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EssentialUpdated for 2025
Common HSA/FSA Eligible Expenses
A comprehensive list of popular eligible expenses organized by category. These items can typically be purchased with your HSA, FSA, or HRA funds according to IRS guidelines.
Quick Guide: Most medical, dental, and vision expenses are eligible. Since the 2020 CARES Act, over-the-counter drugs and menstrual care products no longer require a prescription. Some items require a Letter of Medical Necessity (LMN) from your doctor.
New in 2020CARES Act Expanded Eligibility
The CARES Act made significant changes to HSA/FSA eligible expenses
Starting in 2020, these items became eligible without a prescription:
- ✓Over-the-counter medications - Pain relievers, cold medicine, allergy meds, etc.
- ✓Menstrual care products - Pads, tampons, liners, cups, and similar items
Medical Care & Services
Doctor Visits
View Results →- •Primary care appointments
- •Specialist consultations
- •Co-pays and deductibles
Hospital Services
View Results →- •Inpatient care
- •Outpatient surgery
- •Emergency room visits
Mental Health Services
View Results →- •Therapy sessions
- •Psychiatrist visits
- •Counseling
Chiropractic Care
View Results →- •Adjustments
- •Spinal manipulation
- •Treatment for back pain
Physical Therapy
View Results →- •Rehabilitation
- •Injury recovery
- •Post-surgery therapy
Acupuncture
View Results →- •Pain management
- •Chronic condition treatment
Prescription Medications
Prescription Drugs
View Results →- •Any medication prescribed by a physician
- •Prescription refills
- •Specialty medications
Insulin
View Results →- •All insulin products
- •No prescription required for HSA/FSA
Over-the-Counter (OTC) Products
OTC Pain RelieversCARES Act
View Results →- •Tylenol (acetaminophen)
- •Advil/Motrin (ibuprofen)
- •Aleve (naproxen)
- •Aspirin
Cold & Flu MedicationsCARES Act
View Results →- •Cough syrup
- •Decongestants
- •Throat lozenges
- •Nasal sprays
Allergy MedicationsCARES Act
View Results →- •Antihistamines
- •Claritin
- •Zyrtec
- •Benadryl
Digestive HealthCARES Act
View Results →- •Antacids
- •Anti-diarrheal
- •Laxatives
- •Pepto-Bismol
- •Tums
First Aid Supplies
View Results →- •Bandages
- •Gauze
- •Antibiotic ointments
- •Alcohol wipes
- •Medical tape
Menstrual Care ProductsCARES Act
View Results →- •Pads
- •Tampons
- •Menstrual cups
- •Period underwear
- •Liners
COVID-19 Tests
View Results →- •At-home rapid tests
- •PCR test kits
- •Antigen tests
Dental Care
Preventive Care
View Results →- •Cleanings
- •Exams
- •X-rays
- •Fluoride treatments
Restorative Procedures
View Results →- •Fillings
- •Crowns
- •Root canals
- •Bridges
Orthodontia
View Results →- •Braces
- •Retainers
- •Invisalign
Oral Surgery
View Results →- •Tooth extractions
- •Wisdom teeth removal
- •Dental implants
Vision Care
Eye Exams
View Results →- •Routine vision tests
- •Contact lens fittings
- •Glaucoma screenings
Eyeglasses
View Results →- •Prescription lenses
- •Frames
- •Lens coatings
- •Repairs
Contact Lenses
View Results →- •Prescription contacts
- •Contact lens solution
- •Storage cases
Laser Eye Surgery
View Results →- •LASIK
- •PRK
- •Vision correction procedures
Durable Medical Equipment (DME)
Mobility Aids
View Results →- •Wheelchairs
- •Walkers
- •Canes
- •Crutches
- •Scooters
Monitoring Devices
View Results →- •Blood pressure monitors
- •Blood glucose meters
- •Thermometers
- •Pulse oximeters
Breathing Equipment
View Results →- •Nebulizers
- •CPAP machines
- •Oxygen concentrators
Hearing Aids
View Results →- •Prescription hearing devices
- •Batteries
- •Repairs
Orthopedic Items
View Results →- •Braces
- •Splints
- •Compression stockings
- •Back supports
Conditional Expenses (Require LMN)LMN Required
Massage TherapyLMN Required
View Results →- •Therapeutic massage for diagnosed conditions
Gym MembershipsLMN Required
View Results →- •Medically necessary fitness programs
- •Doctor-prescribed exercise
Weight Loss ProgramsLMN Required
View Results →- •Programs for obesity (diagnosed condition)
- •Doctor-supervised plans
Special DietsLMN Required
View Results →- •Medically necessary food substitutes
- •Gluten-free for celiac disease
Common Non-Eligible Expenses
These items are typically NOT eligible
Even with HSA/FSA funds available, these expenses usually cannot be reimbursed
- ✗General vitamins and supplements (unless prescribed for specific condition)
- ✗Cosmetic procedures (unless for medical reconstruction)
- ✗Teeth whitening
- ✗Hair transplants
- ✗Over-the-counter supplements for general health
- ✗Gym memberships for general fitness
- ✗Most alternative medicine without LMN
Important: Some items on this list may become eligible with a Letter of Medical Necessity (LMN) from your physician if prescribed for a specific medical condition. Learn more about LMNs.
How to Use This List
Search for Specific Items
Use our search tool to look up specific products or services for detailed eligibility information.
Go to Search ToolKeep Your Receipts
Always save itemized receipts showing the product name, purchase date, and amount spent. You may need these for substantiation.
Learn MoreCheck Your Plan Rules
While IRS rules determine general eligibility, your specific plan administrator may have additional restrictions. Always verify with your plan before making large purchases.
Understand LMN Requirements
Some expenses require a Letter of Medical Necessity from your doctor. Don't skip this step or your claim may be denied.
Understanding LMNOfficial IRS Guidance
Source Documents
This list is based on official IRS publications
IRS Publication 502 (2025)
Medical and Dental Expenses - The comprehensive guide to qualified medical expenses.
IRS Publication 969 (2025)
Health Savings Accounts and Other Tax-Favored Health Plans.
CARES Act Guidance
Official guidance on OTC drugs and menstrual care product eligibility changes.
Related Articles
Disclaimer: This information is for educational purposes only and should not be construed as tax, legal, or financial advice. Eligibility rules are subject to change and plan-specific rules may vary. Always consult with your plan administrator and keep receipts for all purchases. Information is current as of 2025 based on IRS Publication 502 and Publication 969.