FSA funds cover medical and dental expenses your insurance doesn't fully pay for, plus some over-the-counter items
Your Flexible Spending Account (FSA) money can pay for prescription medications, doctor visits, dental work, vision care, and certain over-the-counter products. The IRS maintains a detailed list of what counts as a may have access to medical expense. The key rule: the expense must be for diagnosis, treatment, or prevention of a medical condition — not for general health or cosmetic reasons.
You can use FSA funds to cover your deductible, copays, and coinsurance. You can also use them for services your health insurance doesn't cover at all, like some dental procedures or vision correction. The money comes out of your paycheck before taxes, which means you pay less in federal income tax on the amount you set aside.
What you cannot use FSA funds for matters just as much. Cosmetic procedures, gym memberships, vitamins (unless prescribed by a doctor), and most over-the-counter medications were off-limits for years. That changed in 2020 — now you can use FSA money for over-the-counter medications without a prescription, but only if you have a doctor's note saying you need them for a specific condition.
Key Takeaways
- FSA funds cover copays, deductibles, coinsurance, and medical services your insurance doesn't pay for, including prescription drugs, dental work, and vision care.
- Over-the-counter medications and medical supplies (like bandages, glucose monitors, or pain relievers) now may have access to, but you need a doctor's note for the medication to count.
- Cosmetic procedures, gym memberships, vitamins without a prescription, and general wellness products do not may have access to, even if they improve your health.
- You must spend FSA money on yourself, your spouse, or your dependents — you cannot use it for anyone else's medical expenses.
- Unused FSA money does not roll over to the next year; most plans have a grace period of up to 2.5 months or let you carry forward up to $570 (the amount changes yearly).
Medical and dental expenses that may have access to
Doctor visits, lab tests, X-rays, and hospital stays all may have access to. So do prescription medications, insulin, and inhalers. Dental work including cleanings, fillings, root canals, and orthodontia counts. Vision expenses like eye exams, glasses, contact lenses, and laser eye surgery are covered.
Mental health treatment, including therapy and psychiatric medications, qualifies. Physical therapy, chiropractic care, and acupuncture count if a doctor prescribes them. Hearing aids and hearing tests are covered. Medical equipment like crutches, wheelchairs, blood pressure monitors, and glucose meters all may have access to.
You can also use FSA funds to pay for medical transportation to treatment, certain home modifications for medical reasons (like a ramp for someone in a wheelchair), and nursing care. Fertility treatments, including in vitro fertilization and related medications, are covered expenses.
Over-the-counter items you can now buy with FSA funds
Since 2020, you can use FSA money for over-the-counter medications without a prescription — but only if you have written documentation from your doctor stating you need the medication for a specific condition. This means you can buy over-the-counter pain relievers, allergy medications, cold medicines, antacids, and anti-diarrheal products if your doctor has noted that you need them.
Over-the-counter medical supplies do not require a doctor's note. You can buy bandages, gauze, first-aid kits, thermometers, blood pressure cuffs, glucose monitors and test strips, heating pads, ice packs, and crutches. Sunscreen counts as a medical expense only if a dermatologist prescribes it for a skin condition.
Menstrual products (pads and tampons) became FSA-may be able to access in 2021 and do not require a doctor's note. Incontinence products and adult diapers may have access to. Pregnancy tests and fertility-related over-the-counter products are covered.
What does not may have access to for FSA funds
Cosmetic procedures — including teeth whitening, Botox, hair removal, and plastic surgery — do not may have access to unless they are medically necessary (for example, reconstructive surgery after an accident). General wellness products like vitamins, supplements, and herbal remedies do not may have access to unless a doctor prescribes them for a specific medical condition and documents that in writing.
Gym memberships, fitness classes, and sports equipment do not may have access to, even if they improve your health. Cosmetic dental work like veneers or teeth whitening is not covered. Hair loss treatments and wigs do not may have access to unless prescribed by a doctor for a medical condition like alopecia.
Toiletries and personal care items — toothpaste, deodorant, shampoo, soap — do not may have access to. Weight loss programs and diet supplements do not may have access to unless a doctor prescribes them for a medical condition. Travel for medical reasons (like flights to a treatment center) does not may have access to, though local medical transportation does.
How to know if something qualifies before you buy it
Your FSA plan administrator or your employer's benefits office can tell you whether a specific item qualifies. Many FSA debit cards are set up to flag questionable purchases at checkout, which means the transaction may be declined if the item does not clearly may have access to. If that happens, you can usually pay out of pocket and then submit a receipt to your FSA plan for reimbursement — the plan will review it and tell you whether it qualifies.
The IRS publishes a searchable database of may have access to medical expenses on its website. You can also check your plan's summary of benefits, which lists what your specific plan covers. Keep in mind that some employers offer more generous FSA plans that cover items beyond the IRS minimum — ask your benefits office what your plan includes.
When you buy something and are unsure, keep the receipt. If your FSA plan denies reimbursement, you can appeal the decision or pay for the item out of pocket and move on. Do not assume something qualifies just because it is sold in a pharmacy or health store.
Using FSA funds for family members
You can use your FSA money to pay for medical expenses for yourself, your spouse, and your dependents — including adult children if you claim them on your tax return. You cannot use FSA funds for anyone else's medical expenses, even if you pay for their care.
Your dependents must be claimed on your tax return for their expenses to may have access to. If your adult child is no longer your dependent, you cannot use your FSA to pay for their medical care. The same rule applies to parents or other relatives, even if you support them financially.
What happens to unused FSA money
FSA money does not roll over to the next year. Whatever you do not spend by the end of the plan year is forfeited — this is called the "use-it-or-lose-it" rule. However, your employer can offer one of two options to soften this rule: a grace period of up to 2.5 months into the next year to spend remaining funds, or the ability to carry forward up to $570 (this amount is adjusted yearly by the IRS) to the next plan year.
Your employer chooses which option to offer, if any. Check your plan documents to see what applies to you. If your plan offers neither option and you have money left over, you lose it — which is why many people set aside only what they know they will spend in a year.
Frequently Asked Questions
Can I use FSA funds to pay for my spouse's medical expenses?
Yes. You can use your FSA to pay for medical expenses for yourself, your spouse, and anyone you claim as a dependent on your tax return. Your spouse does not need to be on your health insurance plan — they just need to be your legal spouse.
Do I need a receipt to use my FSA debit card?
When you use an FSA debit card at a pharmacy or doctor's office, the transaction usually goes through without a receipt requirement. However, your plan administrator may ask you to provide a receipt later to verify the purchase was for a may have access to expense. Keep receipts for at least three years in case you are asked to prove the expense was legitimate.
Can I use FSA funds for prescription glasses or contacts?
Yes. Vision expenses including eye exams, glasses, contact lenses, and contact lens solution all may have access to. Laser eye surgery (LASIK) also qualifies. You can use your FSA debit card at an optometrist or eyeglasses retailer, or you can pay out of pocket and submit a receipt for reimbursement.
What if I buy something and later find out it doesn't may have access to?
If you use your FSA debit card and the purchase is denied, you will know immediately. If you pay out of pocket and submit a receipt that is denied, you cannot get reimbursed — the money stays in your FSA account. You can appeal the denial if you believe the item should may have access to, but the plan administrator has the final say.
Can I use FSA funds for my pet's medical care?
No. FSA funds can only be used for medical expenses for you, your spouse, and your dependents. Veterinary care does not may have access to, even if your pet is a service animal. However, if you have a service animal, the cost of training or equipment specifically for the animal's medical function may may have access to — check with your plan administrator.