What you can buy with FSA funds
Your FSA money can pay for medical, dental, and vision costs that your health insurance does not cover or that you have to pay out of pocket before you meet your deductible. The IRS maintains a list of what counts as a may have access to medical expense, and it is longer than most people expect — it includes things like copays, deductibles, prescription drugs, glasses, dental work, hearing aids, and even some over-the-counter items if a doctor writes a prescription for them.
The key rule is that the expense must be for you, your spouse, or a dependent you claim on your tax return. You cannot use FSA funds to pay for a friend's medical bills or for cosmetic procedures like teeth whitening or Botox. If you are unsure whether something counts, your FSA plan administrator can tell you yes or no before you spend the money.
Common expenses that work include prescription eyeglasses, dental fillings, orthodontia, copays at the doctor's office, insulin and other prescription medications, and even items like crutches or a blood pressure monitor. Over-the-counter pain relievers, allergy medicine, and cold medicine now count too — you just need to keep the receipt showing you bought them.
Key Takeaways
- FSA funds cover copays, deductibles, prescription drugs, glasses, dental work, and many over-the-counter medical items if you have a receipt or prescription.
- You must use the money only for yourself, your spouse, or dependents on your tax return — not for anyone else's medical costs.
- Your FSA plan administrator can confirm whether a specific expense counts before you pay for it, which saves you from buying something you cannot reimburse.
- You can pay out of pocket and then ask your FSA plan to reimburse you, or you can use an FSA debit card at the point of sale if your plan offers one.
- Unused money at the end of the plan year is forfeited unless your employer offers a grace period or a carryover option.
How to pay for medical expenses with your FSA card
If your FSA plan issued you a debit card, you can swipe it at pharmacies, doctor's offices, and other medical providers just like a regular payment card. The card draws directly from your FSA balance. This is the fastest way to use your money because you do not have to wait for reimbursement.
Some merchants — especially large pharmacy chains and medical suppliers — will accept the FSA card without asking for proof that the expense is may have access to. Others will ask you to sign a form confirming that you are buying a may have access to item. If the card is declined, it usually means either your balance is too low or the merchant's system does not recognize the item as medical.
Keep your receipt even when you use the card. Your FSA plan may ask you later to prove that the purchase was a may have access to expense, and the receipt is your proof. If you cannot provide it, the plan can ask you to repay the money to your FSA account.
How to get reimbursed if you paid out of pocket
You do not have to use an FSA card. You can pay for a medical expense with your own money — a credit card, check, or cash — and then submit a reimbursement request to your FSA plan administrator. The administrator will review your receipt, confirm the expense is may have access to, and send you a check or deposit the money into your bank account.
To request reimbursement, log into your FSA plan's website or mobile app, or call the plan administrator's customer service number. You will need to provide the date of the expense, the amount, the provider's name, and what the money was for. Upload a photo or scan of your receipt — most plans require this as proof.
Reimbursement usually takes one to two weeks from the time you submit the request. Some plans are faster. If you are waiting for money and need it sooner, check whether your plan allows you to request expedited processing, though this is not common.
What happens if you do not use all your FSA money
FSA accounts operate under a use-it-or-lose-it rule: money you do not spend by the end of your plan year is forfeited. You cannot roll unused funds into the next year, and you cannot get a refund. This is why it is important to estimate carefully at the start of the year how much you will actually spend.
Some employers offer a grace period — usually two and a half months after the plan year ends — during which you can still use the previous year's leftover money. Other employers offer a carryover option that lets you roll up to a certain amount (often $570, though this changes yearly) into the next plan year. Check your plan documents or ask your benefits administrator whether your plan has either of these.
If your plan has neither a grace period nor a carryover, and you have money left over, you have lost it. This is why many people choose to contribute a conservative amount — enough to cover expenses they are certain about, like regular prescriptions or annual dental cleanings — rather than guessing high and risking forfeiture.
Expenses that do not count as FSA-may have access to
Some medical costs look like they should count but do not. Health insurance premiums themselves are not may have access to expenses, though you can use FSA money to pay for certain types of coverage through a separate account called a Limited FSA or an HRA. Gym memberships and general wellness programs do not count, even if your doctor recommends exercise. Cosmetic procedures like teeth whitening, hair removal, or plastic surgery do not count unless they are medically necessary — for example, reconstructive surgery after an accident.
Vitamins and supplements do not count unless a doctor prescribes them for a specific medical condition. Long-term care insurance premiums do not count. Maternity clothes do not count. If you are unsure, ask your plan administrator before you spend the money — they have a detailed list and can give you a definitive answer for your specific situation.
Keeping records and receipts
The IRS requires that you keep receipts for all FSA expenses in case you are audited. Your FSA plan administrator may also ask you to provide proof of purchase if the expense seems unusual or if the plan is audited. A receipt should show the date, the amount, the provider's name, and what was purchased.
If you use an FSA debit card, the transaction will appear on your account statement, but that alone is not enough proof — you still need the itemized receipt from the merchant showing what you bought. If you lose a receipt, contact the provider and ask them to send you a copy. Keep receipts in a folder or take photos and store them in a cloud folder for at least three to five years.
Some FSA plans offer a mobile app where you can photograph and upload receipts as you go. This makes it easier to stay organized and reduces the chance you will lose proof of a purchase.
Frequently Asked Questions
Can I use my FSA card to buy over-the-counter medicine without a prescription?
Yes, as of 2020 you can use FSA funds for over-the-counter pain relievers, allergy medicine, cold medicine, and similar items without a doctor's prescription. You do need to keep your receipt. Some FSA debit cards will decline the purchase at the register if the merchant's system does not recognize it as medical, in which case you can pay out of pocket and request reimbursement instead.
What if I change jobs — can I take my FSA balance with me?
No. FSA accounts are tied to your employer's plan, and you cannot transfer the balance to a new job. When you leave, you have until the end of your employer's plan year to use any remaining balance, or until the grace period ends if your plan has one. After that, the money is forfeited. This is another reason to be conservative with how much you contribute.
Can I use FSA money to pay for my spouse's medical expenses?
Yes, if your spouse is on your tax return as a dependent or as your spouse. You can use your FSA to pay for their copays, prescriptions, dental work, and other may have access to medical expenses. The same rule applies to children and other dependents you claim.
Do I need to submit receipts every time I use my FSA card?
Not at the time of purchase. But your FSA plan may ask you to submit receipts later to verify that the expenses were may have access to. If you cannot provide them, the plan can ask you to repay the money. It is safest to keep all receipts for at least three to five years.
Can I use my FSA to pay for dental implants or braces?
Yes. Dental work including implants, crowns, fillings, root canals, and orthodontia like braces all count as may have access to FSA expenses. You will need a receipt from your dentist showing the date and cost. If the work is expensive, spread the cost across multiple years by planning your FSA contributions accordingly.