FSA Eligible Expenses: The Complete 2026 List
If you have a Health Flexible Spending Account (FSA), you already know it saves you money on medical expenses by using pre-tax dollars. But many people don’t realize just how broad the list of eligible expenses is. Beyond the obvious doctor visits and prescriptions, your FSA can cover everything from sunscreen to acupuncture. For a broader comparison of flexible spending options, check out FSA vs HSA vs HRA.
This guide organizes every major FSA-eligible expense by category, highlights the items people most commonly miss, lists what’s not eligible, and covers Dependent Care FSA expenses too.
2026 Health FSA limit: $3,300 (with up to $640 rollover to 2027 if your plan allows it)
How FSA Eligibility Works
An expense is FSA-eligible if it qualifies as a medical expense under IRS Section 213(d). The general rule: it must be primarily for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for the purpose of affecting any function of the body.
Since the CARES Act of 2020, over-the-counter medications and menstrual care products are eligible without a prescription — a significant expansion that many employees still don’t know about.
Medical Expenses
These are the core FSA-eligible expenses that most people are familiar with:
Doctor Visits and Services
- Office visit copays
- Specialist copays
- Urgent care visits
- Annual physicals and wellness exams
- Lab work and diagnostic tests
- X-rays, MRIs, and CT scans
- Surgery and surgical fees
- Hospital stays and inpatient care
- Ambulance services
- Telehealth/virtual doctor visits
Prescription Medications
- All prescription medications (brand and generic)
- Prescription eye drops
- Prescription skin treatments
- Insulin (always eligible, even without a prescription)
- Prescription sunscreen (with UVA/UVB protection)
Over-the-Counter Medications (No Prescription Needed)
Since the CARES Act, these are all eligible:
- Pain relievers (ibuprofen, acetaminophen, aspirin)
- Allergy medications (antihistamines, nasal sprays)
- Cold and flu medications
- Digestive aids (antacids, anti-diarrheal)
- First aid supplies (bandages, gauze, antiseptic)
- Cough drops and throat lozenges
- Motion sickness medications
- Sleep aids (melatonin, diphenhydramine)
- Topical anti-itch creams (hydrocortisone)
- Medicated lip balm
- Nicotine gum and patches (smoking cessation)
- Acne treatments
- Sunscreen (SPF 15+) and sunburn treatments
- Menstrual care products (pads, tampons, cups, liners)
Dental Expenses
Dental care is often one of the best uses of FSA funds, since out-of-pocket costs can be significant:
- Dental cleanings and exams
- Fillings and crowns
- Root canals
- Tooth extractions
- Dentures and bridges
- Dental implants
- Orthodontics (braces, retainers, Invisalign)
- TMJ treatment
- Dental X-rays
- Fluoride treatments
- Sealants
- Mouth guards (for teeth grinding)
- Dental anesthesia
Tip: Orthodontic expenses can be reimbursed as payments are made, not just when the total is billed. If you’re paying $200/month for braces, each payment is an eligible FSA expense.
Vision Expenses
Vision care is another high-value FSA category:
- Eye exams
- Prescription eyeglasses (frames and lenses)
- Prescription sunglasses
- Contact lenses and contact lens solution
- Reading glasses (over-the-counter)
- LASIK and other corrective eye surgery
- PRK surgery
- Glaucoma treatments
- Prescription eye drops
- Eye patches (for medical treatment)
- Occlusion therapy
Commonly missed: Over-the-counter reading glasses are FSA-eligible. If you buy them at the drugstore, keep the receipt.
Mental Health and Therapy
Mental health services are fully FSA-eligible:
- Psychotherapy and counseling
- Psychiatrist visits
- Psychological testing
- Substance abuse treatment (inpatient and outpatient)
- Smoking cessation programs
- Biofeedback therapy
- Hypnotherapy (when prescribed for a medical condition)
- Applied Behavior Analysis (ABA therapy)
Women’s Health
- Breast pumps and supplies
- Lactation consultant fees
- Prenatal vitamins (OTC, eligible since CARES Act)
- Pregnancy tests
- Fertility treatments (IVF, IUI)
- Contraceptives (prescription and OTC)
- Midwife services
- Doula services (when medically necessary)
- Pelvic floor therapy
- Menstrual care products
Children’s Health
- Well-child visits and pediatric care
- Immunizations
- Orthodontics
- Lead-based paint removal (when a child has lead poisoning)
- Speech therapy
- Occupational therapy
- Physical therapy
- Special education costs for learning disabilities (when recommended by a doctor)
- Service animals for children with medical conditions
Hearing
- Hearing exams
- Hearing aids
- Hearing aid batteries
- Cochlear implants
- Hearing aid repairs
Durable Medical Equipment
FSA funds can be used for equipment prescribed or recommended for medical care:
- Blood pressure monitors
- Blood glucose monitors and test strips
- Thermometers
- Nebulizers
- CPAP machines and supplies
- Crutches, walkers, and wheelchairs
- Compression stockings (when prescribed)
- Orthopedic shoes and inserts (amount exceeding cost of regular shoes)
- Back braces and supports
- Knee braces
- Wrist splints and supports
- Elastic bandages and wraps
- Breast pump
- Bed wetting alarms
Alternative and Complementary Medicine
Many alternative treatments are FSA-eligible:
- Acupuncture
- Chiropractic care
- Physical therapy
- Occupational therapy
- Speech therapy
- Osteopathic manipulative treatment
- Naturopathic treatments (when prescribed by a licensed practitioner)
Eligible With a Letter of Medical Necessity (LMN)
Some treatments require a letter from your doctor stating they’re medically necessary:
- Massage therapy (for a specific medical condition, not general relaxation)
- Weight loss programs (when prescribed for a specific disease like obesity, heart disease, or diabetes)
- Nutritional supplements (when prescribed for a medical condition)
- Gym membership (rarely approved — only for a specific, diagnosed medical condition)
- Air purifier (for allergies or asthma)
- Mattress (orthopedic, for back problems — only the cost exceeding a standard mattress)
Travel and Transportation
Getting to and from medical care counts:
- Mileage to and from medical appointments (2026 rate: check IRS publication for current rate)
- Parking fees at medical facilities
- Tolls for medical travel
- Bus, taxi, or rideshare to medical appointments
- Airfare for medical treatment not available locally
- Lodging for out-of-town medical care (up to $50/night)
Tip: Keep a log of medical travel. Mileage adds up faster than you’d think, especially for ongoing treatments like physical therapy or orthodontic appointments.
Commonly Missed FSA-Eligible Expenses
These are expenses that many FSA holders don’t realize they can claim:
- Sunscreen (SPF 15+) — Eligible as an OTC health product
- Contact lens solution — Eligible vision expense
- Bandages and first aid supplies — Eligible medical supplies
- Menstrual products — Eligible since the CARES Act
- Over-the-counter reading glasses — No prescription needed
- Acne treatments — Including OTC products
- Motion sickness bands — Eligible medical device
- Thermometers — Eligible medical equipment
- Pregnancy tests — Eligible OTC diagnostic
- Lip balm with SPF — Eligible as sun protection
- Mileage to the pharmacy — Not just doctor visits
- Lactation supplies — Including breast milk storage bags
- Smoking cessation products — Gum, patches, programs
- Sleep aids — Melatonin and OTC options
- Hand sanitizer — Eligible since COVID-era IRS guidance
Expenses That Are NOT FSA-Eligible
Not everything health-related qualifies. Here are common expenses that cannot be reimbursed from a Health FSA:
Explicitly Not Eligible
- Cosmetic procedures — Botox, teeth whitening, hair transplants (unless related to a deformity, injury, or disease)
- Gym memberships — Unless prescribed for a specific diagnosed condition with an LMN
- Health insurance premiums — Cannot be paid from an FSA (they’re handled separately through the Section 125 plan)
- Vitamins and supplements — Unless prescribed for a specific medical condition
- Toiletries — Toothpaste, regular soap, deodorant, shampoo
- Cosmetics — Makeup, skin care products used for beauty rather than medical treatment
- Teeth whitening — Considered cosmetic
- Maternity clothes — Not a medical expense
- Funeral expenses — Not eligible
- Childcare — Not from a Health FSA (but eligible through a DCAP)
- Elder care — Not from a Health FSA (but may be eligible through a DCAP)
- Diet food — Even if part of a weight loss program (you can only deduct the cost exceeding regular food)
- Personal trainers — Unless prescribed for a medical condition with an LMN
- Swimming pools — Even if recommended by a doctor (unless very specifically prescribed)
- Vacation/travel — Even if it improves your health
The General Rule
If something makes you look better but doesn’t treat a medical condition, it’s probably not eligible. If something treats, prevents, or diagnoses a medical condition, it probably is.
Dependent Care FSA (DCAP) Eligible Expenses
If your employer offers a Dependent Care FSA, here’s what qualifies:
2026 DCAP limit: $5,000 ($2,500 if married filing separately)
Eligible DCAP Expenses
- Daycare center fees — Licensed or accredited facilities
- In-home childcare (nanny, au pair) — Must report as household employment
- Before-school and after-school care programs
- Preschool tuition — If primarily custodial/care-based
- Summer day camp — Day camps only (not overnight)
- Elder care — For a dependent who lives with you and can’t care for themselves
- Babysitter fees — When you and your spouse are both working
- Late pickup fees at daycare — Eligible if care-related
NOT Eligible for DCAP
- Overnight camp — Day camps only
- Kindergarten and above tuition — Educational, not custodial care
- Food and clothing for dependents — Not care expenses
- Activities and enrichment programs — Unless primarily custodial
- Transportation to/from care — Not eligible
- Babysitter for date night — Must be work-related
DCAP vs. Child Tax Credit
For some families, the Child and Dependent Care Tax Credit may be more valuable than a DCAP. The decision depends on your income level and tax bracket. Generally:
- Higher-income families (over ~$43,000 AGI) benefit more from the DCAP
- Lower-income families may benefit more from the tax credit
- You can use both, but expenses claimed through the DCAP can’t also be claimed for the tax credit
How to Submit FSA Claims
Benefits Debit Card
Most modern FSA plans issue a benefits debit card that works like a regular debit card at eligible merchants. When you swipe at a doctor’s office, pharmacy, or vision center, the card automatically pulls from your FSA balance.
Auto-substantiation means many transactions are approved automatically — especially at medical providers and pharmacies with IIAS (Inventory Information Approval System) compliance.
For some purchases, you may need to submit documentation after the fact. Keep your receipts.
Manual Claims Submission
For expenses not covered by your debit card, you can submit a manual claim:
- Pay out of pocket for the eligible expense
- Collect documentation — an Explanation of Benefits (EOB) from your insurer or an itemized receipt showing the date, provider, description, and amount
- Submit the claim through your TPA’s online portal or mobile app
- Receive reimbursement — typically via direct deposit within 3–5 business days
What Documentation Do You Need?
| Document Type | When Needed |
|---|---|
| Explanation of Benefits (EOB) | Best documentation — shows what insurance covered and what you owe |
| Itemized receipt | When no insurance claim was filed (e.g., OTC purchases) |
| Letter of Medical Necessity | For items that require medical justification (massage, gym, supplements) |
| Prescription | For certain items if requested by your TPA |
Tip: Most TPAs have mobile apps that let you snap a photo of your receipt and submit a claim in under a minute. Set this up at the beginning of the year.
Important FSA Deadlines
Plan Year
Most FSAs run on a calendar year (January 1 – December 31), but your employer may use a different plan year.
Grace Period vs. Rollover
Your plan will offer one of these (not both), or neither:
| Option | How It Works |
|---|---|
| $640 rollover | Up to $640 of unused funds carry over to next year automatically |
| 2.5-month grace period | You have until March 15 to incur expenses against last year’s balance |
| Neither | Unused funds are forfeited at plan year end — true “use it or lose it” |
Run-Out Period
After the plan year (or grace period) ends, you typically have 90 days to submit claims for expenses incurred during the plan year. After the run-out period, unsubmitted claims are gone.
Year-End Strategy
If you have unused FSA funds in Q4, consider:
- Scheduling dental cleanings or vision exams
- Stocking up on eligible OTC items (sunscreen, first aid, contact solution)
- Purchasing new prescription glasses or sunglasses
- Scheduling any medical procedures you’ve been putting off
- Buying larger quantities of FSA-eligible products you use regularly
The Bottom Line
Your Health FSA covers far more than most people realize. By understanding the full range of eligible expenses, you can maximize the value of your pre-tax contributions and avoid leaving money on the table. At year-end, consider using your balance on eligible items by reading Maximize FSA Before Year-End.
The key habits:
- Save every medical receipt — even for small purchases
- Check eligibility before assuming something doesn’t qualify — you’ll be surprised
- Set up your TPA’s mobile app for quick claim submission
- Review your balance quarterly to avoid year-end scrambles
- Budget conservatively in year one — you can always increase next year
Want to see how much an FSA could save you? Try our Value Calculator to estimate your annual tax savings based on your typical medical expenses.
This guide is for informational purposes and does not constitute tax or legal advice. FSA eligibility can change based on IRS guidance. Consult your plan administrator for your specific plan’s rules.
