What Can You Buy With Your Flex Spending Card?

You can use a flex spending card to pay for hundreds of medical, dental, vision, and mental health expenses, plus a long list of over-the-counter health products that used to require a prescription. The card draws from your Flexible Spending Account, which your employer funds through pre-tax payroll deductions of up to $3,400 for 2026.¹ The IRS defines eligible “medical care” broadly as anything that diagnoses, treats, or prevents disease, or affects a structure or function of the body.² What follows is what that definition actually buys you at the register.

Doctor Visits, Copays, and Medical Services

The most common use of the card is at the front desk of a doctor’s office. Copays, coinsurance, and your deductible are all eligible. Your health insurance premium is not.³

Beyond office visits, the card pays for lab work such as blood panels, diagnostic imaging like X-rays and MRIs, physical therapy prescribed for an injury or chronic condition, and ambulance transportation. The service has to be performed by a licensed provider for a legitimate medical reason.

Prescription and Over-the-Counter Medications

Prescription drugs have always been eligible. The bigger news is over-the-counter. Before 2020, most OTC medications required a doctor’s prescription to be reimbursable. The CARES Act permanently eliminated that requirement, so pain relievers, allergy medication, cold and flu remedies, antacids, and similar drugs can now go straight from the shelf to your card.⁴

The same law added menstrual care products. Tampons, pads, liners, and cups all qualify.⁴ Smoking cessation programs are eligible, and nicotine gum and patches are now covered as OTC medications.⁵

First-aid supplies like bandages and antiseptics count, along with diagnostic tools such as thermometers and pulse oximeters. Many retailers now flag “FSA-eligible” items on the shelf, which speeds up verification at checkout. Sunscreen with an SPF of 15 or higher is widely accepted by FSA administrators as a preventive product, though the IRS has not published specific SPF guidance in Publication 502.

Vision and Dental Care

Eye care is one of the easiest ways to spend down a balance. Prescription eyeglasses, contact lenses, saline solution, and enzyme cleaner are all eligible. Nonprescription reading glasses qualify too. LASIK and similar procedures to correct defective vision are covered.⁵

Dental coverage includes both preventive and restorative work: cleanings, fluoride treatments, sealants, fillings, extractions, dentures, and orthodontic devices such as braces. The rule of thumb is function and health, not appearance. Teeth whitening is explicitly excluded.⁵

Mental Health Care

Therapy and psychiatric care are fully eligible, and many cardholders don’t realize it. You can pay for visits to a psychiatrist, psychologist, or licensed therapist. Psychoanalysis qualifies as long as it’s treatment and not part of your own training to become an analyst.⁵

Prescription medications for mental health conditions have always been covered. OTC sleep aids sold as drugs or medicines are now purchasable with the card as well, though general wellness supplements are not.

Family Health and Chronic Condition Supplies

Breast pumps and lactation supplies qualify as medical equipment for nursing mothers. The pump, tubing, shields, and storage bags all count. Extra bottles used only for food storage do not.⁵

For chronic condition management, home diagnostic devices are broadly eligible. The IRS specifically names blood sugar test kits, and the same logic covers blood pressure monitors and similar equipment. Hearing aids, including batteries and repairs, also qualify.⁵

Medical Travel and Lodging

Getting to and from medical care is itself an eligible expense, and it’s one of the most overlooked categories. Bus, taxi, train, and plane fare all qualify when the trip is primarily for medical care. If you drive, you can claim actual gas and oil costs or the IRS standard medical mileage rate, which for 2026 is 20.5 cents per mile. Parking fees and tolls count either way.⁶⁵

If you need to stay overnight near a treatment facility, lodging (not at a hospital) is eligible up to $50 per night per person. A parent traveling with a sick child can claim up to $100 per night total for both.⁵

What You Cannot Buy

The boundaries trip people up more than the eligible list does. The main categories the IRS excludes:

Cosmetic procedures. Surgery or treatments that improve appearance without treating a disease or correcting a deformity from an injury, congenital condition, or disfiguring disease. Face lifts, hair transplants, and liposuction are common examples.
Teeth whitening, classified as cosmetic rather than restorative.
Personal hygiene products such as toothpaste, toothbrushes, deodorant, and shaving supplies.
Gym memberships and health club dues. The narrow exception is a specific treatment program a physician prescribes for a diagnosed condition, and even then only the program fee qualifies, not the membership itself.
Vitamins and supplements, unless a medical practitioner recommends them to treat a specific diagnosed condition.
Health insurance premiums.

⁵

When in doubt, ask whether the expense treats or prevents a specific medical condition. If the honest answer is that it just makes you feel better generally, it probably doesn’t qualify.

How the Card Verifies Purchases

Most flex spending cards run through an Inventory Information Approval System at participating retailers. When you swipe, the system checks each item in your cart against a database of eligible products and approves only the qualifying portion. You can buy FSA-eligible bandages and a candy bar in the same transaction, and the card only draws from your FSA for the bandages.⁷

Not every purchase auto-verifies. Your plan administrator may request additional documentation for items that straddle the line between medical and personal use. A Letter of Medical Necessity from your doctor is the typical requirement for things like massage therapy, weight-loss programs, or supplements being used to treat a diagnosed condition. That letter usually has to be renewed annually.

Keep every itemized receipt. The receipt should show the date of service, a description of the product or service, the provider’s name, and the amount you paid after insurance. A credit card statement or canceled check alone is not enough. If you can’t substantiate a transaction when asked, the charge can be reversed and the amount may be treated as taxable income.

Spend It Before You Lose It

FSAs are use-it-or-lose-it accounts. Any balance left at the end of your plan year is forfeited unless your employer offers one of two softeners, and they can’t offer both:⁷

A grace period of up to 2½ extra months after the plan year ends. For a plan year ending December 31, that runs to March 15.
A carryover of up to $680 into the next plan year. Anything above $680 is still forfeited.

Not every employer offers either. If yours offers neither, every dollar you don’t spend by the plan year’s end is gone. Check your plan documents before the calendar closes in on you, and use the eligible categories above (vision hardware, OTC medications, dental cleanings, travel mileage) to draw down a balance you’d otherwise lose.

1
Internal Revenue Service. Revenue Procedure 2025-32
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. IRS Outlines Changes to Health Care Spending Available Under CARES Act
5
Internal Revenue Service. Publication 502 (2025), Medical and Dental Expenses
6
Internal Revenue Service. IRS Sets 2026 Business Standard Mileage Rate at 72.5 Cents Per Mile, Up 2.5 Cents
7
Internal Revenue Service. Publication 969 (2025), Health Savings Accounts and Other Tax-Favored Health Plans