What Does FSA Cover That HSA Won't? Explained

When it comes to choosing between a Flexible Spending Account (FSA) and a Health Savings Account (HSA), understanding the differences in coverage can help you make the best decision for your healthcare needs. Both accounts offer tax advantages and can be used to pay for qualified medical expenses, but there are key distinctions in what each account covers.

Here are some common expenses that an FSA may cover that an HSA won't:

  • Certain over-the-counter medications: FSAs typically cover a wide range of over-the-counter medications without a prescription, while HSAs may require a prescription for reimbursement.
  • Cosmetic procedures: FSAs may cover certain cosmetic procedures that are not deemed medically necessary, whereas HSAs are designed to cover qualified medical expenses only.
  • Medical equipment for general health: FSAs may cover items like blood pressure monitors or thermometers for general well-being, which may not be eligible for reimbursement through an HSA.
  • Laser eye surgery: While FSAs often cover laser eye surgery for vision correction, this may not be an eligible expense under an HSA.

It's important to review the specific guidelines of your FSA or HSA plan to understand what is and isn't covered. Consulting with a healthcare benefits specialist can also provide clarity on the differences between the two account types.


When you're stuck between a Flexible Spending Account (FSA) and a Health Savings Account (HSA), knowing what each option can cover is vital for maximizing your healthcare budget. While both accounts are designed to provide financial relief for medical expenses, there are notable differences in coverage examples that can aid in your decision-making process.

For instance, an FSA will generally cover a variety of over-the-counter medications that you don't need a doctor's note for, offering convenience for everyday health needs, which HSAs might not reimburse unless prescribed.

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