Understanding FSA Eligibility

One of the most common questions FSA participants ask is: "Can I use my FSA for this?" The IRS defines eligible expenses broadly as costs for the "diagnosis, cure, mitigation, treatment, or prevention of disease" — but the details matter. Knowing what qualifies helps you plan your contributions accurately and avoid costly reimbursement denials.

Commonly Eligible FSA Expenses

Medical & Prescription Costs

  • Doctor's office copays and coinsurance
  • Prescription medications
  • Over-the-counter (OTC) medications (no prescription required, following CARES Act changes)
  • Insulin and diabetic supplies
  • Mental health services (therapy, psychiatry)
  • Physical therapy and occupational therapy
  • Lab fees and diagnostic tests
  • Hospital services and surgery costs
  • Hearing aids and batteries
  • Wheelchairs, crutches, and other medical equipment

Dental Expenses

  • Routine cleanings and exams
  • X-rays
  • Fillings, crowns, and root canals
  • Braces and orthodontics
  • Tooth extractions
  • Dentures and dental implants

Vision Expenses

  • Eye exams
  • Prescription eyeglasses and frames
  • Contact lenses and contact lens solution
  • LASIK eye surgery
  • Prescription sunglasses

Women's Health & Family Planning

  • Menstrual care products (pads, tampons, menstrual cups)
  • Pregnancy tests
  • Fertility treatments (in most cases)
  • Breast pumps and supplies
  • Birth control (prescription)

Expenses That Are NOT FSA-Eligible

Many common purchases are not covered by a Health Care FSA, even if they seem health-related:

  • Cosmetic procedures (e.g., teeth whitening, Botox for cosmetic purposes)
  • Gym memberships or fitness equipment (unless prescribed by a doctor for a specific condition)
  • Health insurance premiums
  • Vitamins and supplements (unless prescribed for a diagnosed condition)
  • Toothpaste, deodorant, and general toiletries
  • Childcare costs (use a Dependent Care FSA instead)
  • Funeral expenses
  • Nonprescription sunglasses (not vision-correcting)

The "Letter of Medical Necessity" Exception

Some borderline expenses — like weight loss programs, special foods, or air purifiers — may become FSA-eligible with a Letter of Medical Necessity (LMN) from a licensed healthcare provider. An LMN establishes that the expense is medically required to treat a specific diagnosed condition. Check with your FSA administrator about their LMN requirements before assuming eligibility.

Dependent Care FSA: Different Rules Apply

A Dependent Care FSA covers an entirely different category of expenses:

  • Licensed daycare centers
  • After-school programs and summer day camps
  • In-home babysitters or nannies (when care is for a qualifying dependent)
  • Adult daycare for qualifying dependents

Note: Overnight summer camps and private school tuition are not eligible under a Dependent Care FSA.

How to Verify Eligibility

When in doubt about whether an expense qualifies, use these resources:

  1. Check your FSA administrator's online eligibility tool or database.
  2. Reference IRS Publication 502 (Medical and Dental Expenses) for official guidance.
  3. Contact your FSA administrator's customer service team directly.

Always save your receipts and itemized statements. If your FSA administrator requests substantiation, you'll need documentation that shows the date, provider, type of service, and cost.