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How a health FSA saves you on taxes
A health FSA is an employer-established benefit, generally funded through salary reductions; an employer may also contribute. Employee contributions are not subject to federal income or employment taxes, employer contributions may be excluded from gross income, and qualified reimbursements are generally tax free, according to the IRS.
In general, you elect an annual amount and your employer deducts contributions from pay over the plan year. You may generally access the full elected reimbursement amount during the coverage period before all payroll deductions have accumulated. Reimbursement is for expenses already incurred: the plan cannot pay in advance for projected future costs.
What expenses can a health FSA cover?
A health FSA can reimburse medical care expenses allowed under federal rules and your employer’s plan. The IRS describes medical care as costs for diagnosis, cure, mitigation, treatment or prevention of disease. Eligible expenses may be for you, your spouse, qualifying tax dependents, certain people who would otherwise qualify as dependents, and a child under age 27 at year end. Each expense must still meet the applicable rules and plan terms.
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Over-the-counter and other named expenses
- Over-the-counter medicines: The IRS identifies medicines as eligible medical care whether or not they are prescribed.
- Menstrual care products: These are identified as medical care for health FSA purposes.
- Condoms: IRS Notice 2024-71 treats amounts paid for condoms as medical care under section 213(d), eligible for health FSA reimbursement subject to applicable requirements.
See IRS Publication 969 and IRS Notice 2024-71. A product’s category or seller description alone does not guarantee reimbursement; the plan’s rules and substantiation requirements apply.
Expenses a health FSA generally cannot reimburse
IRS Publication 969 says health FSA distributions generally cannot pay health insurance premiums, long-term-care costs or expenses covered by another health plan. You also cannot claim an expense reimbursed by an FSA as an itemized medical expense deduction. See IRS Publication 502 for the medical-expense deduction rules.
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Contribution limits: confirmed 2025 figures
For 2025, the employee salary-reduction limit for a health FSA was $3,300, and the maximum permitted carryover was $660, according to IRS Revenue Procedure 2024-40 and Publication 969. These are 2025 figures, not confirmed 2026 limits. Do not substitute an HSA limit or estimate a health FSA limit from inflation; check the latest IRS guidance and your employer’s plan materials for the applicable year. See Publication 969 and Revenue Procedure 2024-40.
The federal maximum is not a requirement for an employer to offer that full amount, a carryover or a grace period. Your plan’s election rules and available features govern what you can use.
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How to submit a claim and document an expense
The plan administrator must substantiate claims. Generally, the IRS requires documentation from an independent third party showing that the expense was incurred and its amount, plus confirmation that another health plan did not pay or reimburse it. Certain qualifying payment-card methods can satisfy substantiation rules. Keep receipts and follow the administrator’s submission instructions; an eligible type of expense can still be denied if you do not provide required evidence.
- Check the plan’s eligible-expense rules. Confirm that the specific expense is covered before relying on reimbursement.
- Keep proof of the purchase or service. The documentation should identify the expense and amount; submit any additional information the administrator requests.
- Submit by the plan deadline. Filing deadlines and procedures are set by your plan, so consult its documents or administrator.
What happens to unused FSA money?
Health FSAs generally follow “use-it-or-lose-it” rules. An employer may choose to offer either a carryover or a grace period of up to 2½ months after the plan year, but a health FSA cannot offer both. Neither feature is automatic; check your plan for whether it offers one, the amount that can carry over, and the dates for incurring expenses and submitting claims. The 2025 maximum carryover was $660; that is not a verified 2026 amount. The IRS explains these rules in Publication 969.
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Health FSA and dependent-care FSA are different benefits
A health FSA reimburses qualified medical expenses. A dependent-care assistance program—sometimes offered through a dependent-care FSA—covers eligible care needed to enable you to work and follows separate rules. For 2025, the exclusion maximum described in IRS Publication 503 was $5,000, or $2,500 for married taxpayers filing separately. Those are dependent-care limits, not health FSA contribution limits. See IRS Publication 503.
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What to check before choosing an election
- Estimate expenses you expect to incur during the coverage period that meet both federal rules and your plan’s terms.
- Review the plan’s eligible-expense list, substantiation process and claim-submission deadline.
- Find out whether the plan offers a carryover or grace period and how each works; do not assume either is available.
- Consider how other health coverage affects reimbursement and whether you need to preserve eligibility for an HSA. Confirm the interaction with your employer or plan administrator before making an election.
- Verify the limit for the relevant plan year from current IRS guidance rather than relying on a prior year’s figure.
Product prices and availability are accurate as of the date/time indicated and are subject to change. Any price and availability information displayed on Amazon at the time of purchase will apply.
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