You can pay for a broad range of medical costs with a healthcare FSA: doctor and dentist visits, prescriptions, most over-the-counter medications, eyeglasses and contacts, medical equipment, therapy, and even mileage to appointments. The IRS defines eligible expenses under Internal Revenue Code Section 213(d) as anything that diagnoses, treats, or prevents disease, or affects the structure or function of your body.1Office of the Law Revision Counsel. 26 USC 213 – Medical, Dental, Etc., Expenses That definition is wide, but it draws hard lines at cosmetic procedures, insurance premiums, and general wellness spending. Knowing where those lines fall before you contribute matters, because unspent money generally disappears at the end of the plan year.
Doctor Visits, Therapy, and Diagnostics
The most common FSA expenses are the routine costs your health insurance doesn’t fully absorb: co-pays for office visits, your annual deductible, and the coinsurance percentage you owe after your plan pays its share. These are all eligible.
Beyond primary care, FSA funds cover a wide range of professional treatments when they address a medical condition. Physical therapy for a back injury, chiropractic care for chronic pain, acupuncture, and mental health counseling all qualify.1Office of the Law Revision Counsel. 26 USC 213 – Medical, Dental, Etc., Expenses Some treatments straddle the line between medical care and general wellness, and your FSA administrator may require a letter of medical necessity from your doctor before reimbursing them. If yours does, get the letter before the appointment rather than scrambling afterward.
Diagnostic testing is another major category. Lab work, X-rays, MRIs, and other imaging ordered by your provider to diagnose or monitor a condition are eligible. The expense has to be tied to diagnosing or treating something specific, but in practice nearly all physician-ordered diagnostics meet that standard.
Prescriptions and Over-the-Counter Products
Prescription medications are among the most straightforward FSA expenses. Anything your doctor prescribes, from antibiotics and blood pressure drugs to insulin and birth control, qualifies.2Internal Revenue Service. Publication 969, Health Savings Accounts and Other Tax-Favored Health Plans The FSA is especially useful for recurring monthly pharmacy costs that insurance covers only partially.
The CARES Act permanently eliminated the old requirement that over-the-counter drugs needed a doctor’s prescription to qualify for FSA reimbursement. Since January 1, 2020, you can buy pain relievers, allergy medications, cold and flu treatments, antacids, and similar OTC drugs with pre-tax FSA dollars, no prescription needed.3FSAFEDS. FAQs – Are There Any Requirements That Must Be Met for an OTC Drug to Be Eligible for Reimbursement Through My HCFSA The same law added menstrual care products to the eligible list.
First aid supplies qualify too: bandages, gauze, antiseptic wipes, thermometers, and similar items you’d keep in a medicine cabinet. Sunscreen rated SPF 15 or higher is eligible because it prevents skin damage from UV radiation. Diagnostic tools like home pregnancy tests, blood pressure cuffs, and pulse oximeters are also covered.
Dual-Purpose Items
Products that serve both a medical and a personal care purpose often need a letter of medical necessity before your FSA administrator will approve them. A humidifier bought for asthma treatment, compression garments for lymphedema, and dermatologist-recommended skincare products for chronic conditions like eczema or rosacea all fall into this gray zone. Without a letter from your doctor explaining the medical reason, these claims get denied. Vitamins and supplements also fail to qualify unless your doctor writes a letter tying them to a specific diagnosed condition rather than general health maintenance.
Vision and Dental Care
FSA funds work well for vision and dental expenses because insurance in these categories tends to have tight annual caps, leaving you with sizable out-of-pocket costs.
Vision Expenses
Comprehensive eye exams, prescription eyeglasses, and contact lenses are all eligible, along with contact lens solution and cases. Laser eye surgery like LASIK qualifies as vision correction, not a cosmetic procedure, so it’s fully reimbursable.4Internal Revenue Service. IRS: Eligible Employees Can Use Tax-Free Dollars for Medical Expenses Non-prescription sunglasses and blue-light-blocking glasses without a corrective prescription don’t qualify.
Dental Expenses
Routine cleanings, fillings, extractions, root canals, and crowns are straightforward FSA-eligible expenses. Orthodontia, including braces, qualifies when it corrects a functional problem like malocclusion rather than purely improving appearance.1Office of the Law Revision Counsel. 26 USC 213 – Medical, Dental, Etc., Expenses Since braces typically cost $3,000 to $7,500 or more depending on the type, spreading those payments across FSA plan years can save hundreds in taxes.5Healthline. How Much Do Braces Cost? Teeth whitening and purely cosmetic veneers are excluded.
Medical Equipment and Supplies
Durable medical equipment qualifies when medically necessary. Crutches, wheelchairs, walkers, hearing aids and their batteries, and prosthetic devices are all eligible. Monitoring equipment for chronic conditions, including glucose meters, test strips, and blood pressure monitors, falls squarely within the IRS definition of medical care because it tracks a diagnosed condition.
Breast pumps and lactation supplies have been explicitly eligible since the IRS confirmed their status in 2011. This covers the pump itself, storage bags, and related accessories. These costs can run several hundred dollars even after insurance, making them a useful FSA purchase for new parents.
Medical Travel and Lodging
When you have to travel for medical care, the trip itself can be an FSA-eligible expense. For 2026, the IRS sets the standard mileage rate for medical travel at 20.5 cents per mile.6IRS.gov. 2026 Standard Mileage Rates You can also use FSA funds for bus fare, train tickets, ambulance fees, and parking costs at medical facilities. The key requirement is that the travel is primarily for and essential to medical care, not a side trip during a vacation.
If treatment requires an overnight stay away from home, lodging costs qualify up to $50 per night per person. When a parent travels with a sick child, that’s $100 per night total.7Internal Revenue Service. Publication 502, Medical and Dental Expenses The lodging can’t be lavish or extravagant, and there can be no significant element of personal pleasure in the trip. A hotel near a specialty hospital fits; a resort with a spa appointment tacked on doesn’t.
Home Modifications and Service Animals
Home modifications that accommodate a disability or medical condition qualify as eligible medical expenses. The IRS lists specific examples: entrance ramps, widened doorways, grab bars in bathrooms, lowered kitchen cabinets, and stairway modifications.7Internal Revenue Service. Publication 502, Medical and Dental Expenses These improvements generally don’t increase a home’s market value, so the full cost counts as a medical expense. If a modification does increase your property value, an elevator for instance, only the portion of the cost exceeding that value increase qualifies.
The cost of buying, training, and maintaining a service animal qualifies when the animal assists someone with a visual impairment, hearing disability, or other physical condition. Ongoing care costs, including food, grooming, and veterinary bills, are also eligible because they keep the animal healthy enough to perform its duties.7Internal Revenue Service. Publication 502, Medical and Dental Expenses Regular pet expenses for an emotional support animal without formal service training do not qualify.
Whose Expenses You Can Cover
Your FSA isn’t limited to your own expenses. You can use it to pay for qualified medical costs incurred by your spouse, anyone you claim as a dependent on your tax return, and your child under age 27 at the end of your tax year, even if that child isn’t your tax dependent.2Internal Revenue Service. Publication 969, Health Savings Accounts and Other Tax-Favored Health Plans That under-27 rule is especially useful for recent college graduates still getting on their feet. Your spouse and dependents don’t need to be enrolled in your health insurance plan for their expenses to qualify.
What Your FSA Won’t Cover
The IRS draws a firm line at cosmetic procedures. Any surgery or treatment directed at improving your appearance that doesn’t meaningfully treat illness, prevent disease, or promote proper body function is excluded. There are three exceptions: procedures needed because of a congenital abnormality, an injury from an accident or trauma, or a disfiguring disease.8Office of the Law Revision Counsel. 26 U.S. Code 213 – Medical, Dental, Etc., Expenses Reconstructive surgery after a car accident qualifies; a nose job for aesthetic reasons doesn’t.
Several other common expenses are specifically excluded:
- Health insurance premiums for your health, dental, or vision coverage.
- Long-term care services, which have their own tax rules and don’t qualify under a standard health FSA.
- Gym memberships and general fitness programs, even when a doctor recommends exercise. Most administrators reject these claims outright.
- Cosmetics and most general toiletries.
- Expenses already paid by insurance. You can’t double-dip by also running them through your FSA.
How to Pay and What to Keep
Most FSA plans issue a debit card linked to your account. When you swipe it at a pharmacy or doctor’s office, many eligible purchases are approved automatically at checkout through inventory verification systems the store uses. That automatic approval doesn’t mean you’re off the hook for records. Your plan administrator or the IRS can request proof at any time, and if you can’t produce it, the expense gets reclassified as taxable income.
Acceptable documentation means an itemized receipt or an Explanation of Benefits from your insurer showing the date of service, the provider, a description of the service or product, and the amount you owed. Credit card statements, canceled checks, and balance-forward statements do not count.9FSAFEDS. Eligible Health Care FSA (HC FSA) Expenses Photograph every receipt the day you get it. Chasing down documentation months later is the top reason people lose FSA money they were entitled to spend.
After your plan year ends, you typically have a run-out period to submit claims for expenses you incurred during the plan year. Federal employees using FSAFEDS, for example, have until April 30 of the following year to file claims for the prior benefit period.10FSAFEDS. Key Dates and Deadlines Private employer plans set their own run-out deadlines, so check yours early.