A flexible spending account (FSA) covers a surprisingly wide range of medical, dental, vision, and even over-the-counter expenses. The IRS defines eligible expenses as anything used for the diagnosis, cure, treatment, or prevention of disease, or anything that affects a structure or function of the body. That broad definition means your FSA works for far more than just doctor visits and prescriptions.
For 2025, you can contribute up to $3,300 to a health care FSA. Any money you don’t spend could be lost, so knowing what qualifies helps you get the full value of your account.
Doctor Visits, Hospital Care, and Lab Work
The most straightforward FSA expenses are the ones you’d expect: copays, coinsurance, and deductibles for doctor and specialist visits. Annual physicals, lab fees, X-rays, body scans, diagnostic tests, and hospital services all qualify. So do ambulance rides, operations, transplants, and nursing services.
Mental health care is fully eligible too. That includes psychiatrists, psychologists, psychoanalysis, and therapy. Treatment for drug addiction and alcoholism also qualifies.
Prescriptions and Over-the-Counter Products
All prescribed medications are FSA-eligible. But since a 2020 change in federal law, you no longer need a prescription for most over-the-counter medicines either. Allergy medication, cold medicine, pain relievers, antacids, acne treatments, and anti-diarrheal drugs all qualify without a doctor’s note.
Beyond medicines, OTC products that treat or prevent a medical condition are also covered. That includes bandages, first aid supplies, sunscreen, and contact lens solution. Menstrual care products like tampons and pads became permanently eligible under the same 2020 law. Pregnancy test kits and condoms qualify as well.
Vision Expenses
Your FSA covers eye exams, prescription eyeglasses, prescription sunglasses, contact lenses, and contact lens solution. Eye surgery to correct vision, such as LASIK, is eligible. Reading glasses purchased over the counter also qualify as long as they serve a corrective purpose.
Dental Expenses
Dental cleanings, fillings, crowns, bridges, dentures, dental sealants, and orthodontia (including braces) are all eligible. Your FSA can also cover dental copays, coinsurance, and deductibles. The key restriction is that the work cannot be purely cosmetic, so teeth whitening doesn’t count, but virtually all restorative and preventive dental care does.
Home Medical Devices and Supplies
A range of medical equipment you can buy and use at home qualifies for FSA reimbursement. Blood pressure monitors, thermometers, pulse oximeters, and body composition scales are all eligible. So are at-home diagnostic tools like UTI test strips and COVID/flu home tests.
Larger medical equipment and supplies are covered too: wheelchairs, crutches, hearing aids, artificial limbs, breast pumps and supplies, and oxygen equipment. If you need car modifications to accommodate a disability, those costs qualify. Guide dogs and other service animals, including their food and veterinary care, are eligible expenses.
Alternative and Specialty Therapies
Acupuncture and chiropractic care are straightforwardly eligible with just a receipt. Massage therapy requires a bit more documentation: you’ll need a letter of medical necessity signed by your doctor explaining that the massage treats a specific condition. The same applies to massage devices like percussion guns.
Other qualifying services include osteopathic care, fertility treatments, stop-smoking programs, and weight-loss programs when prescribed for a specific disease like diabetes or heart disease. Special education for children with learning disabilities qualifies, as do fees for medical conferences related to a chronic condition you or a dependent has.
What Your FSA Cannot Cover
The general rule is that cosmetic procedures don’t qualify. Teeth whitening, elective cosmetic surgery, and hair transplants for appearance purposes are out. General health supplements and vitamins typically don’t qualify unless a doctor prescribes them for a specific medical condition. Gym memberships and general fitness expenses aren’t eligible either, even if exercise improves your health.
Toiletries like toothpaste, shampoo, and basic skincare products that aren’t treating a medical condition are excluded. Health insurance premiums generally can’t be paid with FSA funds (your employer already handles premiums with pre-tax payroll deductions in most cases).
Dependent Care FSA: A Separate Account
If your employer offers a dependent care FSA, it’s a completely different account with different rules. This one covers childcare and elder care expenses that allow you and your spouse to work. Eligible costs include daycare, before- and after-school programs, day camps, babysitting (both in your home and someone else’s), and adult day care for elderly dependents. The babysitter can even be a relative, as long as that person isn’t your tax dependent.
Overnight camps don’t qualify, and neither does tutoring or school tuition. The dependent care FSA is strictly use-it-or-lose-it: unspent funds at the end of the plan year are forfeited entirely.
Deadlines and Carryover Rules
Health care FSA funds generally must be spent within the plan year, but your employer may offer one of two safety nets. Some plans include a grace period of up to 2.5 extra months to use remaining funds. Others allow a carryover, which for 2025 maxes out at $660 rolled into the next year. Your employer can offer one option or the other, but not both, and some offer neither.
Check your plan documents or ask your HR department which rule applies to you. If your plan has no grace period and no carryover, any unspent balance disappears when the plan year ends. That’s why many people schedule dental cleanings, eye exams, or stock up on eligible OTC products toward the end of the year to avoid leaving money on the table.