FSA money covers medical and dental costs that your health insurance doesn't pay for

A Flexible Spending Account (FSA) holds pre-tax dollars you set aside to pay for out-of-pocket medical, dental, and vision expenses. You can use the money for copays, deductibles, prescription drugs, and dozens of other health-related purchases. The IRS maintains a specific list of what counts as an may be able to access expense, and if you buy something that's not on that list, you'll owe taxes on it plus a penalty.

The key rule: the expense must be for medical care, and you must have already incurred it or be paying for it now. You cannot use FSA money to buy something you might need in the future, and you cannot use it for cosmetic procedures or general wellness products that aren't treating a diagnosed condition.

Key Takeaways

  • FSA money covers copays, deductibles, prescription drugs, and medical equipment like crutches or blood pressure monitors.
  • Dental and vision expenses count, including cleanings, fillings, glasses, and contact lenses, even if your insurance doesn't cover them.
  • Over-the-counter medicines like pain relievers and allergy medication are may be able to access, but only if you have a prescription or doctor's note.
  • Gym memberships, vitamins, and cosmetic procedures do not count, even if they improve your health or appearance.
  • You must keep receipts and documentation because your FSA plan may ask you to prove the expense was medical.

Prescription medications and over-the-counter drugs

Prescription medications are always may be able to access. This includes birth control, insulin, asthma inhalers, antibiotics, and any other drug your doctor prescribes. You pay with your FSA debit card at the pharmacy, or you submit a receipt for reimbursement if you paid out of pocket.

Over-the-counter drugs are may be able to access only if you have a prescription or a written note from your doctor. This means you can use FSA money for ibuprofen, allergy pills, or cold medicine, but only if your doctor has documented that you need it for a specific condition. Without that documentation, the purchase is not may be able to access. The pharmacy can usually process this at the register if your doctor's note is on file, or you can submit the receipt and note to your FSA plan for reimbursement.

Copays, deductibles, and coinsurance

Any amount you owe out of pocket because of your health insurance plan is may be able to access. This includes the copay when you visit your doctor, the deductible you pay before insurance kicks in, and the coinsurance (your percentage of the bill after insurance pays its share). FSA money covers all of these.

If your insurance requires you to pay $50 to see a specialist, or $1,500 toward your deductible before coverage begins, you can use FSA funds for those amounts. This is one of the most common uses of an FSA, because these costs add up quickly and FSA money lets you pay them with pre-tax dollars instead of after-tax income.

Dental and vision care

Dental expenses are may be able to access whether your employer's dental plan covers them or not. You can use FSA money for cleanings, fillings, root canals, crowns, braces, and tooth extractions. Orthodontia for children and adults counts. If your dental insurance has a waiting period or annual maximum, FSA money can cover the gap.

Vision care is also may be able to access. This includes eye exams, glasses, contact lenses, and contact lens solution. If you need a new prescription and your insurance doesn't cover the full cost of frames, you can use FSA money for the difference. Laser eye surgery (LASIK) is may be able to access too. Sunglasses are not may be able to access, even if they have a prescription, because they are considered cosmetic.

Medical equipment and supplies

Medical equipment and supplies that treat a diagnosed condition are may be able to access. This includes blood pressure monitors, glucose meters, thermometers, crutches, wheelchairs, hearing aids, and orthopedic braces. Bandages, gauze, and first-aid supplies count. Pregnancy tests and ovulation kits are may be able to access. Elastic bandages for a sprained ankle or a heating pad for back pain are may be able to access.

The item must be primarily medical in nature and not something you would use for general wellness. A humidifier for a child with asthma is may be able to access; a humidifier for dry air in winter is not. A foam roller marketed as a recovery tool is not may be able to access, but a foam roller prescribed by a physical therapist for a specific injury may be. When in doubt, check with your FSA plan or keep the receipt so you can document the medical purpose if asked.

Mental health and therapy services

Copays and coinsurance for therapy, counseling, and psychiatric care are may be able to access. If you see a therapist or psychiatrist and your insurance requires you to pay a copay or coinsurance, FSA money covers it. Therapy sessions not covered by insurance are also may be able to access if they are provided by a licensed mental health professional.

Some employers offer Employee information Programs (EAPs) that provide free or low-cost counseling. If you use an EAP and still have out-of-pocket costs, those costs are may be able to access. Meditation apps and self-help books are not may be able to access, because they are not provided by a licensed professional.

What is not may be able to access

Cosmetic procedures are not may be able to access, even if they improve your appearance and confidence. This includes Botox, dermal fillers, teeth whitening for cosmetic reasons, and hair removal. If the same procedure is medically necessary—for example, reconstructive surgery after an injury or removal of a mole that could be cancerous—it may be may be able to access, but you will need documentation from your doctor.

General wellness products and gym memberships are not may be able to access. Vitamins and supplements are not may be able to access unless prescribed by a doctor for a specific deficiency. Weight loss programs and diet plans are not may be able to access. Toothpaste and toothbrushes are not may be able to access, even though they are dental products, because they are considered general hygiene rather than treatment. Sunscreen is not may be able to access. Condoms are not may be able to access. Marijuana, even in states where it is legal, is not may be able to access under federal FSA rules.

How to pay and get reimbursed

Most FSA plans issue a debit card that you can use at pharmacies, doctors' offices, and other medical providers. When you swipe the card, the amount is deducted from your FSA balance. Some providers may ask you to submit a receipt later to verify the expense was may be able to access; this is called a substantiation request, and you should keep all receipts for at least three to five years.

If you don't have an FSA debit card, or if a provider doesn't accept it, you can pay out of pocket and then submit a receipt and claim form to your FSA plan for reimbursement. This takes longer—usually one to two weeks—but you get the money back. Keep the original receipt, not a copy, because some plans require it. If your plan uses an online portal, you can often upload receipts and submit claims there.

Frequently Asked Questions

Can I use FSA money for my spouse or children?

Yes, as long as they are claimed as dependents on your tax return. You can use FSA money for your spouse's medical expenses, your children's medical expenses, and your parents' medical expenses if you claim them as dependents. The expense must still be may be able to access—copays, prescriptions, dental work, and so on.

What happens if I use FSA money for something that's not may be able to access?

You will owe income tax on that amount plus a 20 percent penalty. For example, if you use $100 of FSA money to buy vitamins that aren't prescribed, you owe income tax on $100 plus $20. Your FSA plan may also flag the transaction and ask you to prove it was may be able to access. If you cannot, you will have to repay the money.

Can I use FSA money for pet medical care?

No. FSA money is for human medical care only. Veterinary expenses, even for a service animal, are not may be able to access under the IRS rules for FSAs. Service animals may have other tax deductions available, but not through an FSA.

Do I need a receipt to use my FSA debit card?

Not always at the point of purchase, but you should keep receipts anyway. Some merchants and providers automatically send may be able to access information to your FSA plan, so the transaction is approved without you submitting anything. Others may ask you to submit a receipt later to confirm the expense was may be able to access. Keeping receipts protects you if there is a question.

Can I use FSA money for travel to a medical appointment?

Mileage to and from a doctor's appointment is may be able to access if you itemize deductions on your tax return, but FSA money cannot be used for it directly. Parking and tolls at a medical facility are may be able to access. Airfare or hotel for travel to a medical appointment is not may be able to access under FSA rules.