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FSA & HSA Eligibility Guide

Know what qualifies for tax-free health spending

What Are FSA & HSA Accounts?

FSA (Flexible Spending Account)

Employer-sponsored account. Use pre-tax dollars for medical expenses. "Use it or lose it" — funds typically expire at year-end (some plans allow a $610 rollover).

HSA (Health Savings Account)

Available with high-deductible health plans. Funds roll over indefinitely and can be invested. Triple tax advantage: deductible contributions, tax-free growth, and tax-free withdrawals for medical expenses.

CARES Act Update (2020+)

The CARES Act permanently expanded FSA/HSA eligibility to include most over-the-counter medications without a prescription, plus menstrual products. This means common drugs like ibuprofen, allergy pills, and heartburn meds now qualify.

Eligible Items

All prescription drugs

Any medication prescribed by a licensed physician

Insulin

Eligible even without a prescription

OTC pain relievers

Ibuprofen, acetaminophen, aspirin (CARES Act)

Allergy medications

Cetirizine, loratadine, fexofenadine (CARES Act)

Antacids & heartburn meds

Omeprazole, famotidine OTC (CARES Act)

Menstrual products

Tampons, pads, cups (CARES Act)

First aid supplies

Bandages, gauze, antiseptics

Sunscreen (SPF 15+)

Considered preventive care

Reading glasses

Including prescription glasses and contacts

Blood glucose monitors

Test strips and lancets included

Not Eligible

Vitamins & supplements

Unless prescribed to treat a specific condition

Cosmetics & personal care

Face wash, moisturizer, toothpaste (regular)

Gym memberships

Even if recommended by a doctor

Teeth whitening

Considered cosmetic, not medical

General wellness items

Essential oils, aromatherapy

Nutritional supplements

Protein powder, meal replacements

Quick Eligibility Checker

Common medications and their FSA/HSA eligibility status:

Metformin (prescription)Eligible
Atorvastatin (prescription)Eligible
Lisinopril (prescription)Eligible
Advil / Motrin (ibuprofen)Eligible
Tylenol (acetaminophen)Eligible
Zyrtec (cetirizine)Eligible
Prilosec (omeprazole OTC)Eligible
Insulin (all forms)Eligible
Centrum MultivitaminNot Eligible
Fish oil supplementsNot Eligible
Collagen supplementsNot Eligible
MelatoninNot Eligible

Eligibility may vary by plan administrator. When in doubt, check with your FSA/HSA provider or save your receipts and submit for reimbursement. A Letter of Medical Necessity from your doctor can make some otherwise-ineligible items (like vitamins) eligible.