What is FSA Eligible but Not HSA? A Comprehensive Guide

When it comes to maximizing healthcare benefits, understanding the differences between Flexible Spending Accounts (FSA) and Health Savings Accounts (HSA) is crucial. While both accounts offer tax advantages for medical expenses, there are certain expenses that are FSA eligible but not HSA eligible.

FSAs and HSAs are both valuable tools for managing healthcare costs, but their rules and benefits vary. Here are some key differences:

  • FSAs are offered by employers, while HSAs can be established by individuals.
  • HSAs require a high-deductible health plan, while FSAs do not have this requirement.
  • HSAs are owned by the account holder and are portable, while FSAs are typically use-it-or-lose-it accounts that are tied to the employer.

When it comes to eligible expenses, there are items that may be covered by an FSA but not by an HSA. These include:

  • Over-the-counter medications without a prescription
  • Health insurance premiums
  • Certain cosmetic procedures
  • Health-related items like sunscreen and first aid supplies
  • Alternative therapies like acupuncture or chiropractic care

It's important to note that the rules and guidelines for both FSAs and HSAs can change, so it's always wise to consult with a healthcare benefits specialist or tax advisor to ensure compliance.


Understanding the nuances between FSA and HSA accounts is critical for making the most of your healthcare dollars. While FSAs may provide coverage for numerous items that HSAs do not, this distinction can significantly impact your out-of-pocket costs.

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