FSA funds cover medical expenses your health insurance doesn't pay for
Your Flexible Spending Account (FSA) holds pre-tax dollars you set aside to pay for out-of-pocket medical costs. You can use that money to buy things your insurance plan requires you to pay for yourself — copays, deductibles, coinsurance — plus certain medical supplies and services that insurance often doesn't cover at all.
The IRS maintains a specific list of what counts as an FSA-may be able to access expense. If an item is on that list and you have a medical reason to buy it, you can use your FSA card or reimburse yourself from your account. The catch is that many everyday health products look medical but aren't on the list, so it pays to know the difference before you swipe.
Key Takeaways
- FSA money covers copays, deductibles, and coinsurance you owe to your health plan, plus prescription medications and certain medical devices.
- Over-the-counter medicines like pain relievers and cold medicine require a prescription from your doctor to be FSA-may be able to access, even though you can buy them without one at the pharmacy.
- Items like vitamins, cosmetics, and general wellness products are not FSA-may be able to access, even if they support your health.
- Dental work, vision care, and mental health services are FSA-may be able to access when you pay out of pocket, including copays and deductibles for those services.
- Your FSA plan document or your employer's benefits website lists which specific items your plan covers, since some employers restrict the list further.
Prescription medications and over-the-counter drugs with a prescription
Any prescription medication your doctor writes is FSA-may be able to access. That includes pills, inhalers, injections, and creams — as long as a licensed pharmacist fills the prescription.
Over-the-counter drugs like ibuprofen, acetaminophen, antihistamines, and cough syrup are also FSA-may be able to access, but only if your doctor writes a prescription for them first. You can still buy them without a prescription at the pharmacy, but to use FSA funds you need that written prescription on file. Some people ask their doctor to write a prescription for OTC items they use regularly, then buy the generic version at the store and pay with their FSA card.
Insulin is FSA-may be able to access without a prescription because it is classified as a drug, not a device. Other diabetes supplies like test strips and lancets are also covered.
Medical devices and supplies you use at home
FSA funds cover medical equipment your doctor says you need. That includes blood pressure monitors, thermometers, glucose meters, pulse oximeters, and similar diagnostic devices. Bandages, gauze, medical tape, and first-aid supplies are FSA-may be able to access. So are crutches, braces, compression sleeves, and other supports.
Hearing aids and batteries for hearing aids are FSA-may be able to access. Eyeglasses and contact lenses are covered, along with solution and cases. Orthopedic shoes are may be able to access if a doctor prescribes them for a specific condition, though regular shoes are not.
Items like heating pads, ice packs, and TENS units (electrical stimulation devices) are FSA-may be able to access when used to treat a medical condition. Humidifiers and air purifiers are not, because they are considered general wellness rather than treatment for a specific diagnosis.
Dental and vision care you pay out of pocket
If you have a separate dental plan through your employer or buy dental coverage on your own, you can use FSA funds to cover your share of the cost. That includes copays for cleanings and checkups, coinsurance for fillings and root canals, and any dental work your plan doesn't cover.
The same applies to vision care. FSA funds cover copays for eye exams, the cost of glasses or contacts if your plan doesn't cover them, and any vision correction procedure you pay for yourself, such as LASIK.
Cosmetic dental work — like teeth whitening or veneers done purely for appearance — is not FSA-may be able to access. Dental work that restores function or treats disease is covered.
Mental health and therapy services
Copays and coinsurance for therapy, counseling, and psychiatric visits are FSA-may be able to access. If your health plan covers mental health services but requires you to pay a portion, your FSA can cover your share.
If you see a therapist outside your insurance network and pay the full cost yourself, that expense is also FSA-may be able to access, as long as the therapist is a licensed mental health professional.
Items that look medical but are not FSA-may be able to access
Vitamins and supplements are not FSA-may be able to access, even prescription-strength ones, because they are classified as nutritional rather than medicinal. The exception is if your doctor writes a prescription for a specific supplement to treat a diagnosed deficiency — then it may be covered, but this is rare and depends on your plan.
Sunscreen, toothpaste, and mouthwash are not FSA-may be able to access because they are considered personal care or prevention rather than treatment. Deodorant, shampoo, and soap are also not covered. Feminine hygiene products like pads and tampons are not FSA-may be able to access under current IRS rules.
Weight loss programs, gym memberships, and diet supplements are not covered. Cosmetics and skincare products are not FSA-may be able to access, even medicated acne treatments, because they are classified as cosmetic.
Massage therapy is not FSA-may be able to access unless a doctor prescribes it as treatment for a specific medical condition and refers you to a licensed massage therapist. General wellness massage is not covered.
How to know what your specific plan covers
Your employer's FSA plan document or benefits website should list which items are covered under your account. Some employers restrict the IRS list further — for example, some plans do not cover over-the-counter items at all, even with a prescription.
Your FSA card issuer (the company that manages your account) also publishes a list of may be able to access items. You can usually search by product name on their website or call their customer service line to ask whether a specific item is covered before you buy it.
If you are unsure whether something is may be able to access, ask your benefits administrator or the FSA plan's customer service team. Buying something that turns out to be ineligible means you have to pay for it out of pocket, so it is worth checking first.
Frequently Asked Questions
Can I use my FSA to buy vitamins and supplements?
No, vitamins and supplements are not FSA-may be able to access because they are classified as nutritional products, not medications. The only exception is if your doctor writes a prescription for a supplement to treat a specific diagnosed deficiency, which is uncommon. Check your plan document to confirm.
Do I need a receipt to use my FSA card at the pharmacy?
Most FSA card issuers do not require a receipt at the pharmacy because the pharmacy system flags FSA-may be able to access items automatically. However, you should keep receipts for your records. If you are reimbursing yourself from your FSA, you will need to submit the receipt as proof of the expense.
Can I use FSA funds for my family members' medical expenses?
Yes, you can use your FSA to pay for medical expenses of your spouse and dependents, as long as they are claimed on your tax return. This includes their copays, prescriptions, dental work, and other may be able to access medical costs.
What happens if I buy something with my FSA card and it turns out to be ineligible?
Your FSA card issuer may decline the transaction at the point of sale if the item is flagged as ineligible. If the charge goes through and is later determined to be ineligible, you may be asked to reimburse your FSA account. Keep receipts so you can dispute charges if needed.
Are over-the-counter pain relievers FSA-may be able to access without a prescription?
No. Over-the-counter pain relievers like ibuprofen and acetaminophen require a prescription from your doctor to be FSA-may be able to access, even though you can buy them without one at the pharmacy. Ask your doctor to write a prescription if you use them regularly.