What can I buy with my health care spending card?

You can use your Health Savings Account (HSA) tax-free for IRS-qualified medical, dental, and vision expenses for yourself, your spouse, and your dependents.

According to HealthEquity and financial experts on Reddit, here are the main categories of what you can buy and pay for:

Everyday Medical & Out-of-Pocket Costs

• Care costs: Doctor office visit copays, deductibles, and coinsurance.
• Prescriptions: Medicines prescribed by a doctor, birth control pills, and GLP-1 weight-loss medications (with a prescription).
• Over-the-counter (OTC) items: Pain relievers (ibuprofen, acetaminophen), cold/flu medicine, allergy pills, acne treatments, and sunscreen (SPF 15+).
• Emergency & specialized care: Ambulance services, ER visits, lab tests, and mental health therapy.
• First aid & supplies: Bandages, blood-sugar test kits, and first aid supplies.

Dental and Vision Care

• Dental: Routine cleanings, fillings, root canals, X-rays, dentures, and braces/orthodontia.
• Vision: Eye exams, prescription eyeglasses, contact lenses, contact solution, and LASIK surgery.

Specialized and Alternative Care

• Equipment: Crutches, wheelchairs, blood pressure monitors, and breast pumps.
• Alternative therapies: Acupuncture or chiropractic care when used to treat a specific medical condition.
• Items needing a Letter of Medical Necessity (LMN): Certain vitamins, supplements, or specific exercise/massage equipment prescribed by a physician to treat a diagnosed condition.

Insurance Premiums & Retirement Exceptions

• Premiums: Standard health insurance monthly premiums are generally not eligible, except for COBRA, health coverage while receiving unemployment, and Medicare premiums if you are 65 or older.
• After age 65: You can withdraw money from your HSA for any non-medical purpose without a penalty, though you will pay ordinary income tax on it (just like a traditional 401(k)). Medical withdrawals remain tax-free.

No, you cannot buy regular toilet paper with your Flexible Spending Account (FSA) card.

According to IRS guidelines, toilet paper is classified as a general toiletry and personal hygiene product used for everyday living rather than the treatment or mitigation of a specific medical condition. Because it is a general health and personal use item, it is 100% ineligible for reimbursement under an FSA, HSA, HRA, or LPFSA.

If you attempt to purchase standard toilet paper using an FSA debit card at checkout, the store’s Inventory Information Approval System (IIAS) will automatically decline that specific item.

Are there any exceptions?

• With a Letter of Medical Necessity (LMN): Personal hygiene items can occasionally become eligible if a medical professional explicitly prescribes or recommends them to treat a specific medical issue. However, even with an LMN, you typically cannot swipe your FSA card directly for these items at checkout; you will need to pay out-of-pocket and submit the receipt along with your LMN to your plan provider for manual reimbursement.
• Bidet Attachments: While toilet paper is excluded, some medicated wipes, perineal cleansers, or bidet toilet seats/attachments designed to treat specific medical conditions (like severe hemorrhoids) may qualify under certain plans, often requiring an LMN.

Note: Be aware that when searching online marketplaces, searching for terms like "FSA approved toilet paper" may display normal retail listings for toilet paper that are not actually tax-deductible or eligible under IRS guidelines. Always consult an official resource like the FSA Store Eligibility List to check what qualifies before purchasing.

No, you cannot cash out or withdraw unused Flexible Spending Account (FSA) funds as cash.

❌ Rules Against Cashing Out

• No direct withdrawals: You cannot use an FSA card at an ATM or get cash back.
• Pre-tax restrictions: IRS rules limit FSA funds strictly to qualified medical expenses.
• Use-it-or-lose-it: Unused money generally returns to your employer at the end of the plan year.

💡 Valid Ways to Use Remaining Funds

• Stock up on eligible items: Buy first-aid supplies, sunscreen, or pain relievers via FSA Store.
• Submit past receipts: Pay out-of-pocket for eligible care and request a reimbursement check from your administrator.
• Check for extensions: See if your employer offers a grace period or a small rollover limit.

No, standard laundry detergent is not FSA eligible because it is considered a general household and personal care item rather than a medical expense.

Why Laundry Detergent Is Not Covered

• General Use: Regular cleaning and household supplies are for general living, not the treatment or prevention of a specific medical condition.
• IRS Rules: Flexible Spending Accounts (FSAs) only cover diagnostic devices, treatments, and products prescribed by a doctor or classified strictly as medical care.

You can buy an Apple Watch with a Flexible Spending Account (FSA) only if you have a Letter of Medical Necessity from a licensed physician.

⚠️ How Eligibility Works

• General Wellness: Not eligible by default because it is a consumer electronic.
• Medical Necessity: Eligible only when prescribed to treat or monitor a specific diagnosed condition.
• Plan Limits: Some federal or employer plans cap smartwatch reimbursement (e.g., FSAFEDS caps smartwatches at $125).

💡 Steps to Qualify and Buy

• 🔎 Consult Doctor: Ask your physician to write a Letter of Medical Necessity (LMN) specifying the medical condition (like heart rate monitoring or diabetes management).
• 🗓 Get Approval: Submit the LMN to your FSA Administrator for pre-approval before purchasing.
• 📅 Save Receipts: Pay out-of-pocket or use your FSA card if approved, then file an itemized receipt with your administrator for reimbursement.