What Can You Buy With A Flex Spending Account?

A Flexible Spending Account (FSA) lets you pay for medical expenses with pre-tax dollars. You can use it for doctor visits, prescription drugs, dental work, vision care, and a wide range of over-the-counter items like bandages and sunscreen. The key is that the expense must treat or prevent a medical condition for you, your spouse, or your dependents.

What Exactly Is a Flexible Spending Account?

An FSA is a benefit your employer offers. You choose an amount to set aside from each paycheck before taxes are taken out. This lowers your taxable income for the year.

The money goes into your FSA. You then use that money to pay for eligible medical expenses. The IRS sets the rules for what counts as an eligible expense. Your employer may also offer a limited-purpose FSA or a dependent care FSA, which have different rules.

The biggest catch is the “use-it-or-lose-it” rule. Most plans require you to spend all your FSA money by the end of the plan year. Some plans offer a grace period of up to 2.5 months or let you carry over up to $640 into the next year. Check your plan documents to know your deadline.

What Medical Services Can You Pay For With an FSA?

Doctor and specialist visits are covered. This includes copays, coinsurance, and deductibles you owe for medical care. It also covers hospital stays, surgery, and emergency room visits.

Dental care is fully eligible. You can use your FSA for cleanings, fillings, crowns, root canals, braces, and dentures. Vision care is also covered, including eye exams, glasses, contact lenses, and contact lens solution.

Mental health services qualify. Therapy sessions with a licensed psychologist or psychiatrist are eligible. So are substance abuse treatment programs and psychiatric hospital stays.

Prescription medications are covered. You need a prescription from your doctor for the drug to be eligible. Insulin is eligible even without a prescription.

What Over-the-Counter Items Are FSA-Eligible?

Since the CARES Act passed in 2020, you no longer need a prescription for most over-the-counter (OTC) items. You can buy them directly with your FSA card. This rule change made many common health products eligible.

Here is a list of OTC items you can buy with your FSA:

• Pain relievers like ibuprofen, acetaminophen, and aspirin
• Cold and allergy medicines like antihistamines and decongestants
• Digestive aids like antacids, laxatives, and anti-diarrhea medicine
• First aid supplies like bandages, gauze, and adhesive tape
• Sunscreen with SPF 15 or higher
• Menstrual care products like pads, tampons, and menstrual cups
• Contact lens solution and saline solution
• Thermometers and blood pressure monitors

Some items require a letter of medical necessity from your doctor. This includes things like compression stockings, breast pumps, and prenatal vitamins. Check with your FSA administrator if you are unsure about a specific item.

Can You Use an FSA for Dental and Vision Expenses?

Yes, dental and vision expenses are some of the most common FSA uses. The IRS specifically includes them in the list of eligible expenses. You do not need a prescription for routine dental or vision care.

For vision, you can pay for eye exams, prescription glasses, prescription sunglasses, contact lenses, and contact lens solution. Laser eye surgery like LASIK is also eligible. So are reading glasses if you have a prescription.

For dental, you can pay for cleanings, fillings, crowns, bridges, dentures, and orthodontia like braces or Invisalign. Teeth whitening is not eligible because it is cosmetic, not medical. The same rule applies to cosmetic dentistry like veneers done solely for appearance.

What Can You NOT Buy With an FSA?

The IRS is clear about what does not qualify. Cosmetic procedures are out. This includes facelifts, liposuction, and teeth whitening. Weight loss programs are only eligible if your doctor prescribes them for a specific medical condition like diabetes or heart disease.

General health items are not covered. You cannot buy vitamins or supplements unless a doctor prescribes them for a specific medical condition. Protein powder, meal replacement shakes, and fitness trackers are not eligible. Neither are gym memberships or exercise equipment.

Insurance premiums are not eligible. You cannot use your FSA to pay for your health insurance premiums, Medicare premiums, or long-term care insurance premiums. Pet care is also not covered, even if your pet has a medical condition.

Here is a quick comparison of eligible and ineligible items:

How Do You Know If an Item Is FSA-Eligible?

The easiest way to check is to look for the FSA-eligible logo on the product packaging. Many stores also have a searchable list of eligible items on their website. Your FSA administrator may provide a tool on their site to check specific items.

The IRS Publication 502 is the official source for all eligible expenses. It is a long document, but it lists every type of medical expense that qualifies. You can also call your FSA administrator directly. They have the final say on what is covered under your specific plan.

If you buy an item and later find out it was not eligible, you have options. You can pay for it out of pocket and submit a claim for reimbursement if your plan allows it. Or you can return the item and get a refund back to your FSA card. Most plans let you do this within a certain timeframe.