10 Unexpected Health Costs Your FSA Covers (and 10 it Doesn't)

A flexible spending account is a useful tool for saving on the high costs of health care. But the first step is knowing how to use it.
Updated April 11, 2024
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Your flexible spending account — better known as an FSA — is a great tool for budgeting health-related expenses.

Unlike other savings accounts, the money you put in an FSA is not subject to taxes. And it’s possible your employer will make contributions to your FSA, which is an overlooked way to add a little more cash to your pocket.

However, navigating what is and isn’t eligible for FSA spending can be challenging. Here are 10 surprising expenses that your FSA covers and 10 that it doesn’t.

Crutches (Covered)

mkitina4/Adobe disabled woman with crutches

If you break a body part or have a similar injury, your doctor might recommend using one or two crutches to properly allocate your body weight.

Whether you buy or rent crutches, you can use your FSA to cover the cost.

Pregnancy tests (Covered)

Prostock-studio/Adobe happy afro couple holding pregnancy test with positive result

You can include the cost of a pregnancy test in your FSA. Sure, these aren’t usually a major expense, but every little bit you save adds up.

Dentures (Covered)

wutzkoh/Adobe dentures with dentist working on table in clinic

Dentists may suggest having teeth removed for many different health reasons. In some cases, this might require partial or complete dentures.

Fortunately, dentures are eligible for FSA spending.

Guide dog (Covered)

hedgehog94/Adobe guide dog helping blind man in the city

Guide dogs are highly trained animals that assist and improve the quality of life of those living with disabilities. The cost of a guide dog is covered by an FSA.

This includes any costs related to the purchasing, training, and general care of a guide dog or other service animal.

Hearing aids (Covered)

Alexander Raths/Adobe hearing aid

Not only can you include the cost of a hearing aid in your FSA, but you can also include the cost of maintaining a hearing aid.

This includes things like the purchasing of new batteries, repairs, and general maintenance.

Eyeglasses (Covered)

Production Perig/Adobe young attractive woman testing new glasses with optician

If you’re one of the more than 197 million American adults who need vision correction, know that eyewear is covered by your FSA as long as you need it for a medical reason.

The same thing goes for contact lenses.

Laser eye surgery (Covered)

Vadim/Adobe laser correction for vision

You can pay for your laser eye surgery with your FSA. This includes LASIK, PRK, and SMILE surgeries.

Just be aware that the cost of laser eye surgery can go up to $5,000, which would be over your FSA spending limit.

Breast pumps (Covered)

alexanderon/Adobe electric breast pump and bottles

Breast pumps are a useful tool for breastfeeding mothers who are looking to control their milk supply or alleviate engorged breasts.

The IRS allows FSA spending on breast bumps, as well as any other supplies that help with the lactation process.

TMJ-related treatments (Covered)

Khunatorn/Adobe Temporomandibular Joint and Muscle Disorder

Anyone who has experience with TMJ issues knows how terrible the condition can be. The temporomandibular joint connects your jaw to your skull, and pain in this area can be especially debilitating.

Fortunately, TMJ treatments are within the domain of your FSA.

Ambulances (Covered)

temp-64GTX/Adobe Ambulance car rides through tunnel warm yellow light

In some cases of severe illness or injury, you might need the services of an ambulance. Fortunately, you can use your FSA to pay for the cost of an ambulance ride.

The average ambulance cost has been rising over recent years and can cost you nearly $1,000 out of pocket. So, your FSA can definitely save you money here.

Gym memberships (Not covered)

Seventyfour/Adobe man and woman running on treadmills

Even if attending a gym — or, as the IRS puts it, a “health club” — improves your overall health, you can’t use your FSA to cover its costs.

There may be exceptions to this, as the IRS seems to imply that there is some wiggle room if the gym dues are "related to a particular medical condition." However, in most cases, your Planet Fitness or LA Fitness membership is on your own dime.

Life insurance (Not covered)

WrightStudio/Adobe Life insurance online application form on device screen

Life insurance coverage can protect your loved ones from disaster if you die and they lose a large chunk of the income they need to survive.

However, you cannot use your FSA to pay for life insurance premiums.

Cosmetic surgery (Not covered)

Gorodenkoff/Adobe cosmetic surgeon examines beautiful woman's face

There are many reasons people opt for cosmetic surgery, and most of them are not eligible for FSA spending.

However, if you are receiving cosmetic surgery to counteract the result of an accident or a disease, you can use FSA money to pay for cosmetic surgery.

Massage therapy (Not covered)

WavebreakMediaMicro/Adobe young woman receiving back massage

For many people, massage therapy is a routine part of a wellness routine. However, it’s not usually eligible for FSA spending.

On the other hand, if your doctor prescribes massage therapy to treat a specific condition, it will be eligible.

Maternity clothes (Not covered)

meepoohyaphoto/Adobe pregnant women wear navy blue maternity clothes

Anyone who has been pregnant knows that the cost of maternity clothes can certainly add up.

You might want to shop secondhand or look for hand-me-downs, though: You can’t use an FSA to pay for maternity clothes.

Hair transplants (Not covered)

nenetus/Adobe hairdresser examining client hair with a special apparatus for diagnostic hair

Hair transplants are generally thought of as a cosmetic procedure and therefore are not eligible for FSA spending.

Teeth whitening (Not covered)

HBS/Adobe dentist starting teeth whitening procedure with young man

Your FSA can only be used for dental expenses if they help to prevent or control disease.

Unfortunately for those on the search for perfect pearly whites, this disqualifies teeth whitening treatments.

Ear piercing (Not covered)

Igorzvencom/Adobe equipment for ear piercing

This one shouldn’t come as much of a surprise: The IRS considers ear piercing to be an aesthetic choice and therefore does not allow FSA funds to be spent on it.

Lessons (Not covered)

highwaystarz/Adobe feet in children's ballet dancing class

Even if your doctor suggests that you look into dancing or swimming lessons for the sake of your health, you can’t use your FSA to buy them, as per the IRS.

Tattoo removal (Not covered)

stanislav_uvarov/Adobe laser tattoo removal from woman's hand

Thanks to the modern technology of laser tattoo removal, we have options when it comes to getting rid of unwanted tattoos. However, you can’t pay for these options with an FSA.

Bottom line

Maksym Yemelyanov/Adobe Health Insurance cards total and dental care with stethscope

An FSA can be a great way to save on medical costs, and knowing what is and isn’t covered can help you avoid making foolish mistakes with your money.

Also, remember that an FSA isn’t the only option for trimming health care costs. Maybe a health saving account or health reimbursement arrangement would be a better deal for you. No matter how you get your health expenses covered, just make sure that you do. There is nothing more important.

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Author Details

Rachel Cribby Rachel Cribby is a personal finance writer from Canada. Once a terrible math student with a fear of numbers, Rachel has embraced the world of personal finance and is passionate about empowering others to do the same. She especially loves taking topics that seem complicated and boring and making them interesting and easy to understand.

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