What are FSA eligible items? Your 2025 savings guide

Flexible spending accounts (FSAs) are a valuable tool for managing out-of-pocket healthcare expenses while saving money through pre-tax contributions. However, maximizing the benefits of an FSA requires a clear understanding of which expenses qualify for reimbursement. 

From medical supplies and prescriptions to dental care and vision needs, knowing what’s eligible can help employees make smarter spending decisions and avoid leaving funds unused.

In this 2025 savings guide, we’ll outline the latest list of FSA-eligible items, highlight key changes to be aware of, and provide tips to help you get the most value from your FSA funds. 

Key takeaways

• FSA-eligible items include medical, dental, and vision expenses like prescriptions, copays, thermometers, OTC medications, menstrual products, and preventive care services. Some require a Letter of Medical Necessity (LMN).
• Surprising FSA-eligible items include sunscreen (SPF 15+), breast pumps, guide dog expenses, smoking cessation products, and transportation costs related to medical care.
• Ineligible expenses typically include cosmetic procedures, gym memberships for general health, diapers, supplements (unless medically necessary), and childcare (unless under a dependent care FSA).
• Use tools to confirm eligibility like plan documents, FSAFEDS guidelines, online eligibility checkers (FSAStore), or by consulting your plan administrator to avoid claim rejections.
• Maximize your FSA funds by planning for predictable expenses, using funds for dental cleanings, eye exams, OTC products, and stocking up on eligible health supplies before year-end.
• Avoid losing unused funds under the FSA "use-it-or-lose-it" rule by scheduling end-of-year appointments, restocking medical essentials, and considering eligible items like prescription sunglasses or orthotics.

What are FSA eligible items?

FSA eligible items are expenses that can be reimbursed through your Flexible Spending Account. These include a wide range of medical products and services that are primarily used to diagnose, treat, or prevent a disease or health condition.

The US Internal Revenue Service determines which expenses qualify for FSA reimbursement. Eligible items must be medically necessary and not just for general health or cosmetic purposes.

Categories of FSA eligible items for 2025

Here is a quick overview of FSA eligible item categories with examples.

Always check with your plan administrator to confirm eligibility before making a purchase. Please note that some of the items here are not generally covered by FSAs. However, with proper documentation, such as a Letter of Medical Necessity (LMN), they may still be eligible.

• Home healthcare: Includes thermometers, pain relief devices, blood pressure monitors, medical alert devices, blood sugar test kits, and similar items.
• Over-the-counter medications (OTC): Covers products for cough, cold, allergies, pain relief, and other common conditions.
• Baby and child supplies: Includes breast pumps, baby breathing monitors, children’s pain relievers, and related products.
• Skin care: Covers sunscreen, acne treatments, lip balm with SPF 15 or higher, and more.
• Eye care: Includes prescription-required contact lenses, eye drops, and related items.
• Oral care: Covers tooth pain relief products, water flossers (with a letter of medical necessity), denture cleanser tablets, and more.
• Foot care: Includes orthotics, foot creams, callus and corn removers, and other related items.
• Digestive health: Covers heartburn relief products, antacid tablets, laxatives, and similar items.
• Vitamins and supplements: Includes prenatal vitamins and nutritional supplements with a letter of medical necessity (LMN).
• First aid supplies: Covers bandages, antibiotic ointments, first aid kits, and related items.
• Sexual health: Includes OTC and prescription birth control, condoms, erectile dysfunction medications (with a prescription), fertility tests, and more.
• Menstrual products: Covers pads, tampons, and menstrual pain relief products.
• Incontinence supplies: Includes pads, and related items.
• Smoking cessation: Covers smoking cessation programs and products to aid in quitting.

Categories of FSA eligible expenses for 2025

FSA eligible items fall into several categories, each covering a specific aspect of healthcare. Understanding these categories can help you plan your FSA spending and maximize your savings.

Here are some of the most common expenses that qualify for FSA reimbursement. Be sure to verify with your plan administrator to ensure these expenses are covered under your specific FSA plan:

• Health plan costs such as copayments, office visits, coinsurance payments, and deductibles
• Dental procedures and services
• Vision care, including eyeglasses and prescription contact lenses
• Prescription medications
• Therapy and counseling services (an LMN may be required; note that marriage or family counseling is not eligible)
• Chiropractic treatments and acupuncture sessions
• Hospital fees, surgeries, and diagnostic procedures
• Allergy testing and related services

How to determine FSA eligibility

Understanding FSA eligible items can be challenging, especially with the wide range of products and services available. However, there are several resources you can use to determine whether an expense qualifies for FSA reimbursement.

Check your FSA plan documentation

Your FSA plan documents, provided by your employer or third party administrator (TPA), should include a list of eligible expenses. These documents may also outline any specific requirements or restrictions for your plan. Reviewing this information is a good starting point when determining FSA eligibility. Most of your eligibility concerns will be addressed through the TPA documentation.

Consult the FSAFEDS Guidelines

For the most accurate and up-to-date information on eligible expenses, refer to the FSAFEDS guidelines. FSAFEDS provides a detailed and comprehensive list of items that qualify for reimbursement under Health Care FSAs and Limited Expense FSAs (LEX HCFSA). While eligibility may vary slightly depending on the type of FSA, FSAFEDS serves as a reliable resource to understand which medical and healthcare expenses generally qualify.

You can visit the FSAFEDS website to explore eligible expenses, specific documentation requirements, and any conditions, such as needing a prescription or a Letter of Medical Necessity (LMN), for certain items.

Use an FSA eligibility checker tool

Many FSA administrators offer online tools that allow you to search for specific items or services to determine their eligibility. These tools are regularly updated to reflect changes in IRS regulations and can provide quick answers to your eligibility questions.

Some popular FSA eligibility checker tools include the FSA Store Eligibility List and the SIGIS Eligible Products List.

Ask your FSA administrator

If you're still unsure about an item's eligibility after reviewing your plan documents and checking online resources, don't hesitate to contact your FSA administrator directly. Your TPA can provide guidance specific to your plan and help you determine whether an expense qualifies for reimbursement.

Your FSA administrator may require additional documentation, such as a letter of medical necessity from a healthcare provider, for certain expenses. They can also assist you with the claims process and answer any questions you have about using your FSA funds.

What are some surprisingly FSA eligible items?

While many people are familiar with common FSA eligible expenses like prescription medications and doctor's office copays, there are some surprising items that also qualify for reimbursement. Here are a few examples that may catch you off guard:

• Sunscreen with SPF 15+: Sunscreen is not just a summertime necessity; it's also an FSA eligible item. As long as the sunscreen has an SPF rating of 15 or higher, you can use your FSA funds to purchase it. This includes sunscreen lotions, sprays, and lip balms. The SPF 15+ requirement aligns with recommendations from major health authorities, such as the FDA, which considers SPF 15 as the minimum level needed to provide adequate protection against harmful UVA and UVB rays.
• Breast pumps and lactation supplies: If you're a new mother, you can use your FSA to cover the cost of a breast pump and related supplies. This includes items like breast milk storage bags, nursing pads, and nipple cream. These items are eligible without a prescription or letter of medical necessity.
• Guide dog expenses: If you have a guide dog or service animal, certain expenses related to their care may be FSA eligible. This can include the cost of purchasing, training, and maintaining the animal, as well as veterinary care and food specifically prescribed for the animal's health.
• Smoking cessation programs: If you're trying to quit smoking, your FSA can help cover the cost of smoking cessation programs and products. This includes nicotine gum, patches, lozenges, and inhalers, as well as smoking cessation classes or programs prescribed by a doctor.

Other surprising FSA eligible items include:

• Acupuncture and chiropractic care
• Orthopedic shoe inserts and custom-molded shoes
• Fertility treatments, including in vitro fertilization (IVF)
• Home modifications for medical reasons, such as installing handrails or widening doorways
• Transportation costs related to medical care, including mileage, parking fees, and tolls

It's important to note that eligibility requirements may vary depending on your specific FSA plan. Always check with your plan administrator or consult your plan documents to confirm whether an item or service qualifies for reimbursement.

What expenses are not FSA eligible?

While FSAs provide significant tax savings for many healthcare expenses, not all items or services qualify for reimbursement. It's important to understand which expenses are not FSA eligible to avoid confusion and potential rejection of your claims.

Cosmetic procedures

Cosmetic procedures and treatments that are not medically necessary are generally not FSA eligible. This includes things like teeth whitening, hair removal, and cosmetic surgery. However, if a cosmetic procedure is required for a medical reason, such as reconstructive surgery after an accident, it may qualify for FSA reimbursement with proper documentation from a healthcare provider.

General health and wellness

Gym memberships and fitness programs for general health and wellness are not FSA eligible. However, if a gym membership or fitness program is prescribed by a doctor for a specific medical condition, such as physical therapy or rehabilitation, it may be eligible with a letter of medical necessity.

Childcare expenses

Childcare expenses for regular babysitting or daycare are not FSA eligible. However, if you have a dependent care FSA (DCFSA), you can use those funds to pay for eligible childcare expenses that allow you to work, look for work, or attend school full-time.

Other expenses that are not FSA eligible include:

• Nutritional supplements for general health (unless prescribed by a doctor)
• Toiletries and personal care items like toothpaste and shampoo
• Diapers and baby formula (unless prescribed for a medical condition)
• Funeral expenses
• Illegal operations or treatments

If you're unsure whether an expense is FSA eligible, consult your plan documents or contact your FSA benefits platform provider for guidance. They can help you determine if an item or service qualifies and what documentation may be required for reimbursement.

Tips to maximize your FSA savings

Here are some strategies to help you make the most of your FSA funds and save money on healthcare expenses.

Plan ahead for predictable medical expenses

Many medical expenses are predictable, such as annual check-ups, dental cleanings, or recurring prescriptions. At the beginning of each plan year, take some time to estimate these expected costs and set aside appropriate funds in your FSA. This proactive approach ensures you have the necessary funds available when you need them, reducing out-of-pocket expenses.

Use your FSA for eye exams, dental cleanings, and more

FSAs cover a wide range of preventive care services, including eye exams, dental cleanings, and routine check-ups. These services help maintain your overall health and can prevent more serious (and expensive) issues down the line. By using your FSA funds for these regular appointments, you can save money on essential healthcare while prioritizing your well-being.

Check for FSA eligible items before paying out of pocket

Before purchasing any health-related products or services, check if they are FSA eligible. Many items you might not expect, such as sunscreen, first aid kits, and transportation costs for medical appointments, can be covered by your FSA. By verifying eligibility beforehand, you can avoid unnecessary out-of-pocket expenses and maximize your FSA savings.

Don't forget about over-the-counter products

FSAs can be used for a variety of over-the-counter (OTC) products, such as pain relievers, allergy medications, and bandages. With the passage of the CARES Act in 2020, many OTC items no longer require a prescription for FSA reimbursement. Keep this in mind when shopping for everyday healthcare essentials, as you can likely use your FSA funds to cover these purchases.

How to spend down your FSA balance

As the end of the plan year approaches, it’s important to understand the “use-it-or-lose-it” policy that applies to most FSAs. Any unused funds may be forfeited, so having a strategy to spend down your balance can help you make the most of your hard-earned contributions.

Schedule end-of-year appointments

Take advantage of your remaining FSA funds by scheduling any necessary medical, dental, or vision appointments before the end of the plan year. This could include annual check-ups, dental cleanings, eye exams, or any other eligible services you've been putting off. Not only will you make the most of your FSA dollars, but you'll also prioritize your health and well-being.

Stock up on eligible health products

Your FSA can be used to purchase a wide variety of eligible health products, such as first aid supplies, over-the-counter medications, and medical equipment. Before your plan year ends, take inventory of your medicine cabinet and restock any items you may need in the coming months. While “stockpiling” is not permitted, purchasing these items in amounts that can reasonably be used during the plan year is allowed.

Don't forget about less obvious eligible expenses like sunscreen, orthopedic shoe inserts, or a blood pressure monitor. Stocking up on these items now allows you to use your remaining FSA balance while preparing for future healthcare needs.

Consider prescription sunglasses or backup glasses

If you wear prescription glasses or contact lenses, consider using your FSA funds to purchase a backup pair of prescription sunglasses. Having a spare set of glasses can be a lifesaver in case of loss, damage, or for different activities like driving or sports. 

Prescription sunglasses not only provide vision correction but also protect your eyes from harmful UV rays. These purchases are typically FSA eligible and can help you use up remaining funds while investing in your eye health.

Final thoughts

Maximizing the value of your Flexible Spending Account (FSA) requires careful planning and a clear understanding of eligible expenses. By staying informed and strategically managing your FSA balance, you can take full advantage of this powerful benefit to save money on essential healthcare costs.

For companies looking to offer streamlined, flexible benefits that meet the diverse needs of today’s workforce, partnering with a trusted TPA makes all the difference. Forma, a leading flexible benefits platform, simplifies benefits management, ensures compliance, and empowers employees to make the most of their accounts. Trusted by companies like Honda, lululemon, and Tripadvisor, Forma delivers a seamless experience for both employers and employees.