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5 things you can’t use your FSA or HSA to pay for

You can use your health accounts to purchase a lot of qualified health expenses. Find out some key ones that aren’t included on that list.

You don’t always have to swipe your credit card at the doctor’s office for certain health care expenses. Two alternatives include using a flexible spending account (FSA) or a health savings account (HSA).

What exactly are FSAs and HSAs? Let’s start with an FSA. If you enroll in health insurance through your employer, you may also have the option of signing up for an FSA during your Open Enrollment Period (that can vary from company to company, so check with your company’s human resources or HR representative). An FSA is a type of health account that allows you to put away pretax dollars to pay for medical costs your health insurance plan doesn’t usually cover. The only catch is you’ll have to spend all your pretax dollars before the end of the plan year.

An HSA, on the other hand, is a type of health account you can only get if you have a high deductible health plan (HDHP). That’s a type of health insurance plan that has a higher deductible than traditional insurance plans. (A deductible is how much you have to pay before your insurance pays for covered services.) Unlike an FSA, your HSA funds roll over to the next year and can grow in value over time.

While there’s a long list of qualified medical expenses you can use your FSA or HSA dollars to pay for, there are expenses you can’t use your accounts for. Here are 5 of those types of off-limits expenses:

Need health insurance? Explore your options now, or contact a licensed insurance agent at 1-844-211-7730.

#1. Your monthly insurance bill (premium)

While you can certainly use your FSA or HSA funds to pay for health-related expenses such as deductibles and copayments (a fixed amount you pay for health services), you can’t use your account to pay for your monthly health insurance bills (premiums).

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#2. Your future medical care

Let’s say you know you’re going to have surgery next year. You can’t use your FSA or HSA like you would your credit card, paying for it before you’ve accumulated enough money in the account. You can only use the funds that are already in your FSA or HSA account. So, that means you can’t use your accounts to pay for future medical care or expenses without planning ahead. Here are a few ways you can:

  • HSA: If you let your HSA funds grow over time, you’ll have more funds later to use for future expenses. You can also pay for a medical expense using your own money, then reimburse yourself using your HSA funds. You’ll just need to submit a receipt. But if you pay yourself back too much or for something that isn’t covered, you may get penalized.
  • FSA: If you know you’re going to have a big health care expense next year, such as having surgery, whenever you sign up for next year’s FSA, you can set aside additional funds to cover it. For example, if you normally take out $1,000 of your pay to go into your FSA, and you know that next year you’re going to have a large medical expense, you can raise the amount higher. But you can only contribute a fixed amount to your account each year, so make sure to ask your HR rep what that dollar amount is.

Have further questions about what types of plans may offer an FSA or HSA? Call a licensed insurance agent at 1-844-211-7730 to discuss.

#3. Gym memberships

While some companies and private insurers may offer discounts on gym memberships, you generally can’t use your FSA or HSA account to pay for gym or health club memberships. An exception to that rule would be if your doctor deems fitness medically necessary for your recovery or treatment. They have to write a letter saying so in order for that expense to be eligible for reimbursement.

#4. Nutritional supplements

Let’s say you’ve decided to start taking a daily vitamin to add to your healthy eating and regular exercise regimen. Although it may be a positive change in your health, vitamins aren’t FSA or HSA eligible expenses, and neither are:

  • Herbal supplements
  • Natural medicines
  • Nutritional supplements

That is unless a certain supplement is recommended by your doctor as treatment for a specific medical condition. Like that gym membership, your doctor would have to provide a letter stating that you need a certain type of supplement as part of your diagnosis and treatment to have it be deemed eligible.

#5. Teeth whitening (and other cosmetic procedures)

While you can definitely pay dental copays and deductibles using your FSA or HSA, you can’t pay for a cosmetic procedure such as teeth whitening. In fact, that goes beyond the dental realm, too. You also can’t use your pretax funds to pay for other procedures that improve your appearance, like:

  • Face-lifts
  • Hair removal (electrolysis)
  • Hair transplants
  • Liposuction

An exception to that rule might be breast reconstruction surgery if you have a breast or breasts removed as part of your cancer treatment. You’ll want to check with your doctor about your eligibility.

These are just some of the expenses that aren’t FSA/HSA eligible. Find out more about the types of plans that offer health accounts by exploring your options now or contacting a licensed agent at 1-844-211-7730.


Department of the Treasury: Internal Revenue Service. “Health Savings Accounts and Other Tax-Favored Health Plans.” Retrieved from Accessed June 22, 2023.

Department of the Treasury: Internal Revenue Service. “Publication 502 (2022), Medical and Dental Expenses.” Retrieved from Accessed June 22, 2023.

University of Northern Iowa. “Flexible Spending Account (FSA) Reimbursable Wellness Expenses.” Retrieved from Accessed June 22, 2023.

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