Guide · Updated October 30, 2026
What can I buy with my FSA? A list of eligible expenses
A health FSA pays for medical care: things that diagnose, treat or prevent a health problem. That covers more than doctor visits. Glasses, contacts, sunscreen, first aid kits, over-the-counter medicine and menstrual products are commonly eligible too. Here's what most plans cover, and what they usually don't.
Always confirm with your plan. The IRS sets the outer limits, but your employer's plan decides what it reimburses, and some plans cover less. Your FSA administrator has the final word.
Commonly eligible FSA expenses
These are the categories most health FSAs reimburse. They're the same ones Tallydown uses for its checklist.
| Category | Examples | Good to know |
|---|---|---|
| Vision | Eye exams, prescription glasses and sunglasses, contact lenses and solution | Book early: eye doctors fill up in December |
| Dental | Cleanings, fillings, crowns, braces, night guards | Many insurance plans cover two cleanings a year; the FSA can pay the copay |
| Prescriptions | Prescribed medicine and insulin | Ask about a 90-day supply before your deadline |
| Doctor visits | Copays, deductibles, a yearly physical, urgent care | Your share of the bill is eligible; insurance premiums are not |
| Over-the-counter medicine | Pain relievers, allergy and cold medicine, antacids | No prescription needed since 2020 |
| Menstrual care | Pads, tampons, cups, liners | No prescription needed since 2020 |
| First aid | Bandages, first aid kits, thermometers, blood pressure monitors | Easy to buy any day up to the deadline |
| Sunscreen | Broad-spectrum sunscreen SPF 15 or higher, lip balm with SPF | Administrators commonly require SPF 15+ and broad spectrum |
| Lab tests | Blood work, screenings, at-home diagnostic tests | Includes many at-home test kits |
| Hearing | Hearing exams, hearing aids and batteries | Over-the-counter hearing aids qualify too |
| Chiropractic and acupuncture | Chiropractor visits, acupuncture sessions | Treatment from a licensed provider |
Over-the-counter medicine and menstrual products
Since the CARES Act of 2020, you can use a health FSA for over-the-counter medicine without a prescription, and menstrual care products count as medical care. Before 2020, over-the-counter medicine needed a doctor's prescription to be reimbursed.
That makes the pharmacy aisle a good place to use a small leftover balance: allergy medicine, pain relievers, cold and flu medicine, heartburn tablets, and a year's supply of menstrual products.
Not sure what to spend your balance on? Tallydown turns what's left into a short, dated plan, appointments first and shopping last, and keeps a checklist of these categories on your iPhone.
Expenses that may need a letter of medical necessity
Some things are only eligible when they treat a specific medical condition. Your plan may ask for a letter of medical necessity (LMN) from your doctor before it reimburses them. Common examples:
- Massage therapy
- Vitamins and supplements prescribed for a diagnosed condition
- Weight-loss programs for a specific disease, such as obesity or heart disease diagnosed by a doctor
- Special foods, only for the cost above ordinary food
What an FSA usually doesn't cover
- Health insurance premiums. These can't be paid from a health FSA.
- Cosmetic procedures, such as teeth whitening or cosmetic surgery.
- General health items, such as gym memberships, everyday vitamins and toiletries, without a medical reason.
- Expenses from before your coverage started, or after it ended.
Tips before you buy
- Check your administrator's eligible-items list. Most have a searchable list online.
- Pay with your FSA card when you can. Many pharmacies and online stores mark eligible items at checkout.
- Keep the itemized receipt. Your administrator can ask for proof, even for card purchases.
- Mind the deadline. An expense counts for the plan year in which you get the care or buy the item, not when you file the claim. See the FSA deadline guide.
Sources
- IRS, Publication 502, Medical and Dental Expenses (what counts as medical care)
- IRS, Publication 969, Health Savings Accounts and Other Tax-Favored Health Plans
Tallydown isn't tax, legal or medical advice. Only your plan administrator can confirm that an expense is eligible.