Nearly every over-the-counter medication sold at a U.S. pharmacy is eligible for purchase with Flexible Spending Account funds, and no prescription is required. That has been the rule since 2020. Alongside OTC drugs, a wide range of health products qualify too: menstrual care items, first aid supplies, home diagnostic devices, reading glasses, contact lens solution, and more. For the 2026 plan year, employees can contribute up to $3,400 in pre-tax dollars to a health FSA, and every dollar spent on eligible OTC medications and health products avoids federal income and payroll taxes.1FSAFEDS. New 2026 Maximum Limit Updates
Over-the-Counter Medications You Can Buy
If a product contains an active drug ingredient recognized by the FDA, it almost certainly qualifies. The major categories:
- Pain relievers, including ibuprofen, acetaminophen, naproxen, and aspirin for headaches, muscle pain, and fever.2FSAFEDS. Eligible Health Care FSA (HC FSA) Expenses
- Allergy and sinus medicines: antihistamines, nasal sprays, decongestants.2FSAFEDS. Eligible Health Care FSA (HC FSA) Expenses
- Cold and flu treatments, including cough suppressants, expectorants, and multi-symptom formulas.
- Digestive aids: antacids, acid reducers, anti-diarrheal medications, and laxatives.2FSAFEDS. Eligible Health Care FSA (HC FSA) Expenses
- Topical treatments: antibiotic ointments, anti-itch creams, acne medications, and anti-fungal products.
- Sunscreen, but only if labeled both “broad spectrum” and SPF 15 or higher. Regular suntan lotion and lower-SPF sunscreens do not qualify.3FSAFEDS. Eligible Health Care FSA (HC FSA) Expenses
Menstrual care products are also qualified medical expenses. That includes pads, tampons, liners, cups, and sponges, regardless of whether the product contains any drug ingredient.4Internal Revenue Service. IRS Outlines Changes to Health Care Spending Available Under CARES Act
Home Health Products and Devices
Plenty of non-drug items qualify under the IRS definition of medical care, which covers amounts spent to diagnose, treat, or prevent disease, or to affect the structure or function of the body.5Office of the Law Revision Counsel. 26 USC 213 – Medical, Dental, Etc., Expenses
At-home diagnostic tools are a straightforward category. Blood pressure monitors qualify with a receipt.6FSAFEDS. Eligible Health Care FSA (HC FSA) Expenses Pregnancy test kits are explicitly eligible.7Internal Revenue Service. Publication 502 – Medical and Dental Expenses Diabetes test strips and other monitoring supplies also qualify.
First aid supplies fall squarely within medical care. Bandages, gauze, and similar wound care supplies are deductible medical expenses and therefore FSA-eligible.7Internal Revenue Service. Publication 502 – Medical and Dental Expenses The same reasoning covers joint braces, elastic wraps, and hot or cold therapy packs used for injury treatment or recovery.
Personal protective equipment such as masks and hand sanitizer also qualifies when used to prevent the spread of illness.7Internal Revenue Service. Publication 502 – Medical and Dental Expenses
Vision and Dental Items
Vision products are among the most overlooked FSA-eligible purchases. Reading glasses bought off the rack at a pharmacy qualify. So do contact lenses, contact lens solution, and eye drops.8FSAFEDS. Eligible Health Care FSA (HC FSA) Expenses Eyeglass repair kits, lens cleaning supplies, and prescription goggles or swim masks are eligible too.9FSAFEDS. Eligible Limited Expense Health Care FSA (LEX HCFSA) Expenses
On the dental side, denture adhesive, occlusal guards for teeth grinding, and clear dental aligners (including mail-order options) all qualify with a receipt.9FSAFEDS. Eligible Limited Expense Health Care FSA (LEX HCFSA) Expenses Toothache and teething pain relievers need a Letter of Medical Necessity to be reimbursed.
What Your FSA Won’t Cover
The IRS draws a line between treating a medical condition and maintaining general health. Anything on the general-health side of that line is ineligible, and this trips up more people than you might expect.
Daily vitamins, herbal supplements, and nutritional products are not eligible unless a doctor recommends them to treat a specific diagnosed condition.7Internal Revenue Service. Publication 502 – Medical and Dental Expenses Prenatal vitamins during pregnancy or iron supplements for a diagnosed deficiency can qualify with proper documentation.10FSAFEDS. What Kind of Over-the-Counter Medicines or Products Are Eligible for Reimbursement Through My HCFSA? A general multivitamin does not.
Personal hygiene products are also off-limits. The IRS specifically names toothbrushes and toothpaste as nondeductible personal expenses, and the same applies to soap, shampoo, deodorant, and similar toiletries.7Internal Revenue Service. Publication 502 – Medical and Dental Expenses
Other categories that get rejected:
- Cosmetic procedures such as face lifts, hair transplants, electrolysis, and liposuction, unless they correct a deformity from a birth defect, accident, or disfiguring disease.7Internal Revenue Service. Publication 502 – Medical and Dental Expenses
- Teeth whitening, which is never eligible, even with a dentist’s recommendation.7Internal Revenue Service. Publication 502 – Medical and Dental Expenses
- Gym memberships and fitness classes, though fees for a specific weight-loss activity at a gym can qualify if you have a medical diagnosis.7Internal Revenue Service. Publication 502 – Medical and Dental Expenses
- Sunscreen below SPF 15 or not labeled broad spectrum.3FSAFEDS. Eligible Health Care FSA (HC FSA) Expenses
When a Letter of Medical Necessity Unlocks an Item
Some products sit in a gray area. They could be for general wellness or for treating a real medical condition. For these dual-purpose items, your FSA administrator will require a Letter of Medical Necessity (LMN) from a licensed healthcare provider before approving reimbursement. The letter must include your specific diagnosis, the recommended treatment, and how long the treatment should last.11FSAFEDS. FAQs – What Expenses Are Eligible for Reimbursement Only if Medically Necessary?
Common items that require an LMN include air purifiers and HEPA filters for allergy treatment, special mattresses, supplements for a diagnosed deficiency, and weight-loss programs prescribed for a medical condition. If the treatment period on your LMN expires, get a new one before submitting additional claims.
How to Pay and What to Keep
The easiest method is an FSA debit card at a retailer that supports the Inventory Information Approval System (IIAS). At checkout, the system checks each product’s barcode against a database of qualified health expenses and charges only eligible items to your FSA. In most cases no receipt submission is needed afterward.
If the retailer doesn’t support IIAS, or you pay out of pocket, file a manual claim through your plan administrator’s website or app. Upload a digital copy of the itemized receipt, and the administrator reviews it. Approved reimbursements go out by direct deposit or check. For the 2026 plan year, you have until April 30, 2027, to submit claims for expenses incurred before the plan year ended.12FSAFEDS. FAQs – Key Dates and Deadlines
A valid receipt shows the merchant name, date, an itemized list of products, and the amount paid. Credit card slips that show only a total charge are not sufficient; the IRS requires itemized documentation to verify each purchase was eligible.2FSAFEDS. Eligible Health Care FSA (HC FSA) Expenses Keep receipts and any Letters of Medical Necessity for at least three years. The IRS can request documentation for any tax-exempt FSA distribution during that window, and being unable to produce a receipt can mean the expense gets reclassified as taxable income. A phone photo of each receipt right after purchase is the simplest insurance.