Fact Check: Are fsa eligible items also hsa eligible?

Are FSA Eligible Items Also HSA Eligible?

The claim in question asks whether items eligible for Flexible Spending Accounts (FSA) are also eligible for Health Savings Accounts (HSA). This inquiry is significant for individuals navigating their healthcare financing options, as both accounts offer tax advantages for medical expenses but have different rules and eligibility criteria.

What We Know

1. FSA and HSA Definitions: A Flexible Spending Account (FSA) allows employees to set aside pre-tax dollars for eligible medical expenses. In contrast, a Health Savings Account (HSA) is available to individuals enrolled in high-deductible health plans (HDHP) and allows for tax-free savings for qualified medical expenses 24.

2. Eligible Expenses: According to the IRS, both FSAs and HSAs can cover a range of medical expenses, including doctor visits, prescription medications, and certain over-the-counter items. However, the specific items that qualify can differ between the two accounts. For example, while both accounts may cover prescription drugs, some over-the-counter medications may only be eligible under an HSA if prescribed by a doctor 810.

3. IRS Guidelines: The IRS Publication 502 outlines qualified medical expenses for HSAs and FSAs. While there is overlap, certain expenses may be eligible under one account and not the other. For instance, cosmetic procedures are typically not covered by either account, but some preventive care items might be eligible under one and not the other 8.

4. Use-it-or-Lose-it Rule: FSAs have a "use-it-or-lose-it" rule, meaning funds must be used within the plan year or they will be forfeited. HSAs, on the other hand, allow funds to roll over year after year, making them more flexible for long-term savings 69.

Analysis

Source Evaluation

• FSA FEDS (1): This source is a government-sponsored program, which adds credibility. However, it primarily focuses on FSA eligibility and does not directly compare it with HSA eligibility.

• Benefits Utah (2): This source provides a clear comparison between FSAs and HSAs, making it useful for understanding the differences. However, it is a university benefits page, which may have a slight bias towards promoting employee benefits.

• FedSmith (4): This article discusses FSA and HSA comparisons specifically for federal employees, which may limit its applicability to the general public. The source is generally reliable, but its focus on federal employees could introduce bias.

• Forbes Advisor (6): As a well-known financial advice platform, Forbes provides a balanced view of FSAs and HSAs. However, it is essential to consider that financial advice websites may have commercial interests that could influence their presentation of information.

• Fidelity Investments (8): This source is a reputable financial services company, and its information is likely to be accurate. However, it may have a vested interest in promoting HSAs as investment vehicles.

Conflicting Information

While many sources indicate that there is overlap in eligible expenses for FSAs and HSAs, the specific items can differ based on IRS guidelines and the nature of the accounts. For example, some sources suggest that certain over-the-counter medications require a prescription for HSA eligibility, whereas they may not for FSAs 810. This inconsistency highlights the need for individuals to carefully review their account guidelines and consult IRS publications for the most accurate information.

Additional Information Needed

To further clarify the relationship between FSA and HSA eligible items, it would be beneficial to have:

• A comprehensive list of specific items that are eligible under both accounts, including any recent changes in IRS regulations.
• Case studies or examples of individuals who have navigated the eligibility criteria for both accounts to provide real-world context.
• Expert opinions from tax professionals or financial advisors who specialize in healthcare accounts.

Conclusion

Verdict: Partially True

The claim that items eligible for Flexible Spending Accounts (FSA) are also eligible for Health Savings Accounts (HSA) is partially true. Evidence indicates that there is significant overlap in the types of medical expenses covered by both accounts; however, specific eligibility criteria can differ. For instance, while many prescription medications are covered under both accounts, certain over-the-counter items may require a prescription for HSA eligibility, which is not the case for FSAs.

This nuanced understanding is crucial for individuals managing their healthcare finances, as it underscores the importance of reviewing the specific guidelines of each account. Additionally, the IRS guidelines can change, and the interpretation of these rules may vary among different sources, which introduces a degree of uncertainty.

Readers are encouraged to critically evaluate the information presented and consult official IRS publications or financial advisors for the most accurate and personalized advice regarding their healthcare spending accounts.

Sources

1. Eligible FSA Expenses - FSA FEDS. Retrieved from https://www.fsafeds.gov/support/eligibleexpenses
2. Flexible Spending Account vs. Health Savings Account. Retrieved from https://benefits.utah.edu/fsa-vs-hsa/
3. Comparison Chart - Health Savings Accounts. Retrieved from https://www.opm.gov/healthcare-insurance/healthcare/health-savings-accounts/comparison-chart/
4. FSA and HSA Comparison for Federal Employees in 2025 - FedSmith. Retrieved from https://www.fedsmith.com/2025/01/06/fsa-and-hsa-comparison-for-federal-employees-in-2025/
5. HSA, HRA, & FSA Eligible Items & Expenses - Cigna. Retrieved from https://www.cigna.com/individuals-families/member-guide/eligible-expenses
6. FSA vs. HSA: What's The Difference? - Forbes Advisor. Retrieved from https://www.forbes.com/advisor/health-insurance/fsa-vs-hsa/
7. FSA / HSA Eligibility Checker - Cost How Much. Retrieved from https://costhowmuch.com/fsa-hsa-eligibility-checker/
8. HSA- and FSA-eligible expenses - Fidelity Investments. Retrieved from https://www.fidelity.com/learning-center/smart-money/hsa-and-fsa-eligible-expenses
9. HSA vs. FSA vs. HRA: What is the Difference Between Them? - Aetna. Retrieved from https://www.aetna.com/health-guide/hsa-vs-fsa.html
10. What Expenses Are Covered By My Health Account? - Bank of America. Retrieved from https://healthaccounts.bankofamerica.com/what-expenses-are-covered-by-an-hsa-fsa-hra.shtml