What Can You Use a Limited FSA For: Dental, Vision, and Copays

A limited purpose FSA is primarily for dental and vision expenses paid with pre-tax dollars, and that narrow scope is what lets you keep contributing to a health savings account at the same time. Depending on how your employer designed the plan, you may also be able to use it for certain preventive care before you hit your high deductible health plan’s deductible, and for general medical expenses after you meet it.¹

Dental Expenses That Qualify

Routine dental care is the most common use. Cleanings, fluoride treatments, sealants, and X-rays all qualify, and so does restorative work like fillings, extractions, and dentures because it treats existing dental disease.² The underlying rule is that the IRS treats costs for diagnosing, treating, or preventing disease as eligible medical expenses, and dental care fits that definition.³

Orthodontics is often the biggest single expense people run through these accounts. Braces and aligners are eligible when they correct misalignment or a functional problem; purely cosmetic work is not. If your orthodontist requires a lump-sum payment up front, you can typically be reimbursed for the portion attributable to the current plan year, then claim the rest in later years as long as you re-enroll and treatment continues.⁴ Oral surgery for wisdom teeth or periodontal disease qualifies as well.

Vision Expenses That Qualify

Eye exams are fully reimbursable whether you see an optometrist or an ophthalmologist. Prescription glasses and contact lenses qualify, along with the supplies you need to maintain them, such as saline solution and enzyme cleaner.² Over-the-counter reading glasses count as long as they address a vision impairment.⁵

Corrective surgery like LASIK and PRK is eligible because the IRS treats surgery that corrects defective vision as a medical expense, with costs typically running $1,500 to $2,750 per eye. Follow-up appointments tied to the surgery are also covered. Non-prescription sunglasses and decorative lenses are not reimbursable because they serve a cosmetic purpose.

Preventive Care Before You Meet the Deductible

Many limited FSAs cover certain preventive services in addition to dental and vision, even before you hit your HDHP deductible. Federal law lets HDHPs provide preventive care without a deductible, and IRS Notice 2004-23 sets out what counts.⁶ Whether your account includes this category depends on how your employer wrote the plan, so check your plan documents.

When preventive care is included, eligible services generally cover:

Annual physicals and any diagnostic tests ordered during them
Child and adult immunizations
Health screenings performed before symptoms appear, including blood pressure checks, cholesterol panels, mammograms, colonoscopies, and other cancer screenings
Routine prenatal visits and standard well-child care
Structured tobacco cessation and obesity programs aimed at prevention rather than treatment

The IRS draws a firm line: preventive care does not include services that treat an existing illness, injury, or condition.⁶ A cholesterol screening is preventive. A follow-up visit to manage diagnosed high cholesterol is treatment, and your limited FSA will not cover it until you have met your deductible.

General Medical Expenses After You Meet the Deductible

Once you satisfy your HDHP’s minimum annual deductible, many limited FSAs convert into what plan documents call a post-deductible FSA, expanding to general medical expenses. After clearing that threshold, you can use your remaining balance for office visit copays, hospital charges, prescription drugs, and other qualified medical expenses that were previously off-limits.¹ For 2026, the minimum HDHP deductible is $1,700 for individual coverage or $3,400 for a family plan.⁷

You will usually need to send your plan administrator proof that the deductible has been met, such as an explanation of benefits showing accumulated out-of-pocket costs. Not every employer offers this conversion feature, so confirm with your benefits department before assuming it applies. If it does, submit that documentation promptly so you have time to spend the balance before the plan year closes.

Whose Expenses Your Account Can Pay

Your limited FSA is not just for your own care. You can use it to pay eligible dental, vision, and preventive care costs for your spouse and your tax dependents as defined in the Internal Revenue Code.⁸ A qualifying dependent generally means someone who lives with you, receives more than half of their financial support from you, and meets the relationship requirements in the code.⁹

Children get a broader rule. Under Section 105(b), your child’s medical expenses are eligible through the end of the tax year in which they turn 26, regardless of whether they qualify as your dependent for other tax purposes.⁸ Financial dependency, student status, and where they live do not matter for this purpose. A domestic partner is different: they have to meet the standard tax-dependent test, which most working adults will not satisfy.¹⁰

What a Limited FSA Will Not Cover

The flip side of the “limited” label is a real list of things the account will not pay for, at least not before the deductible is met. Common denials fall into these categories:

General medical bills including doctor visits, urgent care, prescription drugs, and hospital stays, unless your plan offers the post-deductible conversion and you have met the deductible
Cosmetic dental work such as teeth whitening and veneers done for appearance rather than function²
Non-prescription eyewear, including fashion sunglasses and decorative contacts without a corrective prescription
Everyday hygiene products like toothpaste, toothbrushes, and mouthwash
Menstrual care products, which the CARES Act made eligible for regular FSAs and HSAs but not for limited purpose FSAs¹¹
Insurance premiums of any kind, including dental and vision

When you are unsure, the working test is whether the expense would qualify as a medical deduction under IRC Section 213(d) and whether it fits the dental, vision, or preventive care categories your plan allows before the deductible.³ Keep receipts. Plan administrators do ask for documentation, and undocumented claims get denied.

Deadlines That Decide Whether You Keep the Money

Limited FSAs follow the same “use it or lose it” rule as regular health FSAs. Any balance left after the plan year ends, after any grace period or carryover, is forfeited.¹² This is where people lose money. Estimate conservatively when you elect an amount for the year: a predictable set of cleanings and an eye exam is safer than banking on a large expense that may not happen.

For 2026, the most you can contribute to a health FSA, including a limited FSA, is $3,400. If your plan allows a carryover, up to $680 of unused funds can roll into the next plan year.¹³ A carryover and a grace period are mutually exclusive; your employer can offer one or the other.¹² A grace period gives you up to two and a half extra months after the plan year to incur new expenses against the prior-year balance, which for a calendar-year plan runs through March 15.

If you leave your job mid-year, coverage ends on your separation date. Only expenses incurred before that date are reimbursable, even if you had elected a higher annual amount than your employer had deducted so far. If you already spent more than you contributed before leaving, you do not owe back the difference.¹⁴ Most plans also give you a run-out period, typically 60 to 90 days after the plan year or your separation date, to submit receipts for expenses already incurred. Mark that deadline: missing it means forfeiting reimbursement on money you have already spent.

1
Internal Revenue Service. Publication 969 (2025) – Health Savings Accounts and Other Tax-Favored Health Plans – Section: Other Employee Health Plans
2
Internal Revenue Service. Publication 502 – Medical and Dental Expenses
3
Office of the Law Revision Counsel. 26 USC 213 – Medical, Dental, Etc., Expenses
4
FSAFEDS. Orthodontia Quick Reference Guide
5
eCFR. 26 CFR 1.213-1 – Medical, Dental, Etc., Expenses – Section: Definitions
6
Internal Revenue Service. Notice 2004-23
7
Internal Revenue Service. Revenue Procedure 2025-19
8
Office of the Law Revision Counsel. 26 USC 105 – Amounts Received Under Accident and Health Plans
9
Office of the Law Revision Counsel. 26 USC 152 – Dependent Defined
10
Internal Revenue Service. Answers to Frequently Asked Questions for Registered Domestic Partners and Individuals in Civil Unions
11
Internal Revenue Service. IRS Outlines Changes to Health Care Spending Available Under CARES Act
12
Internal Revenue Service. Publication 969 (2025) – Health Savings Accounts and Other Tax-Favored Health Plans
13
Internal Revenue Service. Revenue Procedure 2025-32
14
FSAFEDS. What Happens if I Separate or Retire Before the End of the Plan Year?