What expenses can I actually pay for with my HSA or FSA?

Both cover a wide range of qualified medical expenses: doctor and dentist visits, prescriptions, glasses and contacts, mental health care, physical therapy, and many medical supplies. Since the CARES Act, over-the-counter medications and menstrual products qualify without a prescription. Insurance premiums generally do not qualify for an HSA, with exceptions like COBRA, Medicare, and long-term care premiums.

Cosmetic procedures, gym memberships, and general wellness usually don't qualify unless a doctor prescribes them for a specific condition. The IRS lists eligible expenses in Publication 502. Keep every receipt: for an HSA you'll want proof if you reimburse yourself years later, and for an FSA you may need to substantiate claims to your administrator.