Learn What You Can Buy With Your FSA Card

What Is an FSA Card and How Does It Work

A Flexible Spending Account (FSA) card is a debit card issued by your employer's health plan administrator. It functions like a regular debit card but connects directly to your FSA funds—money you've set aside pre-tax from your paycheck specifically for medical expenses. When you use the FSA card at a pharmacy, doctor's office, or medical retailer, the transaction is processed through your FSA account rather than your personal bank account.

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The FSA card system operates on a "use it or lose it" principle. According to the IRS, most FSA plans allow workers to set aside up to $3,300 annually (as of 2024) for healthcare costs. Some employers offer a grace period or carry-over option of up to $640, but funds generally must be spent within the calendar year. The card makes spending FSA funds straightforward because you don't need to submit receipts for most transactions—the system automatically verifies whether your purchase is FSA-eligible at the point of sale.

Understanding how the FSA card connects to your account helps you make informed spending decisions throughout the year. The card typically shows your current FSA balance, allowing you to track how much money remains available. Most FSA card providers offer online accounts or mobile apps where you can monitor spending history, check your balance, and review what purchases were approved or denied.

Practical takeaway: Review your FSA plan documents to confirm whether your employer offers an FSA card, what your annual contribution limit is, and whether your plan includes a grace period or carry-over option. This information shapes your spending strategy for the year.

Medical Expenses Covered by FSA Cards

FSA cards cover a wide range of medical expenses that relate to diagnosing, treating, and managing health conditions. The IRS maintains a detailed list of qualified medical expenses, which includes doctor visits, hospital care, prescription medications, and preventive services. Common FSA-eligible items include copays and coinsurance amounts, which are the portions of medical bills you're responsible for paying out-of-pocket.

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Prescription medications represent one of the largest FSA spending categories. You can use your FSA card at any pharmacy to pay for FDA-approved prescription drugs and insulin. Additionally, many over-the-counter medications are FSA-eligible if you obtain a prescription from your doctor—this includes pain relievers like ibuprofen, allergy medications, cold and flu remedies, and antacids. According to pharmacy benefit data, approximately 35-40% of FSA card transactions involve prescription fills or OTC medication purchases with prescriptions.

Beyond medications, FSA cards cover medical equipment and supplies. This includes items such as blood glucose monitors, test strips, lancets, thermometers, crutches, wheelchairs, hearing aids, glasses, and contact lenses. Dental and vision care are fully covered—FSA funds can pay for dental cleanings, fillings, root canals, eye exams, prescription glasses, and contact lenses. Mental health services, including therapy sessions and psychiatric care, are also FSA-eligible.

Other common eligible expenses include medical transportation (mileage to doctor appointments at the IRS standard rate or actual public transportation costs), medical procedures and surgeries, physical therapy, acupuncture, and certain wellness programs. However, expenses related to cosmetic procedures that don't treat a medical condition—such as teeth whitening purely for appearance—are not FSA-eligible.

Practical takeaway: Keep a running list of anticipated medical expenses for the year, including regular prescriptions, scheduled procedures, and preventive care. Cross-reference planned expenses against the IRS-qualified list to estimate your FSA contribution and avoid over-contributing funds you cannot spend.

Common Items NOT Covered by FSA Cards

Many health-related purchases seem like they should be FSA-eligible but are not. Understanding what you cannot purchase helps you avoid declined transactions and prevents accidentally spending personal funds when you thought FSA coverage applied. One major category of ineligible items includes general wellness products that lack a medical diagnosis or treatment purpose. For example, vitamins and supplements are not FSA-eligible unless prescribed by your doctor to treat a specific medical condition. A multivitamin for general health maintenance cannot be purchased with your FSA card, but a B12 supplement prescribed to treat pernicious anemia can be.

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Over-the-counter items fall into a gray zone. Most OTC medications (pain relievers, cough syrups, antihistamines, antacids) became FSA-eligible again in 2020, but they require a prescription from your doctor. However, other OTC items like bandages, antiseptic wipes, and pain relief creams may or may not be eligible depending on your specific plan—the FSA card will indicate approval or denial at the point of sale. Items like tissues, hand sanitizer, and soap are not FSA-eligible, even though they might relate to health.

Cosmetic and appearance-related expenses are generally not covered. Teeth whitening, hair loss treatments (unless treating a medical condition like alopecia with doctor supervision), and skincare products are typically ineligible. Similarly, gym memberships and fitness equipment are not FSA-eligible, though some employer wellness programs may reimburse gym costs through different mechanisms outside the FSA.

Health insurance premiums themselves cannot be paid with FSA cards. You cannot use FSA funds for your health plan's monthly premiums, deductibles applied before eligible services, or health insurance copays in some circumstances (specific rules vary by plan type). Additionally, services from non-licensed practitioners may be ineligible—for instance, massage therapy by a licensed massage therapist treating a medical condition might be eligible, but a spa massage for relaxation is not.

Practical takeaway: Before making a purchase with your FSA card, confirm eligibility by checking your plan documents or asking your FSA plan administrator. Declined transactions waste time and may require resubmission of receipts for manual review.

How to Use Your FSA Card at Different Retailers and Providers

FSA cards work differently depending on where you're shopping. At pharmacy counters, the process is usually seamless. When you present your FSA card alongside a prescription, the pharmacy system automatically verifies whether the medication is FSA-eligible and processes the payment. You won't need to provide additional documentation for standard prescription fills. For OTC medications with a prescription, the pharmacy may request the prescription on file before accepting the FSA card payment.

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At doctor's offices and hospitals, FSA card usage typically occurs at the checkout or billing desk after your visit. Medical providers increasingly integrate FSA card processing into their payment systems, making it nearly automatic. However, some offices still require manual verification or may ask you to pay and request reimbursement later. When scheduling appointments, ask whether the office accepts FSA cards directly; if not, obtain an itemized receipt for your records so you can submit a reimbursement claim to your FSA plan administrator.

Medical retailers—such as eyewear shops, hearing aid centers, and orthopedic supply stores—usually accept FSA cards without issue. Many of these retailers specifically market FSA acceptance because medical equipment represents a significant expense. When purchasing glasses or contacts at an optical shop, present your FSA card like a regular debit card. The same applies to purchasing medical equipment like blood glucose monitors, mobility aids, or CPAP machines.

Online retailers pose special considerations. Some major pharmacy and medical supply websites accept FSA cards directly, including Amazon's pharmacy section, Walgreens.com, CVS.com, and specialized medical supply retailers. When shopping online, the FSA card processes similarly to any debit card. However, not all online retailers verify FSA eligibility automatically, meaning you might be able to purchase ineligible items. Pay close attention to what you're ordering to ensure compliance with FSA rules.

Certain retailers, particularly large chains like Target and Walmart, accept FSA cards in-store for eligible items, but the system may not automatically verify eligibility. This creates a risk: the card might be declined for ineligible items, or you might successfully purchase something that later requires documentation. A general rule is that if you're buying something from a shelf in a general retail store (rather than a pharmacy or medical specialty retailer), verify FSA eligibility before purchasing.

Practical takeaway: Before visiting a new provider or retailer, confirm they accept FSA cards. Keep receipts for all FSA purchases, even when the card is accepted at point of sale, because your plan administrator may request proof of eligibility for audit purposes.

Managing Your FSA Card Balance