Commonly overlooked FSA and HSA-eligible items—and how to spot what qualifies
Every year, people set aside pre-tax dollars in a Flexible Spending Account or Health Savings account with the best intentions—only to forget about them, underuse them, or scramble at the end of the year to spend what’s left. What many people don’t realize is that FSA and HSA funds can be used on a surprisingly wide range of products—some of which you may already be buying out of pocket. This guide breaks down the basics of FSAs and HSAs, explains how to identify whether a product is eligible, and highlights several commonly overlooked items that may qualify for pre-tax spending.What Are FSA and HSA Accounts?
Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs) are both designed to help people pay for qualified healthcare expenses using pre-tax dollars. While they’re often mentioned together, they work a bit differently—and understanding those differences can help you get more value out of each. An FSA is typically offered through an employer and allows you to set aside a portion of your paycheck before taxes to use for eligible medical expenses. One of the most important things to know about FSAs is that they’re generally considered “use-it-or-lose-it” accounts. That means that unused funds at the end of your plan year may be forfeited, although some employers offer a small rollover or a short grace period. Because FSAs reset annually, many people wait until the last minute to spend what’s left, often missing out on smarter, planned purchases they could have made earlier in the year. Knowing what qualifies ahead of time can help prevent rushed decisions and wasted funds. An HSA is available to individuals enrolled in a high-deductible health plan (HDHP) and function more like a long-term savings tool. Contributions are also made with pre-tax dollars, but unlike FSAs, HSA funds roll over year after year and remain with you even if you change jobs. Many people use HSAs to pay for current healthcare needs, while others treat them as a way to save for future medical expenses. Because there’s no annual spending deadline, HSAs offer more flexibility. But, eligibility rules still apply when it comes to what you can purchase. Flexible Spending Accounts (FSAs)
Health Savings Accounts (HSAs)
How To Tell If a Product Is FSA Or HSA Eligible
At first glance, FSA and HSA eligibility can feel confusing, especially since many qualifying products don’t look “medical” in the traditional sense. Eligibility generally follows a simple principle: if a product is used to diagnose, treat, prevent, or manage a medical condition, there’s a good chance it qualifies. Some retailers clearly mark qualifying items, making it easier to know before you buy. You can also consult your plan administrator’s eligibility list, which outlines covered expenses based on current IRS guidelines. Eligibility rules have evolved quite a bit in recent years.
Many everyday healthcare products—such as pain relief tools, menstrual care items, and mobility supports—no longer require a prescription to qualify. That said, some products may still require a Letter of Medical Necessity (LMN) from a healthcare provider, particularly if they’re used to treat a specific condition rather than for general wellness. When in doubt, checking eligibility ahead of time can save you the hassle of denied claims or unreimbursed purchases.
Keeping receipts and documentation is also important, especially if you plan to submit expenses for reimbursement later. A few extra minutes of research can ensure you’re using your pre-tax dollars as intended—and not paying out of pocket for items you’re already entitled to cover.Surprising FSA & HSA-Eligible Items You May Not Know About
When most people think of FSA or HSA spending, they picture prescriptions, copays, or first-aid supplies. In reality, eligibility extends to a wide range of products and services, many of which support preventative care, pain management, or chronic condition treatments. Some may qualify outright, while others are eligible when supported by documentation. Here are several eligible options that may surprise you: 23andMe is widely known for DNA testing, but it also provides health-only genetic testing. While your FSA or HSA account won’t get you any closer to learning about your DNA makeup, it can help you get tested to identify potential hereditary health risks. This genetic testing provides 65+ health reports and features to help you understand your chances of developing certain health conditions, if you’re a carrier for certain genetic variations, and more. This type of insight can help you take more informed actions when it comes to managing your health. Eligibility only applies to the health-related portion of testing, so it’s important to confirm what’s included before purchasing. Wearables designed to track sleep patterns, heart rate, or other health metrics may qualify when used to monitor or manage a medical condition. Devices like smart rings are often considered eligible when they’re recommended for sleep disorders, stress management, or cardiovascular monitoring. Just double-check with your plan to see if it requires a Letter of Medical Intent before purchasing. While general fitness gear isn’t always eligible, exercise equipment may qualify when it’s prescribed or recommended as part of a treatment or rehabilitation plan. Equipment used to manage conditions like obesity, cardiovascular disease, or post-injury recovery—like Peloton fitness bikes, rowing machines, or dumbbells—may be eligible with a Letter of Medical Necessity. Orthopedic or corrective shoe inserts are commonly overlooked FSA/HSA-eligible items. Orthotic shoe inserts are often used to address conditions such as plantar fasciitis, flat feet, high arches, or joint pain caused by gait issues. Many over-the-counter and custom orthotics qualify, though some plans may require documentation depending on the type. Percussive therapy devices, such as a Therabody devices, and other pain-management tools are commonly used to address muscle soreness, tension, and chronic pain conditions. Because they’re considered therapeutic rather than recreational, they may qualify as eligible expenses under many plans. Some acne cleansers, moisturizers, and even acne treatment patches are often HSA/FSA-eligible expenses. Some specialized treatments, such as light therapy and acne brushes, may qualify as well. While cosmetic products don’t qualify, medically necessary or preventative treatments may be eligible. Preventive Health & Diagnostics
Wearable Health & Sleep Technology
Exercise & Medically Necessary Fitness
Foot Health
Pain Relief & Recovery Therapies
Skin Health & Medical Skincare
How To Maximize Your FSA Or HSA This Year
FSA and HSA accounts are most effective when they’re treated as part of your overall health planning—not just something you remember when a balance reminder email lands in your inbox. With a little foresight, these accounts can help reduce out-of-pocket costs and make it easier to invest in your long-term well-being. Review your current balance early in the year, especially if you have an FSA. Knowing how much you have available—and when it expires—gives you time to plan meaningful purchases instead of scrambling to spend leftover funds at the last minute.
HSAs are a little more flexible since funds roll over, but regular check-ins can still help you use your savings more strategically. When using your plan funds to make larger purchases, check eligibility before paying out of pocket. Your plan administrator should provide clear guidance, and confirming coverage ahead of time can prevent denied reimbursements or unnecessary expenses. If documentation is required, taking care of it upfront can save time later. Finally, remember to save receipts and keep records for any eligible purchases, even if you pay directly with your FSA or HSA card.
Good documentation helps protect you if questions arise and makes reimbursement simpler if you’re submitting claims after the fact. HSAs and FSAs are practical tools designed to make everyday healthcare more affordable. Yet many people continue to underuse them simply because they don’t realize how broad eligibility has become.
From preventative care and recovery tools to mobility support and alternative therapies, qualifying expenses often extend far beyond what most people expect. Understanding what’s eligible—and how to confirm it—can help you make smarter choices with money you’ve already set aside. Instead of paying out of pocket for items that support your health, comfort, or long-term mobility, you may be able to use pre-tax dollars to cover those same needs.
