If your employer offers a flexible spending account (FSA) as a fringe benefit, you probably already know that it is an easy way to save a little money on healthcare. An FSA is a special account in which employees can deposit pre-tax dollars. You can then use that money to pay for certain out-of-pocket healthcare expenses.
When most people think about eligible FSA expenses, they usually consider the usual suspects: copays, over-the-counter medicine, and high-priced dental work, to name a few.
Every year, my husband and I set aside a good chunk of money in our FSA. We have four kids who are fond of riding skateboards and jumping out of trees, so we tend to spend it long before the end of the year. (The urgent care nurse already knows my son’s favorite bandage color.)
But if your family is not quite as accident prone as mine, you might worry that you’ll set aside more than you can spend. After all, the IRS requires you to use all of the money in your account by the end of the year, with a little flexibility for carryover depending on your plan sponsor’s rules.
However, many people are surprised to learn that there are a lot of unique products and services that are eligible FSA expenses.
Eligible FSA Expenses
You can use the money in your FSA to pay for many different expenses for yourself, your spouse, and your dependents. The IRS decides which expenses are eligible and which are not.
There are three basic types of FSAs.
Health Care FSA (HCFSA)
Use this type of FSA to cover healthcare expenses for yourself and your family. For the most part, the IRS determines eligibility based on the product’s use and necessity. If they deem the product necessary to treat or prevent a health problem, it is often reimbursable.
Limited Expense Health Care FSA (LEX HCFSA)
You can use the money in this type of FSA to pay for some dental and vision care products and services. The expenses can be for you, your spouse, or your dependents.
Dependent Care FSA (DCFSA)
You can use your DCFSA to pay for services that you need to care for a dependent child or adult. For the most part, the IRS determines the eligibility of these expenses based on work-related necessity. In other words, if you need the service in order to work, it might be one of the eligible FSA expenses.
So what qualifies for FSA? Let’s take a look at 51 surprisingly eligible FSA expenses:
- AA Meetings: (HCFSA) Many people have used the Alcoholics Anonymous program to successfully treat addiction. The program doesn’t charge people for meetings, but they do accept donations.
- You can also use your Health Care FSA to pay for transportation to said meetings. In fact, transportation to any medical care is an eligible expense.
- Parking (HCFSA) If you have to pay for parking at your doctor’s office, you can charge it to your FSA.
- Airfare: (HCFSA) If you, your spouse, or your dependent child needs to see a doctor out of town, you can pay for your plane ticket with your HCFSA. You’ll have to show the plan administrator documentation to prove that the travel is healthcare related.
- Acupressure: (HCFSA) Do you have body pain, nausea, or anxiety? If so, you might want to use your FSA to pay for acupressure.
- Acupressure mats and wristbands are eligible, too. In some cases, you might need a letter of medical necessity (LMN).
- Acupuncture: (HCFSA) Some people prefer acupuncture to relieve pain, promote sleep, or improve digestion, and it’s one of the eligible FSA expenses, too. You may need an LMN.
- Air conditioning: (HCFSA) Some people with certain respiratory illnesses and allergies need air conditioning to filter the air in their homes and allow them to keep the windows closed (and thus keep pollen out!) You’ll have to have an LMN to get reimbursement.
- Childcare: (DCFSA) You can charge certain childcare expenses, including daycare, after school programs, or extended care, to your DCFSA. However, this expense is only eligible for reimbursement if you need it for you or your spouse to work.
- Childcare agency fees: (DCFSA) To avoid a long, drawn-out process of wading through applications and interviewing a long list of childcare providers, families can use a childcare agency to help them find a nanny. If you use an agency like this to help you find childcare so that you or your spouse can work, you might be able to use DCFSA funds to pay for it.
- Adult day care: (DCFSA) If the expense is work-related and the adult in question has a medical or mental health condition that limits his or her self-care capabilities, it is DCFSA eligible.
- Au pair: (DCFSA) Your DCFSA will also reimburse you for au pair expenses. An au pair is typically a young nanny from another country who comes to live with you to help with childcare.
- Hypoallergenic pillows and pillow protectors: (HCFSA) People who suffer from allergies to dust, pollen, and other things floating in the air might use these products to keep their symptoms at bay while they sleep. In some cases, your HCFSA will reimburse you for these products with an LMN.
- Hypoallergenic mattress covers are eligible FSA expenses, too!
- Alternative healers: (HCFSA) Are you into “natural medicine”? Homeopathy, naturopathy, energy therapy, chiropractic, and reiki are just a few examples of alternative healing that are FSA eligible.
- Anti-snore guards: (HCFSA) If you have an LMN stating that you need it to treat a medical condition, your anti-snore guard may be eligible for FSA reimbursement.
- Arch support: (HCFSA) Use shoe inserts if you were born with high arches in your feet! They may be considered eligible FSA expenses.
- Compression gloves: (HCFSA) These can help ease arthritis pain.
- Intrauterine insemination: (HCFSA) IUI is used to treat infertility. It is a process whereby a doctor injects sperm directly into the mother’s uterus to aid in conception.
- In Vitro Fertilization: (HCFSA) IVF is another artificial fertility treatment.
- Automobile modifications: (HCFSA) If you have an LMN stating that you need to modify your vehicle because of a disability, this is an FSA eligible expense.
- Baby breathing monitor: (HCFSA) Some parents of newborns use these monitors to prevent sudden infant death syndrome (SIDS).
- Baby formula: (HCFSA) If your pediatrician gives you an LMN stating that your baby needs a specialized formula, then the difference between the price of the special formula and the price of regular infant formula can be charged to your FSA.
- Diaper rash cream: (HCFSA) You’ll need a prescription for this one.
- Sunscreen: (HCFSA)
- Batteries: (HCFSA) If you use them to power a medical device, your batteries are FSA eligible.
- Bed-wetting aids: (HCFSA) If you have an older child or adult in your family who suffers from nighttime incontinence, you can use your FSA to pay for their overnight pull-ups or absorbent mattress pads.
- Birth control pills: (HCFSA) If you have a prescription, your FSA can pay for birth control pills and other contraception such as:
- Contraception patch,
- Vaginal birth control rings
- intrauterine devices (IUDs), and
- Spermicidal creams
- Condoms: (HCFSA) Birth control methods that don’t use an active medical ingredient are FSA eligible expenses, too, and they don’t require a prescription.
- Books: (HCFSA) If your doctor recommends that you read a health-related book (and he or she is willing to give you an LMN), then you can charge that expense to your FSA.
- Braille books: (HCFSA) Your FSA will reimburse you for the difference between the price of the braille book and the same book in non-braille form.
- Breast implant removal: (HCFSA) If the implants are causing you health problems and you have an LMN, your FSA will reimburse you for this.
- Breast pump: (HCFSA) Many working mothers couldn’t breastfeed without a breast pump, so this is a covered expense. Many other breastfeeding products are eligible for FSA reimbursement too, including:
- Breast milk storage bags
- Breast milk bottles
- Absorbent breast pads
- Breastfeeding classes, and
- Breast pump bustier
- Lip balm: (HCFSA) No prescription needed!
- Personal trainer: (HCFSA) If you have diabetes or extreme obesity, your payments to your personal trainer can be FSA eligible with an LMN.
- Gym membership: (HCFSA) The requirements for your health club fees are basically the same as the personal trainer requirements.
- Denture adhesive: (HCFSA, LEX FSA) Everyone with dentures needs this to keep their “teeth” in place.
- Dental veneers: (HCFSA, LEX FSA) Use these to brighten your smile. You’ll need an LMN for this one.
- Hand sanitizer: (HCFSA) You’ll need a prescription since it contains an active medical ingredient, but you can use your FSA to pay for hand sanitizer.
- Halfway house: (HCFSA) People leaving an inpatient facility for addiction treatment sometimes live in a halfway house, or a sober living house, to help them ease the transition back to their lives. This requires an LMN.
As always, you should reference your specific FSA policy on eligible expenses. But you may be surprised what is available.
This article is for informational purposes and is not meant to provide legal, regulatory, accounting, or tax advice.