What's Actually HSA and FSA Eligible? A Complete Guide

If you have a Health Savings Account (HSA) or Flexible Spending Account (FSA), you're sitting on a powerful tool for tax-free healthcare spending. But figuring out what's actually eligible can feel like solving a puzzle.

The Basics: What's Always Eligible

Let's start with the easy wins. These expenses are almost always eligible:

Doctor visits and copays - Including specialists, urgent care, and telehealth
Prescription medications - Anything your doctor prescribes
Dental care - Cleanings, fillings, orthodontics, and more
Vision care - Eye exams, glasses, contacts, and LASIK
Medical equipment - Crutches, blood pressure monitors, first aid supplies

The Surprising Eligibles

Here's where it gets interesting. Many people don't realize these expenses qualify:

Sunscreen (SPF 15+)

Yes, really! Sunscreen with SPF 15 or higher is considered a preventive care item and is fully eligible. Stock up without guilt.

Menstrual products

Thanks to the CARES Act, tampons, pads, and menstrual cups are now HSA/FSA eligible. About time!

Acne treatments

Over-the-counter acne medications and treatments qualify as medical expenses.

First aid supplies

Bandages, antiseptic, thermometers - your entire first aid kit can be covered.

The "It Depends" Category

Some items require a Letter of Medical Necessity (LMN) from your doctor:

Gym memberships - If prescribed for a specific condition
Massage therapy - When treating a diagnosed condition
Supplements and vitamins - For specific medical deficiencies
Exercise equipment - When medically necessary

Getting an LMN is easier than you think. Many telehealth providers can issue one after a quick consultation.

What's NOT Eligible

A few things that seem medical but don't qualify:

General wellness or fitness expenses (without LMN)
Cosmetic procedures that aren't medically necessary
Toiletries and personal care items
Most insurance premiums (with some exceptions)

The Bottom Line

Your HSA and FSA dollars go further than you might think. The key is knowing what qualifies and keeping good records. And if you're not sure about an expense, Hammock can help you figure it out automatically.

Ready to start using your HSA for wellness? Hammock includes unlimited Letters of Medical Necessity — so your gym, supplements, and massage are all tax-free.