What Can I Spend My FSA On? Medical, Dental, and Vision

You can use a health care FSA on almost any expense that diagnoses, treats, or prevents a medical condition: doctor and specialist visits, co-pays and deductibles, prescriptions, most over-the-counter medications, dental and vision care, and a long list of medical equipment and supplies. For 2026, the IRS lets you contribute up to $3,400 in pre-tax pay to a health care FSA.¹ The controlling rule is simple: the purchase has to address a specific medical need, not general health or personal grooming.

Medical Care and Services

The IRS defines an eligible medical expense as any amount you pay to diagnose, treat, or prevent a disease or to address a physical or mental condition.² In practice, that covers office visits, specialist appointments, hospital stays, lab work, X-rays, MRIs, and surgical procedures. Co-pays, coinsurance, and amounts applied to your deductible are all reimbursable.³

Therapies that treat a diagnosed condition qualify too. Physical therapy, chiropractic care, acupuncture, and psychiatric or psychological counseling are all eligible.⁴ The common thread is medical purpose: the service must treat or prevent a health problem, not simply promote general well-being.

Prescriptions and Over-the-Counter Products

Prescription drugs are fully eligible. Over-the-counter medications are too — a change that came with the CARES Act, which removed the earlier requirement to get a doctor’s prescription for OTC drugs. Pain relievers, antihistamines, cold and flu remedies, and antacids can all go on your FSA card without a prescription.⁵

Menstrual care products were added to the eligible list by the same law. Tampons, pads, liners, and menstrual cups are all reimbursable without additional documentation.⁵ First-aid supplies have long qualified: bandages, gauze, antiseptic wipes, and digital thermometers. Sunscreen is eligible when labeled both “broad spectrum” and SPF 15 or higher.⁶

Dental Care

Routine dental work is fully reimbursable: cleanings, fillings, extractions, X-rays, and sealants. Orthodontic treatment like braces and clear aligners also qualifies when it corrects structural issues with your teeth or jaw.⁴ For orthodontic work that stretches across plan years, you can usually submit each payment as it’s billed rather than waiting for treatment to end.

Vision Care

Eye exams, prescription eyeglasses (frames and lenses), contact lenses, and contact lens solution are all FSA-eligible. Corrective procedures like LASIK qualify because they treat a vision defect rather than serving a cosmetic purpose.⁴ Because LASIK often runs several thousand dollars per eye, some people plan the procedure for a year when they’ve maxed out their FSA contribution.

Medical Equipment and Supplies

Durable medical equipment and supplies used to treat a specific condition or disability are eligible. Common reimbursable items include:

Hearing aids, replacement batteries, and repair costs.⁴
Mobility aids such as crutches, walkers, and wheelchairs, along with the cost of operating and maintaining them.
Diagnostic devices like blood pressure monitors, blood sugar testing kits, and pulse oximeters used to manage a medical condition.⁴

Some items require a Letter of Medical Necessity, a note from your doctor explaining that the product treats a diagnosed condition. Orthopedic shoes, specialized support braces, and medical recliners commonly trigger this requirement.⁷ Keep those letters on file. Your FSA administrator may ask for documentation when reviewing claims.

Travel to Medical Appointments

Transportation costs to and from medical appointments are reimbursable, including bus fare, rideshare charges, parking, and tolls. If you drive your own car, you can claim the IRS standard medical mileage rate of 20.5 cents per mile for 2026.⁸ Lodging during out-of-town treatment may also qualify, though it is capped and must be primarily for medical care rather than personal travel.

What You Can’t Spend FSA Money On

The IRS draws a firm line between treating a medical condition and maintaining general health or appearance. Expenses on the wrong side aren’t reimbursable, no matter how health-related they look.

Cosmetic procedures such as teeth whitening, face lifts, hair transplants, and liposuction are excluded unless they correct a deformity from a congenital abnormality, an accident, or a disfiguring disease.²
Toiletries and personal care items like toothpaste, shampoo, and deodorant.
Gym memberships and health club dues. A separate fee for a specific weight-loss program prescribed by a physician for a diagnosed condition like obesity may qualify, but the membership itself does not.⁴
Vitamins and supplements, unless a medical practitioner recommends them as treatment for a specific diagnosed condition.⁹
Health insurance premiums.³

For gray-area purchases like a massage or a special mattress, the deciding factor is whether you have a documented medical need. A Letter of Medical Necessity from your doctor explaining that the item treats a specific condition can sometimes convert an otherwise ineligible purchase into a qualified one.

Spending Deadlines and Carryover

Health care FSAs follow a “use it or lose it” rule. Money left in your account when the plan year ends is forfeited unless your employer offers one of two safety valves, and a plan can offer one but not both.

A grace period of up to 2½ months after the plan year ends, during which qualified expenses can be paid from the prior year’s remaining balance.¹⁰
A carryover of up to $680 of unused 2026 funds into 2027. Anything above $680 that you haven’t spent is lost.¹

Not every employer offers either option, so check your plan documents. If your plan has neither, every dollar you contribute must be spent by the last day of the plan year.

Two Related Accounts That Have Different Rules

A dependent care FSA is a separate account governed by a different part of the tax code, and it doesn’t cover medical expenses at all.¹¹ It pays for daycare, preschool, summer day camp, adult day care, and in-home caregivers when the care lets you work or look for work.¹² The 2026 contribution limit is $7,500, or $3,750 if you’re married and file separately.

If you contribute to a Health Savings Account through a high-deductible health plan, a traditional health care FSA is off the table: having one disqualifies you from making HSA contributions. A limited-purpose FSA solves this. It restricts eligible expenses to dental and vision costs only, so it doesn’t overlap with HSA coverage, and you can contribute to both in the same year.¹⁰ Ask your employer whether a limited-purpose option is offered if you want tax-advantaged savings on both sides.

1
Internal Revenue Service. IRS Releases Tax Inflation Adjustments for Tax Year 2026
2
Office of the Law Revision Counsel. 26 USC 213 – Medical, Dental, Etc., Expenses
3
HealthCare.gov. Using a Flexible Spending Account (FSA)
4
Internal Revenue Service. Publication 502 – Medical and Dental Expenses
5
Internal Revenue Service. IRS Outlines Changes to Health Care Spending Available Under CARES Act
6
FSAFEDS. Eligible Health Care FSA (HC FSA) Expenses
7
FSAFEDS. Eligible Health Care FSA (HC FSA) Expenses
8
Internal Revenue Service. 2026 Standard Mileage Rates (Notice 2026-10)
9
Internal Revenue Service. Frequently Asked Questions About Medical Expenses Related to Nutrition, Wellness, and General Health
10
Internal Revenue Service. Publication 969 – Health Savings Accounts and Other Tax-Favored Health Plans
11
Office of the Law Revision Counsel. 26 USC 129 – Dependent Care Assistance Programs
12
Internal Revenue Service. Child and Dependent Care Credit Information