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Information about all aspects of finances affected by a serious health condition. Includes income sources such as work, investments, and private and government disability programs, and expenses such as medical bills, and how to deal with financial problems.
Information about all aspects of health care from choosing a doctor and treatment, staying safe in a hospital, to end of life care. Includes how to obtain, choose and maximize health insurance policies.
Answers to your practical questions such as how to travel safely despite your health condition, how to avoid getting infected by a pet, and what to say or not say to an insurance company.

Summary

A Health Care FSA covers eligible healthcare expenses not reimbursed by any medical, dental or vision care plan you or your dependents may have.

Money in an FSA cannot be used:

  • To pay health insurance premiums.
  • For the costs of over-the-counter drugs which are not prescribed by a doctor. (Costs of over-the-counter drugs with a doctor's prescription are permitted to be reimbursed).

Health Care FSAs can be limited to paying or reimbursing Health Insurance Premiums, or can be more broad and cover qualified Medical Expenses.

The annual cap for a medical FSA is set by the employer and can vary from year to year.

Eligible dependents for this account include your spouse, children, and any other person who is a qualified IRS dependent.

A major advantage of Health Care FSAs is that you get a tax break on medical expenses without having to meet the threshold which the federal tax code requires in order to obtain a tax deduction. Even then, the deduction is only for expenses in excess of the threshold. The threshold for the itemized deduction for unreimbursed medical expenses is 10% of the taxpayer’s Adjusted Gross Income (AGI). However, in the years 2013–2016, if either the taxpayer or the taxpayer’s spouse has turned 65 before the close of the tax year, the threshold is 7.5% of AGI. In 2017 the 10% threshold will apply to all taxpayers (To learn more, see Medical Expenses)

To learn more about FSAs in general, see: FSA

Medical Expenses That Can Be Paid For With Funds From A Medical FSA

In general, qualified medical expenses are those specified in the plan. Plans can permit reimbursement for any service or product that is purchased in order to treat or mitigate an imminent or current medical condition and is not reimbursed by insurance or other means.

According to the IRS, it is also permissible to use money in a FSA to pay for nonprescription medications such as pain relievers and cold and allergy remedies and products such as fiber supplements and glucosamine provided that they are prescribed by a doctor. For safety, ask the doctor for the same type of prescription he or she would write for a drug that requires a prescription. 

Following are some items you may be able to pay for from an IRS point of view with FSA funds that you may not think can be paid from an FSA. Whether you can pay for them with an FSA depends on your particular plan.

  • Doctor prescribed nonprescription medicines. 
  • Eyeglasses or contact lenses.
  • Fertility treatments.
  • Chiropractic care.
  • Doctor recommended weight loss programs.
  • Dental work, including teeth cleaning (to schedule at year end).
  • Prescription sunglasses.
  • A bonus to your caregiver.
  • A doctor's written recommended testing or tutoring for a child with learning disabilities.
  • Infertility treatments.
  • Lasik eye surgery.
  • Herbal remedies recommended by a doctor to treat a specific medical condition.
  • Orthodontia.
  • All the expenses listed as Medical Expenses for federal income tax purposes.

You cannot use FSA funds to pay for:

  • Health insurance premiums.
  • Premiums for long term care insurance.
  • Amounts that are covered under another health plan.
  • Vitamins and other dietary supplements.
  • Cosmetics.
  • Toiletries such as shampoo and toothpaste.

Whose Medical Expense Can Be Paid For By An FSA

Any person's expenses that you claim as a dependent on your Federal income taxes.

It doesn't matter whether this person is on your employer's health insurance. It only matters that the person is a qualified dependent for income tax purposes.

Requirements Concerning Doctor Prescribed Over-The-Counter Drugs

In order for purchase of a doctor prescribed Over-the-counter drug to qualify for payment from an FSA:

  • A prescription must be presented to the pharmacist or other retail seller
  • A prescription number is assigned

A debit card can be used for over-the-counter drugs at drugstores, pharmacies, and at mail-order or web-based vendors.

FSA, HSA, and HRA

You cannot have both an HSA and a FSA, if you use the FSA to pay health care costs with pretax dollars. However, if your FSA restricts reimbursements to wellness care (such as annual physicals) and vision and dental care, you can have both an HSA and an FSA.

You cannot pay for the same item twice by paying once from each account. 

You can ask your employer to transfer the funds in your FSA or HRA to an HSA.