What over-the-counter items can I buy with my FSA?

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Over-the-counter (OTC) medicines and healthcare products can be bought using your FSA without a prescription, thanks to the CARES Act.

Fully Eligible OTC Items (No Prescription Needed)

  • Pain Relief: Acetaminophen, ibuprofen, aspirin, and topical pain relievers.
  • Cold, Flu, and Allergy: Antihistamines, decongestants, cough drops, and nasal sprays.
  • Digestive Health: Antacids, acid reducers, laxatives, and anti-diarrheal medications.
  • First Aid Supplies: Bandages, gauze, antiseptic wipes, hydrogen peroxide, and first aid kits.
  • Diagnostics & Monitors: Blood glucose meters, blood pressure monitors, thermometers, and pregnancy tests.
  • Personal Care: Menstrual care products (tampons, pads), acne treatments, and sunscreens with SPF 15 or higher.
  • Medical Equipment: Reading glasses, orthopedic supports, hot/cold packs, and walking aids.

Ineligible Items

  • Cosmetics & General Wellness: Teeth whitening, makeup, anti-aging creams, and general vitamins or supplements without a specific medical purpose.

You can browse a searchable database of thousands of approved goods directly on the FSA Store Eligibility List.

What are some everyday items I can buy with my FSA?

You can use your flexible spending account (FSA) to buy many everyday health, personal care, and wellness items without a prescription.

Common Everyday FSA-Eligible Items

  • Sunscreen: Broad-spectrum sunscreens with an SPF of 15 or higher (including mineral formulas and SPF lip balms).
  • Menstrual Care Products: Tampons, pads, menstrual cups, liners, and period underwear.
  • Acne Treatments: Pimple patches, benzoyl peroxide, salicylic acid cleansers, and spot lotions.
  • First Aid & Wound Care: Bandages, gauze pads, antibiotic ointment, hydrocortisone cream, and fully stocked first aid kits.
  • Over-the-Counter (OTC) Meds: Pain relievers (ibuprofen, acetaminophen), allergy medication, and cold, cough, and flu relief.
  • Diagnostic Tests: At-home COVID-19, flu, UTI, and pregnancy tests.
  • Eye & Foot Care: Daily or monthly contact lenses, reading glasses, solution, and orthotic shoe insoles.

You can shop for these products using your FSA debit card at major pharmacies or browse pre-vetted selections directly on the Amazon FSA Store or specialized retailers like buyFSA.

Can I use my FSA card at Costco?

You can use your Flexible Spending Account (FSA) or Health Savings Account (HSA) card at every register in Costco warehouses, as well as online through Costco Same-Day Delivery.

Where and How You Can Use It

  • In-Warehouse: Costco accepts FSA, HSA, and Medicare Advantage prepaid cards at all standard checkout registers and self-checkout lanes, not just at the pharmacy counter.
  • Online: You can use your FSA/HSA card on Costco Same-Day Delivery by adding it as a payment method at checkout (you will also need to provide a backup payment method for any ineligible items or non-covered fees).
  • Eligible Items: The card works for qualified medical expenses like over-the-counter medicines, pain relievers, first-aid supplies, allergy medication, contact lenses, glasses, and items explicitly tagged as "FSA Eligible".
  • Ineligible Items: General groceries, membership fees, clothes, and standard non-medical items cannot be purchased using your FSA/HSA card. If you have a mixed cart at a physical register, the system will typically only approve the eligible items or prompt you to split the payment with a standard credit/debit card.

Can I buy toilet paper with my FSA card?

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.

Can I buy an Apple Watch with FSA?

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

Why It Is Not Automatically Eligible

  • General Wellness: The FSA Store classifies smartwatches as general wellness and lifestyle devices rather than primary medical tools.
  • Dual Purpose: Because an Apple Watch handles non-medical tasks like texts, calls, and apps, tax rules state it does not qualify by default.

How to Qualify for Reimbursement

  1. Get a Prescription: Ask your doctor for a signed Letter of Medical Necessity stating you need the watch to treat or monitor a specific diagnosed medical condition (such as an irregular heart rhythm or hypertension).
  2. Submit to Your Plan: Send the letter to your FSA administrator for approval before you buy, or check if they allow retroactive claims.
  3. Buy and File: Purchase the watch using your personal card (your FSA debit card will usually be declined at standard checkout because it is not pre-approved), then submit the receipt and your doctor’s letter to your administrator for reimbursement.

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9 related questions found

What is double dipping FSA?

Double dipping with a Flexible Spending Account (FSA) means receiving tax-free reimbursement twice for the exact same eligible out-of-pocket expense.

Common Scenarios

  • Spousal Overlap: Submitting the same medical or dental receipt to both your FSA and your spouse’s separate FSA.
  • Card + Manual Claim: Paying for an item with an FSA debit card and then manually submitting that same receipt for an extra cash payout.
  • Multiple Tax Benefits: Using pre-tax FSA funds to pay for an expense and then also claiming that same expense as an itemized medical tax deduction on your federal return.
  • Cross-Plan Reimbursing: Trying to cover a single bill using overlapping accounts like an FSA and an HSA or an HRA at the same time.

Consequences

  • Repayment: Administrators will force you to pay back the duplicate funds.
  • Account Freezing: Your FSA debit card may be deactivated or future claims blocked.
  • Plan Penalties: Severe or systemic double dipping can threaten the tax-free compliance status of your entire employer-sponsored plan.

Can I put my gym membership on my FSA?

Yes, you can use your FSA Store resources or Flexible Spending Account for a gym membership only if a doctor or licensed clinician provides a Letter of Medical Necessity (LMN) stating that exercise is required to treat a specific medical condition.

Rules for Eligibility

  • General Wellness: Standard gym memberships for general fitness, weight loss, or general health do not qualify.
  • Medical Necessity: If you have a diagnosed condition (such as obesity, diabetes, hypertension, or physical rehabilitation), your doctor can write an LMN.
  • Timing: You must obtain the LMN before you pay for the membership so the expense qualifies for pre-tax reimbursement.

How to Submit a Claim

  1. Get an LMN: Ask your doctor or use a telehealth platform partnered with your provider to get a signed Letter of Medical Necessity.
  2. Pay Out-of-Pocket: Pay your gym dues directly with a personal card.
  3. Submit for Reimbursement: Send your itemized gym contract, payment receipt, and the LMN to your FSAFEDS or FSA plan administrator.

Can I use my FSA to buy eyeglasses?

Yes, you can use your Flexible Spending Account (FSA) to buy prescription glasses, reading glasses, and prescription sunglasses.

What Is Eligible

  • Prescription eyeglasses and frames: Fully covered when meant to correct vision.
  • Prescription sunglasses: Eligible as long as they feature prescription lenses.
  • Reading glasses: Over-the-counter reading glasses are eligible without a prescription.
  • Accessories: Lens cleaning solutions, cleaning cloths, and eyeglass repair kits qualify if used for prescription eyewear.

What Is Not Eligible

  • Non-prescription sunglasses or fashion glasses: Standard non-prescription shades do not qualify.
  • Non-prescription colored contact lenses: Purely cosmetic lenses are excluded.
  • Extended warranties: Protection plans or extra warranties for eyewear are ineligible.

Can my wife use my FSA if she's not on my insurance?

Yes, your wife can use your healthcare Flexible Spending Account (FSA) for eligible medical expenses even if she is not enrolled in your insurance plan.

✅ IRS Eligibility Rules

  • Legal Marriage: IRS rules allow FSA funds to cover any legally married spouse.
  • Insurance Independence: Eligibility depends on tax status, not on which health insurance plan your spouse uses.
  • No Premiums: You cannot use FSA money to pay for your wife's external health insurance premiums.

💡 Important Caveat: HSA Conflict

  • Disqualifying Coverage: If your wife wants to contribute to her own Health Savings Account (HSA), your general-purpose healthcare FSA makes her ineligible—even if she is on a separate insurance plan and you never use your FSA for her.

Does a Costco receipt show FSA eligible?

Costco warehouse and online receipts mark FSA-eligible items with an 'F' or 'H' next to the item line or display an itemized FSA total at the bottom of the receipt.

How to Identify FSA Items on a Costco Receipt

  • Letter Codes: Look to the left or right of individual product descriptions. An 'F' or 'H' indicates a qualifying medical or over-the-counter expense.
  • Summary Totals: Many receipts list a dedicated FSA/HSA eligible subtotal near the tax breakdown at the bottom.
  • Abbreviated Names: Warehouse receipts often use shorthand for item names (e.g., KS ALLERTEC). If your plan administrator requires full descriptions, you can look up your past digital receipts through the Costco App or online account history.

Using FSA Cards at Costco

  • All Registers: Costco accepts FSA and HSA debit cards at all main warehouse registers, self-checkout lanes, and specialized departments like the pharmacy, optical, and hearing aid centers.
  • Mixed Baskets: If you buy a mixed cart of groceries and eligible health items, the register system attempts to split or approve only the qualifying items, though policies can vary by location. If a card declines on a mixed cart, pay with a standard credit card and submit the itemized receipt to your provider for manual reimbursement.