered. Hearing aid batteries are covered.
Pregnancy-related items are covered: maternity clothes are not, but items like breast pumps and nursing pads are. Incontinence supplies are covered. Compression stockings prescribed for a medical condition are covered. Canes, braces, and orthotic inserts prescribed by a doctor are covered.
Dental and vision expenses
Dental visits, cleanings, X-rays, fillings, root canals, crowns, bridges, and extractions are all covered. Orthodontia (braces) is covered. Dentures and dental implants are covered. Teeth whitening is not covered because it is cosmetic, but whitening prescribed by a dentist to treat tooth discoloration from medication may be covered — ask your plan.
Vision expenses include eye exams, glasses, contact lenses, and contact lens solution. LASIK and other refractive surgery is covered. Sunglasses are not covered, even if you have a prescription for them, because they are considered general eyewear rather than treatment.
What is not covered, even if it seems medical
Cosmetic procedures are never covered: Botox, facelifts, teeth whitening for appearance, hair removal, or any surgery done purely for looks. General wellness products are not covered: vitamins, supplements, protein powder, and herbal remedies do not count unless prescribed by a doctor for a specific deficiency or condition. Gym memberships and fitness classes are not covered, even if recommended for health.
Sunscreen is not covered. Toothpaste and mouthwash are not covered. Deodorant is not covered. Shampoo and conditioner are not covered. Toilet paper, tissues, and paper towels are not covered. Weight loss programs and diet plans are not covered unless prescribed by a doctor as treatment for obesity or a related condition. Marijuana and CBD products are not covered under federal law, even in states where they are legal.
How to know if something is covered before you buy it
Check your plan's summary of benefits or call your FSA administrator before you spend the money. Many administrators have online tools or phone lines where you can ask about a specific item. Write down the product name and what it treats, and ask whether it qualifies.
Keep your receipt and any documentation — a prescription, doctor's note, or the product packaging showing what condition it treats. If your claim is denied, you can appeal with proof that it was medically necessary. Some items are borderline (like certain topical creams or medical-grade skincare), and different plans rule differently.
Frequently Asked Questions
Can I use my FSA card to buy over-the-counter cold medicine?
Only if you have a prescription or written note from your doctor saying you need it. The pharmacy may ask for this at checkout. If you do not have documentation, the FSA card will likely be declined. You can still buy the medicine with regular money and then submit a claim with your receipt and doctor's note.
Are vitamins and supplements covered?
No, unless a doctor prescribes them to treat a specific deficiency or medical condition and you have that prescription in writing. A general multivitamin is not covered. Vitamin D prescribed for low levels, or iron prescribed for anemia, would be covered if you have the prescription.
What happens to money I do not spend by the end of the year?
You forfeit it — FSA money does not roll over. Some plans offer a grace period (usually 2.5 months into the next year) or allow you to carry over a small amount (often $570). Check your plan documents to see if either applies to you. This is why many people contribute conservatively to their FSA.
Can I use my FSA for my pet's medical care?
No. FSA covers only human medical expenses. Veterinary care, pet medications, and pet supplies are not covered under any circumstances.
Is mental health counseling covered?
Yes. Therapy, counseling, and psychiatric visits are covered medical expenses. You can use your FSA to pay for copays, coinsurance, or the full cost if you see an out-of-network provider.