A health care FSA covers out-of-pocket costs that diagnose, treat, or prevent a physical or mental condition. FSA eligible expenses include doctor visits and co-pays, prescription drugs, most over-the-counter medications, mental health care, dental work, vision care, and a range of medical supplies. Cosmetic procedures, general wellness products, and insurance premiums are not eligible. The full list is set by IRS rules, and your plan administrator applies those rules when it reviews your claims.
Medical and Healthcare Services
Most professional medical care qualifies when it treats or prevents a condition. That covers office visit co-pays, annual deductibles, diagnostic tests such as X-rays and blood work, hospital stays, outpatient surgery, and preventive care like physical exams and immunizations.1Internal Revenue Service. Publication 502 (2025), Medical and Dental Expenses Mental health care qualifies on the same terms: therapy, psychiatry, and counseling are eligible as long as they treat a diagnosed condition.
Prescription medications are eligible across the board. So are supplies tied to a prescribed treatment, from diabetic testing strips to prescribed medical equipment.
Medical Travel and Lodging
If you have to travel for care, the trip itself can be reimbursed. For 2026, the IRS standard mileage rate for medical travel is 20.5 cents per mile.2Internal Revenue Service. IRS Sets 2026 Business Standard Mileage Rate Bus, taxi, and ambulance fares qualify when the trip is primarily for medical care. Lodging near a treatment facility is eligible up to $50 per night per person, provided the accommodations are not lavish and the trip has no significant personal-vacation component.3Office of the Law Revision Counsel. 26 U.S. Code 213 – Medical, Dental, Etc., Expenses
Over-the-Counter Medications and Menstrual Products
You no longer need a prescription to use FSA funds on over-the-counter medicine. The CARES Act, signed in March 2020, permanently made OTC drugs eligible, so pain relievers, allergy medicine, cold remedies, antacids, and acne treatments can all be paid for with FSA dollars. The same law added menstrual care products — tampons, pads, liners, cups, and sponges — to the eligibility list for the first time.4Internal Revenue Service. IRS Outlines Changes to Health Care Spending Available Under CARES Act
Non-medication health products that treat or alleviate a condition are also eligible: bandages, thermometers, first-aid kits, and contact lens solution are common examples. Vitamins and supplements are a different matter. They count as general wellness by default and do not qualify unless a doctor prescribes them to treat a specific medical condition.5FSAFEDS. What Kind of Over-the-Counter Medicines or Products Are Eligible for Reimbursement Through My HCFSA?
Vision Care
Vision expenses are among the most common FSA uses. Eligible items include eye exams, prescription eyeglasses, prescription contact lenses, and supplies such as saline solution and lens cleaner.1Internal Revenue Service. Publication 502 (2025), Medical and Dental Expenses Laser eye surgery to correct vision problems qualifies as well. Non-prescription sunglasses do not, because without a corrective prescription they are treated as personal items rather than medical devices.
Dental Care
Dental expenses that prevent or treat dental disease are eligible: cleanings, X-rays, fillings, extractions, dentures, and braces all qualify.1Internal Revenue Service. Publication 502 (2025), Medical and Dental Expenses Purely cosmetic dental work, such as teeth whitening or veneers done for appearance, is not eligible.
Orthodontia gets its own handling because treatment usually spans multiple years on a monthly payment plan. You can submit reimbursement claims as each payment is made during the plan year, but you will need a copy of the orthodontia service contract showing the provider’s name, the patient’s name, the total cost, the payment schedule, and the length of treatment.6FSAFEDS. Orthodontia Quick Reference Guide
Expenses That Are Not Eligible
The IRS separates medical treatment from cosmetic enhancement, and that line drives most denials. Cosmetic procedures that improve appearance rather than treat illness, injury, or a functional problem are not reimbursable. Teeth whitening is a familiar example.1Internal Revenue Service. Publication 502 (2025), Medical and Dental Expenses Other common items that do not qualify:
- Vitamins, supplements, and gym memberships taken for overall wellness rather than to treat a diagnosed condition.
- Cosmetic dental work such as veneers done purely for appearance.
- Non-prescription sunglasses.
- Health insurance premiums, which generally cannot be paid with FSA funds.
There is one narrow exception on the cosmetic side. Cosmetic surgery that corrects a deformity caused by a congenital abnormality, an injury from an accident, or a disfiguring disease may qualify.
Documentation You’ll Need for Reimbursement
Whether you swipe an FSA debit card or pay out of pocket and submit a claim, the administrator decides eligibility from your paperwork. Some card transactions at pharmacies and retailers with an inventory verification system are approved automatically at checkout, but you may still be asked to send a receipt afterward if the system cannot confirm the item.
When you file a claim, three documents cover most situations:
- An itemized receipt showing the date of service, the provider’s name, a description of the service or product, and the amount you paid out of pocket.
- An Explanation of Benefits from your insurer, showing what was covered and what you owe. This is commonly required for hospital stays, procedures, and diagnostic tests.
- A Letter of Medical Necessity when an expense is not obviously medical. A mattress prescribed for a back condition or a supplement prescribed for a deficiency needs a letter from your provider explaining how the item treats a diagnosed condition.
Processing times vary. Some administrators turn claims around in one to two business days, while paperless reimbursement routed through an insurance plan may take 10 to 12 business days.7FSAFEDS. How Long Will It Take to Receive Reimbursement? Approved funds usually arrive by direct deposit.
A Note for HSA Holders
If you have a high-deductible health plan paired with a health savings account, IRS rules generally block you from also holding a standard health care FSA. You can pair the HSA with a limited-purpose FSA, but the eligibility list is narrower: only vision and dental expenses qualify. Everything else described above stays with your HSA.
Dependent care FSAs are a separate account with a different eligibility list — day care, preschool, before- and after-school programs, and elder day care for a qualifying dependent — and are not covered by the health care FSA rules on this page.