FSA funds cover medical and dental costs you pay out of your own pocket, but not everything health-related qualifies

A Flexible Spending Account (FSA) lets you use pre-tax dollars to pay for certain medical, dental, and vision expenses. The IRS maintains a specific list of what counts as an may be able to access expense. If an item is on that list, you can use FSA money to pay for it. If it is not, you cannot — even if it seems medical in nature.

The key distinction: FSA money covers costs that treat or prevent a diagnosed condition or maintain your health, but not general wellness products or services. A prescription for glasses qualifies. Sunglasses do not. A dental filling qualifies. Teeth whitening does not. Understanding which category an expense falls into before you spend saves you from paying twice — once with FSA money and again out of pocket when the IRS denies the claim.

Key Takeaways

  • FSA funds cover doctor visits, prescriptions, dental work, vision care, and medical equipment like crutches or blood pressure monitors, but only if they treat or prevent a specific health condition.
  • Over-the-counter medications and supplements now may have access to for FSA reimbursement without a prescription, but only if they are FDA-approved drugs — not vitamins, minerals, or herbal products.
  • Cosmetic procedures, gym memberships, and general wellness products do not may have access to, even if they improve your health or appearance.
  • You can use FSA money to pay deductibles, copays, and coinsurance, but not insurance premiums themselves.
  • The IRS publishes a searchable database of may be able to access expenses, and your FSA plan administrator can confirm whether a specific item qualifies before you buy it.

Doctor visits, prescriptions, and medical tests

FSA money covers the cost of seeing a doctor, dentist, eye doctor, or other licensed healthcare provider. This includes the office visit itself, any tests or procedures done during that visit, and follow-up care. You can use FSA funds to pay the copay, coinsurance, or the full cost if you have not met your deductible yet.

Prescription medications are may be able to access. Over-the-counter medications that are FDA-approved drugs — such as ibuprofen, acetaminophen, antihistamines, and antacids — now may have access to for FSA reimbursement without requiring a prescription. However, vitamins, minerals, herbal supplements, and homeopathic remedies do not may have access to, even if sold at a pharmacy. The distinction is whether the FDA has approved it as a drug to treat a specific condition.

Medical tests and screenings are may be able to access if ordered by a doctor. This includes blood work, imaging (X-rays, MRI, ultrasound), cancer screenings, and diagnostic tests. Preventive care visits and vaccinations also may have access to. If you pay out of pocket for any of these, you can submit the receipt to your FSA plan for reimbursement.

Dental and vision care

Dental work is one of the largest FSA expense categories. Cleanings, fillings, root canals, extractions, crowns, bridges, and orthodontia (braces) all may have access to. You can use FSA money for the full cost or to cover your share after insurance pays. Dental X-rays and exams are may be able to access. Cosmetic dental work — such as teeth whitening or veneers done purely for appearance — does not may have access to unless it is part of reconstructive work after an injury or illness.

Vision care includes eye exams, prescription glasses, contact lenses, and contact lens solution. Sunglasses, even if you need them for a medical condition like photophobia, do not may have access to because they are not prescribed medical devices. Laser eye surgery (LASIK or PRK) qualifies if it corrects a refractive error. The cost of the surgery itself, the pre-surgery evaluation, and post-surgery follow-up are all may be able to access.

Medical equipment and supplies

FSA funds cover durable medical equipment prescribed by a doctor: crutches, wheelchairs, walkers, canes, hearing aids, blood pressure monitors, glucose meters, and similar devices. The equipment must be used to treat or manage a diagnosed condition. A blood pressure monitor for someone with hypertension qualifies. A fitness tracker does not, even if it monitors heart rate.

Medical supplies are may be able to access if they are used to treat a condition: bandages, gauze, compression stockings, diabetic testing strips, lancets, syringes, and incontinence supplies. Menstrual products now may have access to as may be able to access medical supplies under IRS rules. Sunscreen, insect repellent, and general first-aid items do not may have access to because they are preventive or general-use products, not treatment for a diagnosed condition.

What does not may have access to for FSA reimbursement

Cosmetic procedures and products do not may have access to unless they are reconstructive — meaning they repair damage from injury, illness, or surgery. Botox, facelifts, hair removal, and teeth whitening for appearance only are not may be able to access. Reconstructive surgery after a car accident or burn injury is may be able to access.

Gym memberships, fitness classes, and general wellness programs do not may have access to, even if your doctor recommends exercise. Weight loss programs and diet plans do not may have access to unless they are prescribed as treatment for a diagnosed condition like obesity-related diabetes, in which case the plan itself may may have access to but not the food you buy. Massage therapy does not may have access to unless prescribed by a doctor as treatment for a specific medical condition.

Insurance premiums — including health insurance, dental insurance, and vision insurance — cannot be paid with FSA money. However, you can use FSA funds to pay the deductible, copay, and coinsurance amounts after you have paid the premium with other money.

Childcare, long-term care insurance, and over-the-counter products like pain relievers without a medical purpose do not may have access to. Toiletries, even medicated ones like dandruff shampoo, do not may have access to unless prescribed by a doctor for a specific scalp condition.

How to confirm an expense qualifies before you spend

The IRS publishes a searchable database called Publication 502, which lists may be able to access medical expenses. Your FSA plan administrator also maintains a list specific to your plan, because some plans are more restrictive than IRS rules allow. Before you buy something you are unsure about, contact your plan administrator and ask whether that specific item is may be able to access under your plan.

Many FSA debit cards now come with a feature that flags potentially ineligible purchases at checkout. If a purchase is flagged, the card may decline it or require you to submit documentation later. Submitting a receipt and a letter from your doctor explaining why the expense is medically necessary can sometimes overturn a denial, but it is easier to confirm may be able to access first.

Keep all receipts and documentation. If you are reimbursed and the IRS later audits your FSA account, you will need to show proof that the expense was may be able to access and that you actually paid it. A credit card statement alone is not enough — you need the itemized receipt showing what you bought.

Frequently Asked Questions

Can I use FSA money for my spouse or children?

Yes. FSA money can be used for may be able to access expenses for you, your spouse, and any dependent you claim on your tax return. The dependent does not have to be a child — it can be a parent or other relative you support. The expense must still be may be able to access; the person receiving the care just does not have to be you.

Does my FSA cover therapy or mental health counseling?

Yes. Therapy, counseling, and psychiatric care are may be able to access if provided by a licensed mental health professional. You can use FSA money to pay for the session itself or your copay. Prescription psychiatric medications also may have access to. Self-help books and apps do not may have access to, even if they address mental health.

What about over-the-counter pain relievers — do I need a prescription?

No. Over-the-counter pain relievers like ibuprofen and acetaminophen now may have access to for FSA reimbursement without a prescription. However, you must be able to show that you purchased them — a receipt is required. Vitamins and supplements still do not may have access to, even if sold over the counter.

Can I use FSA money for my pet's medical care?

No. Veterinary care and pet medical expenses do not may have access to for FSA reimbursement. FSA funds are limited to medical care for humans. Some employers offer separate pet insurance or pet FSA options, but these are separate from your health FSA.

What happens if I spend FSA money on something that turns out to be ineligible?

If you are reimbursed for an ineligible expense, you may owe taxes on that amount. The IRS can assess penalties and interest if the error is discovered during an audit. If you realize the mistake before submitting for reimbursement, straightforward do not submit the receipt. If you have already been reimbursed, contact your plan administrator to report the error.