What You Can Buy With Your FSA: The Complete List of Eligible Purchases

FSA funds cover medical expenses your insurance doesn't fully pay for

A Flexible Spending Account (FSA) lets you spend pre-tax dollars on out-of-pocket medical, dental, and vision costs. The IRS publishes a specific list of what counts as an may be able to access medical expense, and it is longer than most people expect. You can use FSA money for copays, deductibles, prescription medications, and dozens of over-the-counter items — but not for everything that feels medical.

The key rule: the expense must be for diagnosis, treatment, or prevention of a disease or condition, and it cannot be something your insurance already covers in full. If your plan pays 100 percent of a service, you cannot use FSA funds for it. If you pay out of pocket because you have not met your deductible, or because your plan does not cover it, FSA money can cover that gap.

Key Takeaways

• Prescription medications, copays, and deductibles are always FSA-may be able to access, whether or not your insurance covers them.
• Over-the-counter items like pain relievers, allergy medicine, and antacids are FSA-may be able to access only if you have a prescription or doctor's note.
• Dental work, vision care, and hearing aids are FSA-may be able to access even when insurance does not cover them.
• Cosmetic procedures, vitamins without a medical reason, and gym memberships are never FSA-may be able to access, even if a doctor recommends them.
• You must keep receipts and documentation showing the expense was medically necessary; your FSA administrator may ask for proof before reimbursing you.

Prescription medications and insulin supplies

Any prescription medication is FSA-may be able to access, regardless of what it treats. This includes birth control pills, antidepressants, blood pressure medication, and inhalers. You pay for the prescription at the pharmacy and submit the receipt to your FSA plan for reimbursement, or you use your FSA debit card directly at checkout.

Insulin and other diabetes supplies — test strips, lancets, syringes, and glucose monitors — are FSA-may be able to access. You do not need a separate prescription for supplies in most states; the original insulin prescription covers the related items. Keep the receipt showing what you bought and the date.

Over-the-counter medications and first aid

Over-the-counter drugs are FSA-may be able to access only if you have a prescription or a written statement from your doctor saying the item is medically necessary. This rule changed in 2020 and catches many people off guard. You cannot simply buy ibuprofen, allergy tablets, or cough syrup with FSA funds without documentation, even though these are common medical expenses.

If your doctor writes "Patient needs acetaminophen for chronic pain" or "Allergy medication recommended for seasonal allergies," you can then use FSA funds for those items. First aid supplies like bandages, gauze, and antiseptic ointment do not require a prescription and are FSA-may be able to access on their own. Thermometers, heating pads, and ice packs also count.

Dental and vision care

Dental work is FSA-may be able to access whether your insurance covers it or not. This includes cleanings, fillings, root canals, crowns, extractions, and orthodontia. If you are paying out of pocket for braces or Invisalign, FSA funds can cover that cost. Dental X-rays, fluoride treatments, and teeth whitening performed by a dentist are also may be able to access.

Vision expenses include eye exams, glasses, contact lenses, and contact lens solution. Laser eye surgery (LASIK) is FSA-may be able to access. Hearing aids and the cost of fitting them are FSA-may be able to access as well. These categories often represent significant out-of-pocket costs, so many people use FSA funds strategically for annual eye exams or replacing glasses.

Medical equipment and supplies you use at home

Medical equipment prescribed by a doctor is FSA-may be able to access. This includes blood pressure monitors, pulse oximeters, nebulizers, and CPAP machines. Crutches, wheelchairs, walkers, and braces are may be able to access. Compression stockings, back braces, and knee supports prescribed for a medical condition are covered.

Bandages, wound dressings, and medical tape are may be able to access. Incontinence supplies are FSA-may be able to access. Pregnancy test kits and ovulation predictor kits are may be able to access. If a doctor has recommended the item for a specific medical reason, keep that recommendation with your receipt.

Mental health and substance abuse treatment

Therapy and counseling sessions are FSA-may be able to access, whether you see a therapist, psychologist, or psychiatrist. Copays for mental health visits count. Inpatient and outpatient treatment for substance abuse is FSA-may be able to access. Psychiatric medications are may be able to access as prescriptions.

Some employers' FSA plans also cover meditation apps or stress-reduction programs if they are prescribed by a healthcare provider for a diagnosed condition. Check your plan documents or call your FSA administrator to confirm whether specific mental health services or apps are covered under your plan.

What is not FSA-may be able to access

Cosmetic procedures are never FSA-may be able to access, even if a doctor performs them. This includes Botox, dermal fillers, hair removal, and teeth whitening for cosmetic reasons (though teeth whitening by a dentist for medical reasons may be covered — ask your plan). Gym memberships and fitness classes are not may be able to access, even if recommended for weight loss or heart health.

Vitamins and supplements are not FSA-may be able to access unless prescribed by a doctor for a specific deficiency or medical condition. Sunscreen is not may be able to access. Toothpaste and toothbrushes are not may be able to access, though dental work itself is. Maternity clothes, diapers, and baby formula are not may be able to access. Travel to receive medical treatment is not may be able to access, even if the treatment itself is.

How to document and submit FSA expenses

Keep every receipt showing the date, the item or service, the cost, and the provider's name. Your FSA administrator may request documentation before reimbursing you, especially for over-the-counter items or equipment. If you use your FSA debit card at a pharmacy or doctor's office, the transaction is usually pre-approved and documented automatically.

If you pay out of pocket and submit a receipt later, include a note explaining the medical reason if it is not obvious from the receipt. For example, if you bought a back brace, write "Prescribed by Dr. Smith for lower back pain, 3/15/2024." Keep copies of any prescriptions or doctor's notes that support the expense. Most FSA plans give you a window of 60 to 90 days after the end of the plan year to submit receipts for expenses you incurred during that year.

Frequently Asked Questions

Can I use FSA money for my spouse's or child's medical expenses?

Yes. FSA funds can cover medical expenses for you, your spouse, and any dependent you claim on your tax return, regardless of whether they are covered under your FSA plan. Keep receipts showing the dependent's name and the date of service.

Is a prescription required for all over-the-counter medications?

Yes, as of 2020. Over-the-counter drugs require a prescription or a written statement from your doctor saying the item is medically necessary. First aid supplies like bandages and antiseptic do not require a prescription. If you are unsure, ask your doctor to write a brief note.

Can I use FSA funds for preventive care like annual checkups?

Yes. Preventive care visits, screenings, and vaccinations are FSA-may be able to access. Many insurance plans cover preventive care at 100 percent, so you would not have an out-of-pocket cost to reimburse. But if you do pay something out of pocket, FSA funds can cover it.

What happens if I buy something and later find out it is not FSA-may be able to access?

You will not be reimbursed. If you submit a receipt for an ineligible item, your FSA administrator will deny the claim and explain why. You can then pay for that expense with after-tax dollars. This is why it is worth checking your plan documents or calling your administrator before buying expensive items like supplements or equipment.

Can I use FSA funds for pet medical expenses?

No. Veterinary care and pet medications are not FSA-may be able to access, even if the pet is a service animal. Service animal training and equipment may have different rules depending on your plan — contact your administrator if you have a service animal.