FSA money covers a wide range of medical, dental, vision, and everyday health expenses, all purchased with pre-tax dollars. The IRS defines eligible expenses as costs related to the diagnosis, cure, treatment, or prevention of disease, and anything that affects a structure or function of the body. That definition is broader than most people realize, stretching well beyond doctor visits to include items like sunscreen, acne treatments, and menstrual products.
Medical Services and Treatments
The core of FSA spending is medical care. You can use your funds for doctor visits, annual physicals, lab work, hospital services, surgery, and ambulance rides. Mental health care is fully covered, including therapy, psychiatric care, and psychologist visits. Substance abuse treatment for alcohol or drug addiction also qualifies.
Fertility treatments, including in vitro fertilization, are eligible. So are chiropractic care, acupuncture, physical therapy, and nursing services. If your doctor prescribes time at a health institute for a specific condition, those fees can qualify too.
Prescription and Over-the-Counter Medications
All prescription drugs are eligible, along with insulin. Since the CARES Act took effect (retroactive to January 2020), over-the-counter medications no longer require a prescription to be reimbursed through your FSA. That means you can use your funds on pain relievers, allergy medicine, cold and flu remedies, antacids, and sleep aids without getting a note from your doctor.
Menstrual care products, including tampons and pads, are also eligible without a prescription.
Dental Expenses
Dental care is one of the most practical uses for FSA money, especially for costly procedures your insurance only partially covers. Eligible expenses include cleanings, fillings, extractions, X-rays, fluoride treatments, sealants, dentures, and artificial teeth.
Orthodontia deserves special attention because it involves large, often multi-year costs. Braces are FSA-eligible, and you have flexibility in how you pay. You can submit a lump-sum down payment for reimbursement, or set up recurring monthly payments directly to your orthodontist through your FSA. If you paid a lump sum in one plan year but weren’t fully reimbursed, you can claim the remaining amount in the next plan year as long as you re-enroll and treatment is still ongoing. You’ll need documentation like a treatment plan showing the date braces were placed, total charges, and payment schedule.
Vision Expenses
Eye exams, prescription eyeglasses, and contact lenses are all eligible. That includes the supplies that go with contacts: saline solution and enzyme cleaner. Corrective eye surgery such as LASIK qualifies as well, making your FSA a useful way to offset the upfront cost of a procedure that insurance rarely covers.
Medical Equipment and Supplies
Your FSA covers a long list of health-related equipment and supplies. Some of the most commonly purchased items include bandages, blood sugar test kits, blood pressure monitors, pregnancy test kits, breast pumps and supplies, hearing aids (plus batteries and repairs), crutches, and thermometers.
Larger purchases qualify too: wheelchairs, prostheses, artificial limbs, oxygen equipment, and special telephone devices for people with hearing or speech disabilities. Service animals, including their food and veterinary care, are eligible when they assist with a disability. Even wigs purchased on a doctor’s advice for disease-related hair loss count.
Sunscreen, Acne Products, and Skin Care
Broad-spectrum sunscreen with SPF 15 or higher is FSA-eligible, including lotions, moisturizers, and even tinted foundations that meet the SPF threshold. Acne treatments such as facial cleansers, spot treatments, and medicated washes also qualify. You typically don’t need a prescription for these, though some plans may ask for a letter of medical necessity for specific products. It’s worth checking with your benefits administrator if you’re unsure about a particular item.
Home Modifications and Transportation
If you or a family member has a disability, certain home improvements qualify as medical expenses. Entrance ramps, widened doorways, modified bathrooms and kitchens, and other accessibility changes can be reimbursed when their primary purpose is medical care. The eligible amount is generally the cost of the improvement minus any increase in your home’s value.
Transportation to and from medical care is also covered. Bus, taxi, train, and plane fares all qualify when the trip is primarily for treatment. If you drive, you can claim mileage or actual car expenses. Lodging while traveling for medical care is eligible too, subject to daily limits.
Items That Require a Letter of Medical Necessity
Some expenses sit in a gray area: they’re eligible only if a doctor writes a letter of medical necessity explaining why the item is required for a specific medical condition. Common examples include weight-loss programs, vitamins and supplements, special dietary foods, and home modifications like lead paint removal.
Gym memberships and general fitness equipment are not eligible on their own. Even with a letter of medical necessity, reimbursement is not guaranteed since your plan administrator makes the final call. The distinction is straightforward: if something treats or prevents a diagnosed condition, it can qualify. If it’s for general wellness, it won’t.
Spending for Spouse, Kids, and Dependents
Your FSA isn’t limited to your own expenses. You can use it for eligible medical costs incurred by your spouse and any dependents you claim on your tax return. Adult children are covered through age 26, which is especially useful for young adults who may not have robust insurance of their own. All the same categories apply: their prescriptions, dental work, glasses, and doctor visits can all be paid from your account.
What Your FSA Won’t Cover
The IRS draws a firm line at cosmetic procedures. Anything done purely to improve appearance, like teeth whitening, cosmetic surgery, or hair transplants not related to disease, is ineligible. Insurance premiums cannot be paid with FSA funds. General toiletries such as toothpaste, regular moisturizer without SPF, and non-medicated shampoo don’t qualify either.
The simplest test: if the expense isn’t related to treating, diagnosing, or preventing a medical condition, it’s probably not eligible.
Contribution Limits and the Use-It-or-Lose-It Rule
For 2025, you can contribute up to $3,300 to a health care FSA. The biggest risk with an FSA is losing unspent money at the end of the plan year. Most employers offer one of two safety nets: a grace period of up to 2.5 extra months to spend remaining funds, or a carryover option that lets you roll up to $660 into the next year. Your plan will offer one or the other, not both, so check which one applies to you.
Planning your contribution carefully matters. Look at last year’s medical spending, factor in any known upcoming costs like braces or new glasses, and estimate conservatively. It’s better to slightly underfund your FSA and pay a small amount out of pocket than to forfeit hundreds of dollars at year’s end.