A Flexible Spending Account lets you set aside pre-tax money from your paycheck to cover a wide range of medical, dental, vision, and care expenses. The maximum contribution for a health care FSA is $3,300 for 2025 and $3,400 for 2026. Since most plans operate on a use-it-or-lose-it basis, knowing exactly what qualifies helps you get the full value of every dollar you contribute.
Everyday Medical Costs
The most straightforward FSA expenses are the ones you’re already paying out of pocket at the doctor’s office: copays, coinsurance, and deductibles. Any cost tied to diagnosing, treating, or preventing a physical or mental health condition qualifies. That includes visits to physicians, surgeons, dentists, psychiatrists, and other licensed practitioners, plus the equipment and supplies they recommend.
Prescription medications and insulin are eligible, and so are clinical treatments like acupuncture, physical therapy, psychiatric care, and surgery. If you pay premiums for medical, dental, or surgical insurance outside of your employer plan, those can count too, though the rules vary by plan.
Over-the-Counter Products
Since the CARES Act took effect in March 2020, you no longer need a prescription to use FSA funds on common drugstore items. Pain relievers like acetaminophen and aspirin, cold and flu medicine, allergy medications, and first aid supplies all qualify. Menstrual care products, including tampons, pads, and cups, are also eligible regardless of whether a doctor recommends them.
A few daily-use items surprise people. Sunscreen qualifies as long as it’s broad-spectrum with SPF 30 or higher. The same goes for lip balm with SPF 30+. Acne treatments, bandages, thermometers, and blood pressure monitors are all fair game. If you’re stocking up at the pharmacy, it’s worth checking your FSA administrator’s online store, which typically flags eligible items automatically.
Vision Expenses
FSA funds cover the full range of routine and corrective vision care. Eye exams, prescription eyeglasses, prescription sunglasses, contact lenses, and contact lens solution all qualify. LASIK surgery is one of the higher-ticket items people commonly use their FSA for, and it’s fully eligible. If you’ve been putting off an eye procedure or a new pair of glasses, your FSA is one of the best ways to reduce the real cost.
Dental Expenses
Dental work adds up fast, and nearly all of it qualifies. Cleanings, X-rays, fillings, crowns, bridges, dentures, dental sealants, and orthodontia (including braces) are all eligible expenses. Copays and deductibles for dental visits count too. The key restriction is that the work can’t be purely cosmetic. Teeth whitening, for example, won’t qualify, but virtually everything your dentist does for the health of your teeth will.
Items That Don’t Qualify
The IRS draws a firm line between treating a medical condition and improving general health. Expenses that are “merely beneficial to general health” are not eligible, which rules out several things people commonly assume they can use FSA dollars for.
- Gym memberships: Only eligible if purchased for the sole purpose of treating a specific diagnosed condition like obesity, hypertension, or heart disease. A general fitness membership does not qualify, even with a doctor’s recommendation.
- Vitamins and supplements: Only eligible when a medical practitioner recommends them as treatment for a specific diagnosed condition. A daily multivitamin for overall wellness is not covered.
- Weight-loss programs: Qualify only when they treat a physician-diagnosed disease such as obesity or diabetes. Programs pursued for general weight management do not.
- Exercise classes: Swimming lessons, dance classes, and similar activities for general fitness are not medical expenses, even if a doctor suggests them.
- Cosmetic procedures: Teeth whitening, elective cosmetic surgery, and similar procedures don’t qualify unless they address a medical condition or disfigurement.
- Special foods: Only eligible if the food doesn’t satisfy normal nutritional needs, treats an illness, and a physician substantiates the need. Even then, the eligible amount is limited to the cost above what ordinary food would cost.
The Letter of Medical Necessity
Some expenses fall into a gray area. Your FSA administrator may categorize them as “maybe eligible,” meaning they’ll reimburse the cost only if your doctor provides a Letter of Medical Necessity. This is a short form where a licensed practitioner identifies your medical condition, confirms the product or service is medically necessary for that condition, and states that it’s not for general health or cosmetic purposes. For chronic conditions like multiple sclerosis, the practitioner can indicate “lifetime” as the duration of treatment, so you won’t need to resubmit every year.
This letter is what turns otherwise ineligible items into covered ones. A gym membership, nutritional supplements, or a weight-loss program can all become FSA-eligible with proper documentation tying them to a diagnosed condition.
Dependent Care FSA
A Dependent Care FSA is a separate account from your health care FSA, and it covers a completely different category of expenses: child and adult care services that allow you to work. If you have kids under 13 or a dependent adult who needs supervision, this account can save you a significant amount in taxes.
Eligible expenses include daycare, babysitting (both in your home and someone else’s, as long as it’s work-related), before and after school programs, day camps during the summer, and custodial elder care. Babysitting by a relative qualifies as long as that relative isn’t your tax dependent. Overnight camps, however, are generally not eligible. The key test is always whether the care enables you to go to work.
Limited Purpose FSA for HSA Holders
If you have a high-deductible health plan with a Health Savings Account, you can’t also have a standard health care FSA. But you can open a Limited Purpose FSA, which covers only dental and vision expenses. This lets you pay for cleanings, fillings, orthodontia, eye exams, glasses, contacts, and LASIK with pre-tax dollars while keeping your HSA intact for broader medical costs or long-term savings. The IRS estimates this combination saves an average of 30 percent on eligible dental and vision expenses.
Getting the Most From Your FSA
The biggest mistake people make with an FSA is underestimating their expenses and then scrambling to spend the balance at year’s end, or overestimating and forfeiting money they didn’t use. Start by adding up what you spent on copays, prescriptions, glasses, dental work, and OTC medications over the past year. Factor in anything you’ve been putting off, like new glasses or a dental procedure, and use that total to set your contribution.
Keep receipts for everything. Your FSA administrator may ask you to substantiate claims with itemized receipts showing the date, provider, and amount. For items purchased at a drugstore, the receipt should identify the specific product. Many administrators now offer debit cards linked to your FSA that auto-verify eligible purchases at the point of sale, which cuts down on paperwork considerably.
Some employer plans offer a grace period of up to two and a half months after the plan year ends, and others allow a limited rollover of unused funds into the next year. Check your specific plan documents, because these features vary by employer and can give you a meaningful cushion if your spending doesn’t line up perfectly with your estimate.