What FSA money covers
A Flexible Spending Account (FSA) lets you set aside pre-tax money for medical costs, but not every health expense qualifies. The IRS maintains a specific list of what counts. Common items include copays, deductibles, prescription medications, glasses, contact lenses, dental work, and hearing aids. Less obvious ones include crutches, bandages, thermometers, and over-the-counter pain relievers — but only if you have a prescription or doctor's note for the over-the-counter item.
What does not may have access to is just as important to know. Cosmetic procedures, gym memberships, vitamins without a medical reason, toothpaste, and most skincare products are off-limits. Health insurance premiums themselves do not may have access to, though copays and deductibles do. The line between medical and non-medical can be blurry — sunscreen qualifies only if prescribed for a skin condition, not for general sun protection.
Your employer's FSA plan document may be stricter than the IRS rules allow. Some plans exclude certain items the IRS permits. Check your plan's summary of benefits or call your plan administrator before you spend, because you cannot get reimbursed for something your specific plan does not cover, even if the IRS would allow it.
Key Takeaways
- FSA money covers copays, deductibles, prescriptions, glasses, dental work, and medical equipment like crutches and hearing aids.
- Over-the-counter medications and supplies need a doctor's prescription or note to count as FSA-may be able to access expenses.
- Cosmetic procedures, gym memberships, vitamins, and general wellness items do not may have access to, even if they relate to health.
- Your employer's FSA plan may have stricter rules than the IRS allows, so check your plan documents before spending.
- You must use FSA money by the end of the plan year or lose it — there is no rollover to the next year.
Medical equipment and supplies that count
Medical equipment qualifies broadly. Crutches, wheelchairs, walkers, blood pressure monitors, glucose meters, and nebulizers all count. Orthopedic braces, compression stockings, and heating pads may have access to if prescribed by a doctor. Bandages, gauze, antiseptic wipes, and first-aid supplies count as long as they are used for medical treatment, not general household use.
Diagnostic devices are covered: thermometers, pulse oximeters, pregnancy tests, and ovulation kits all may have access to. Mobility aids like canes and grab bars count. The key is that the item must be primarily medical in purpose — a regular pillow does not may have access to, but a cervical pillow prescribed for neck pain does.
Prescription and over-the-counter medications
Prescription medications always may have access to, regardless of what they treat. Over-the-counter drugs — pain relievers, cold medicine, allergy tablets, antacids, laxatives — require a prescription or a doctor's written note to be FSA-may be able to access. The note does not have to be a formal prescription; a letter from your doctor stating you need the medication counts.
Insulin is an exception: it qualifies without a prescription. Vitamins and supplements do not may have access to unless prescribed by a doctor for a specific medical condition. A multivitamin for general health does not count; a vitamin D supplement prescribed because your blood work showed deficiency does.
Vision and hearing care
Glasses, contact lenses, and contact lens solution all may have access to. Eye exams and laser vision correction (LASIK) are covered. Hearing aids and hearing aid batteries may have access to, as do hearing tests. Replacement parts for hearing aids count as well.
Sunglasses do not may have access to as a general purchase, but prescription sunglasses do. The distinction is medical necessity — if the item is prescribed or medically necessary, it counts.
Dental and orthodontic work
Dental cleanings, fillings, root canals, extractions, and crowns all may have access to. Orthodontic work — braces, retainers, and aligners — counts. Dental X-rays and exams are covered. Teeth whitening does not may have access to because it is considered cosmetic, even if done by a dentist.
Dentures and dental implants may have access to. Replacement parts and repairs to dentures count as well. Fluoride treatments prescribed by a dentist may have access to, but over-the-counter fluoride rinse does not unless prescribed for a specific condition.
Mental health and therapy services
Copays and deductibles for therapy, counseling, and psychiatric care may have access to. Psychologist and psychiatrist visits count. Substance abuse treatment programs are covered. The cost of therapy itself — whether in-person or telehealth — qualifies as long as it is provided by a licensed mental health professional.
Self-help books and apps do not may have access to, even if they address mental health. The service must be provided by a licensed professional for the cost to count.
What does not may have access to, even if health-related
Cosmetic procedures — including Botox, dermal fillers, hair removal, and teeth whitening — do not may have access to. Gym memberships and fitness classes do not count, even if prescribed by a doctor for weight loss or heart health. General wellness items like vitamins, supplements, and herbal remedies do not may have access to unless prescribed for a diagnosed deficiency or condition.
Toiletries and personal care items do not may have access to: toothpaste, mouthwash, shampoo, deodorant, and soap are not FSA-may be able to access. Maternity clothes do not count. Travel costs to receive medical care do not may have access to. Cosmetic dentistry like veneers or bonding for appearance does not count, though bonding to repair a broken tooth does.
Health insurance premiums themselves are not FSA-may be able to access, though you can use FSA money to pay copays and deductibles on that insurance. COBRA premiums do not may have access to either.
How to know if something qualifies
The IRS publishes a full list of may have access to medical expenses in Publication 502. Your FSA plan administrator can also answer specific questions — most have a phone line or online portal where you can ask before you buy. Keep receipts and documentation showing what you purchased and why, because if you are audited, you may need to prove the expense was medical.
When in doubt, ask your plan administrator rather than your pharmacist or retailer. Retailers often do not know FSA rules and may tell you something qualifies when it does not. Your plan administrator has the final say on what your specific plan covers.
Frequently Asked Questions
Can I use FSA money for my spouse or children?
Yes. FSA money can cover medical expenses for you, your spouse, and any dependent you claim on your taxes, regardless of whether they are on your insurance plan. You do not need to be the one receiving the care to use FSA funds for it.
Do I need a receipt to prove I spent FSA money on a may have access to expense?
Your FSA plan may ask for receipts or documentation, especially if audited. Keep receipts for at least three to five years. Some plans use debit cards that do not require receipts for certain items, but it is safer to keep them anyway.
What happens if I buy something with my FSA debit card and it turns out not to may have access to?
Your plan administrator may ask you to repay the amount, or the card issuer may deny the transaction. If money was already spent, contact your plan administrator to report the error. Some plans allow you to correct mistakes without penalty if you report them promptly.
Can I use FSA money for preventive care like vaccines or annual checkups?
Yes. Preventive care visits, vaccines, and screenings all may have access to as medical expenses. Copays for annual physicals and preventive services count toward your FSA spending.
Does FSA cover medical equipment I buy online?
Yes, as long as the item qualifies and you have documentation of the purchase. Buy from reputable retailers and keep your receipt showing what you bought. Some FSA debit cards work online; others require you to submit a claim form with a receipt.