You're standing in the pharmacy aisle, staring at a bottle of high-end sunscreen, wondering if Uncle Sam is going to foot the bill. It's a weird feeling. Having a Flexible Spending Account (FSA) is basically like having a secret stash of tax-free cash, but the rules feel like they were written by a Victorian tax collector. If you don't spend it, you lose it. That "use it or lose it" pressure is real, and it leads to a lot of frantic shopping at the end of December. But honestly, you shouldn't just be buying twenty boxes of Band-Aids on New Year's Eve.
Knowing what can you purchase with fsa card is the difference between wasting your hard-earned money and essentially getting a 30% discount on your entire life. It’s not just for doctor co-pays or boring gauze. We're talking high-tech health gadgets, skincare that actually works, and even some things that feel like they should definitely be "lifestyle" items but totally count as medical.
The Big Shift: Why Your FSA Card is More Powerful Now
A few years ago, the list of eligible items was pretty pathetic. You couldn't even buy Tylenol without a literal note from your doctor. It was a massive pain. Then the CARES Act of 2020 changed everything. Suddenly, over-the-counter (OTC) medications and menstrual products were back on the menu. This was a huge win for common sense.
The IRS (specifically under Internal Revenue Code Section 213(d)) defines "medical care" fairly broadly. It includes the diagnosis, cure, mitigation, treatment, or prevention of disease. That "prevention" part is the golden ticket. If a product is specifically designed to prevent a physical or mental defect or illness, there's a good chance your FSA card will work.
High-Tech Health: Beyond the Thermometer
Forget the cheap plastic thermometers that never work. Your FSA funds can buy some seriously cool tech. Take the Oura Ring or similar smart rings, for example. While you generally need a Letter of Medical Necessity (LMN) to prove you're tracking a specific condition like sleep apnea or heart rate variability for a medical reason, it’s becoming a standard way to spend those expiring funds.
Modern Diagnostic Tools
Air purifiers are another "maybe" that turns into a "yes" if you have allergies or asthma. You’ll need that LMN from your doctor, but once you have it, a $500 HEPA filter system is suddenly a tax-free purchase. The same goes for high-end blood pressure monitors that sync with your phone. Brands like Withings or Omron make sleek devices that don't look like they belong in a hospital, and they are almost universally eligible.
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Light therapy lamps are a lifesaver for people dealing with Seasonal Affective Disorder (SAD). If the winter blues hit you hard, your FSA card can cover a Verilux HappyLight. It’s a legitimate medical treatment for a recognized condition. No questions asked.
Skincare is Healthcare (Mostly)
This is where people get confused. You can’t buy a fancy night cream just because it makes you look like a movie star. If the primary purpose is cosmetic, the IRS says no. However, the sun is a giant ball of radiation trying to give you cancer. That makes sunscreen a medical necessity.
Anything with SPF 15 or higher is eligible. This includes:
- High-end mineral sunscreens from brands like Supergoop or EltaMD.
- Lip balms with SPF.
- Moisturizers that have broad-spectrum protection.
Acne treatments are also on the list. If you’re struggling with breakouts, your FSA card covers Neutrogena light therapy masks, Differin gel, and even those hydrocolloid pimple patches that everyone is obsessed with on TikTok. Since acne is a medical skin condition, the "cure and mitigation" rule applies.
The Family and Travel Staples
If you’ve got kids, the FSA is basically a 30% off coupon for the most expensive years of your life. Breast pumps? Covered. Replacement parts for those pumps? Covered. Baby monitors that track breathing or oxygen levels, like the Owlet, often qualify.
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And don't forget about travel. If you get motion sickness, those sea-bands or Dramamine are eligible. If you're flying and worried about Deep Vein Thrombosis, compression socks are a valid FSA purchase.
Surprising Items That Actually Count
Most people are shocked to find out what else makes the cut. It’s not all pills and bandages.
- Menstrual Products: Tampons, pads, liners, and even period underwear like Thinx are fully eligible. This was a long-overdue change.
- Neti Pots and Sinus Rinses: If you have allergies, these are essential, and they are 100% covered.
- Acupuncture: Surprisingly, many FSA plans cover alternative treatments like acupuncture or even chiropractic visits without much fuss.
- Condoms and Pregnancy Tests: Family planning is a massive part of the FSA scope. This includes everything from morning-after pills to ovulation trackers.
- Reading Glasses: You don't need a prescription for these. If you're squinting at your phone, grab a pair of Foster Grants and use the card.
Navigating the "Letter of Medical Necessity" (LMN)
Some items sit in a gray area. They are "dual-purpose." A massage is usually for relaxation (not covered), but if it’s to treat chronic back pain or recovery from an injury, it’s medical (covered).
To get these through, you need an LMN. It’s a simple document where your doctor states that the product or service is necessary to treat a specific medical condition. This opens the door to things like:
- Gym memberships (if treating obesity or hypertension).
- Weight loss programs (like WW, if recommended for a disease).
- Vitamins and supplements (if you have a specific deficiency like Vitamin D or Iron).
What You Definitely Can’t Buy
Don't try to buy a toothbrush. I know, it feels like it should be covered because it prevents cavities, but the IRS views it as "general health" or "toiletries." The same goes for toothpaste, floss, and mouthwash.
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Deodorant is a no. Shaving cream is a no. Vitamins for "general well-being" are also a no. Basically, if a healthy person uses it to stay clean or "feel good," the FSA card will likely be declined at the register.
How to Maximize Your FSA Spend Before It Vanishes
Check your balance now. Don't wait until December 31st when the websites crash and the shelves are empty.
Step 1: The Audit. Look through your medicine cabinet. Is your thermometer from 1994? Are your Band-Aids losing their stick? Do you have enough sunscreen for next summer?
Step 2: The Shopping List. Focus on the big-ticket items first. If you need a new pair of prescription glasses or contacts, that’s the fastest way to use up a couple hundred dollars.
Step 3: Use Specialized Sites. Websites like FSA Store are great because they only sell items that are guaranteed to be eligible. You don't have to guess. They even have a "scout" tool that looks at your past purchases.
Step 4: Keep the Receipts. Even if your FSA card works at the register, the administrator might ask for a receipt later to verify the purchase. Take a photo of it immediately and save it in a folder on your phone.
Actionable Next Steps to Take Today
- Log in to your benefits portal. Find out your exact balance and, more importantly, your deadline. Some plans have a "grace period" until March, while others have a "carryover" of up to $640 (for 2024/2025). Know which one you have.
- Check your "hidden" needs. Do you wear a night guard for teeth grinding? Those are expensive and FSA-eligible. Do you use a CPAP machine? Stock up on filters and masks.
- Schedule that appointment. If you've been putting off the eye doctor or the dermatologist, book it now. The exam fee and any resulting products (like prescription acne cream or glasses) will soak up that balance quickly.
- Stock the "First Aid Plus" kit. Don't just get bandages. Get a pulse oximeter, a high-quality heating pad for back pain, and cold packs. These are things you don't want to buy at 2 AM when you actually need them.
Knowing exactly what can you purchase with fsa card isn't just about spending money; it's about reclaiming part of your salary that would otherwise go to taxes. Use it to upgrade your health tech, fix your skin, or just make sure your family is prepared for the next flu season.