Yes, you can use your FSA for dependents, but the rules depend on which FSA you have. A Health Care FSA reimburses medical, dental, and vision costs for anyone who qualifies as your tax dependent under Internal Revenue Code Section 152. A Dependent Care FSA reimburses the cost of caring for a child under 13 or a disabled family member so that you (and your spouse) can work. The two accounts use different definitions of “dependent,” and paying for someone who doesn’t qualify means you owe tax on the amount.
Who Qualifies Under a Health Care FSA
Your Health Care FSA can pay for medical expenses of anyone who meets the IRS definition of your dependent under Section 152. There are two ways someone gets there.
A qualifying child is under 19 at the end of the calendar year, or under 24 if a full-time student. The child must live in your home for more than half the year and cannot have provided more than half of their own financial support. Temporary absences for school, military service, medical care, or vacation don’t break the residency requirement.1Office of the Law Revision Counsel. 26 USC 152 – Dependent Defined
A qualifying relative is someone whose support you cover by more than half during the year, whose gross income is below the IRS threshold ($5,200 for 2025, adjusted annually), and who is either a close relative or a member of your household. Parents, grandparents, and siblings don’t have to live with you to count.2Internal Revenue Service. Publication 501 (2025), Dependents, Standard Deduction, and Filing Information This is the path that typically covers an aging parent or a disabled adult sibling.
One point that catches people: the person doesn’t have to be claimed on your tax return in a given year to qualify for Health Care FSA reimbursement. What matters is that they meet the Section 152 tests. That means an adult child under 24 who is a full-time student, or a parent whose income falls below the threshold and whose bills you mostly cover, is fair game even if you don’t take the exemption.
Who Qualifies Under a Dependent Care FSA
The Dependent Care FSA definition is narrower and structured around a different purpose: paying for care that makes it possible for you to work.
Children qualify only while they are under age 13 when the care is provided. The day your child turns 13, further care costs stop being eligible unless the child is physically or mentally incapable of self-care. If the birthday falls partway through the year, only expenses incurred before it can be claimed.3Internal Revenue Service. Publication 503 (2025), Child and Dependent Care Expenses
Adults qualify only if they are physically or mentally unable to care for themselves and live with you for more than half the year. A disabled spouse counts. So does an elderly parent who needs supervision during your working hours, provided they share your home.
There is also a work requirement that trips up families every year. The care must be necessary for you, and your spouse if you are married, to work or actively look for work. If one spouse is home and not working, not job-hunting, not a full-time student, and not disabled, the expense generally does not qualify. A non-working spouse who is a full-time student or unable to care for themselves is treated as having earned income of $250 a month for one qualifying dependent, or $500 a month for two or more.3Internal Revenue Service. Publication 503 (2025), Child and Dependent Care Expenses
Divorced or Separated Parents
The two accounts diverge sharply when parents live apart.
For a Dependent Care FSA, only the custodial parent can use the account for the child’s care. The IRS defines the custodial parent as whichever parent the child lived with for the greater number of nights during the year. If the count is a tie, the parent with the higher adjusted gross income is treated as custodial.3Internal Revenue Service. Publication 503 (2025), Child and Dependent Care Expenses The noncustodial parent cannot use a DCFSA for that child, even if a custody agreement lets them claim the child as a tax dependent. The tax-dependent designation does not control here.
For a Health Care FSA, the rule is friendlier. Either parent who is entitled to claim the child as a tax dependent under Section 152 can reimburse the child’s medical costs from their own Health Care FSA, regardless of who has physical custody.
What Each Account Will Pay For
Once you know your family member qualifies, the next question is which of their expenses the account covers.
Health Care FSA Expenses
The IRS defines eligible medical expenses broadly: costs that diagnose, treat, prevent, or alleviate a physical or mental condition.4Internal Revenue Service. Publication 502 (2025), Medical and Dental Expenses For a dependent, that commonly includes:
- Doctor visits and hospital care, including copays, deductibles, lab work, and specialist consultations
- Prescription medications, including insulin
- Dental care such as cleanings, fillings, extractions, and orthodontia
- Eye exams, prescription glasses, contact lenses, and hearing aids5Internal Revenue Service. IRS: Eligible Employees Can Use Tax-Free Dollars for Medical Expenses
- Over-the-counter items like bandages, thermometers, sunscreen, and first-aid supplies
Some items are only eligible with a Letter of Medical Necessity from the dependent’s doctor, explaining why the item is needed for a specific condition. Massage therapy, special mattresses, and nutritional supplements typically fall in this category. Purely cosmetic procedures, general-health items, vitamins, and gym memberships are out unless a physician certifies medical necessity.
Dependent Care FSA Expenses
Because the account is tied to enabling work, eligible costs are those that provide care rather than education or enrichment:
- Licensed daycare centers, including enrollment fees and tuition
- Preschool and pre-kindergarten, where supervision is the primary purpose
- Before-school and after-school care for children in kindergarten and above
- Summer day camps, provided they run during your working hours3Internal Revenue Service. Publication 503 (2025), Child and Dependent Care Expenses
- In-home care such as a nanny or babysitter; if a housekeeper also watches the child, only the care portion of their time counts
Overnight camps are excluded regardless of how much supervision they provide. Kindergarten tuition and up counts as education, not care. And you cannot pay a spouse, your own tax dependent, or your child under age 19 as the provider and claim their wages.3Internal Revenue Service. Publication 503 (2025), Child and Dependent Care Expenses
Where the DCFSA Meets the Child and Dependent Care Tax Credit
Many families qualify for both the Dependent Care FSA and the Child and Dependent Care Tax Credit, but the same dollar of expense cannot go through both. Every dollar reimbursed by your DCFSA reduces the expense pool available for the credit, dollar for dollar.3Internal Revenue Service. Publication 503 (2025), Child and Dependent Care Expenses
The credit’s expense cap is $3,000 for one qualifying dependent or $6,000 for two or more. If you put $5,000 through a DCFSA and have one child, you’ve already exceeded the $3,000 cap and no credit is available. With two children, you could still claim up to $1,000 of additional expenses against the credit. Which benefit saves more depends on your tax bracket, your credit percentage, and your total care costs. Running both scenarios before open enrollment is worth the time.
How to Submit a Claim for a Dependent
Most FSA administrators accept claims through an online portal or app. The documentation is what makes or breaks approval.
For a Health Care FSA claim, the cleanest documentation is the Explanation of Benefits from the insurer showing what you owe after coverage. If insurance wasn’t involved, submit an itemized receipt with the provider’s name, the dependent’s name, the date of service, and the amount charged. Credit card slips and balance-due notices are not enough on their own.
For a Dependent Care FSA claim, you’ll need the care provider’s taxpayer identification number or Social Security number.6Internal Revenue Service. Instructions for Form 2441 (2025) If the provider refuses to give it to you, you can still claim the expense but must show a good-faith effort to obtain the number. Include dates of service, the dependent’s name, and either a signed claim form from the provider or an itemized statement.
Reimbursement usually arrives three to five business days after approval, faster if you set up direct deposit. Keep copies of receipts, EOBs, and provider information for at least three years in case the IRS asks.