Every fall we get the same question. Someone has money sitting in a flexible spending account, the year is running out, and they are not sure whether what they buy from us counts.
Often it does. Here is how the rules actually work, and what to keep so you are not arguing about it in February.
One thing first: we sell supplies, not tax advice. The IRS publishes the rules and your plan administrator applies them, and where the two of them say something different from this page, they are right and we are not.
The difference between the two accounts
| FSA | HSA | |
|---|---|---|
| Who offers it | Your employer | You open it, often through an employer, alongside a high-deductible health plan |
| Whose money | Set aside from pay before tax | Yours, and it stays yours |
| End of year | Often use it or lose it, with limited exceptions | Rolls over, every year |
| Why it matters now | The deadline is real | There is no December rush |
That last row is the whole reason this article runs in October rather than January. FSA money often has a deadline attached. Some plans offer a short grace period into the new year, some allow a limited amount to carry over, and some do neither. Yours will say which, and the three are not interchangeable.
What generally qualifies
The governing document is IRS Publication 502, which lists what counts as a medical expense. Broadly, supplies bought because of a medical condition are the kind of thing these accounts are for, and that covers many of the products in our catalog.
We keep an FSA and HSA eligible section with several hundred products in it, which is the fastest way to see the range rather than checking items one at a time.
We accept FSA and HSA cards at checkout for selected FSA and HSA eligible items. If your card does not go through on something, you can pay another way, keep the itemized receipt, and ask your plan administrator whether it can be reimbursed.
Where people get caught out is the general-use items. Something bought for ordinary household reasons is usually not eligible even when it sits in the same cabinet. The question is never what the item is. It is why it was bought.
The paperwork, which is the part that matters
Administrators ask for substantiation, which in practice means an itemized receipt. Not a credit card statement, not an order confirmation showing only a total. The receipt needs to show:
- the date of purchase
- the merchant
- each item, named
- the amount paid for each
Keep it. Keep it even when the card went through without a question, because plans can ask for substantiation months later, and a claim held up in March over a receipt from October is a miserable way to spend an afternoon.
If you need an itemized receipt for something you bought from us, email support@savemedical.com and we will send one. Your account also lists every order item by item, which helps if you are reconstructing a year.
Letters of medical necessity
Some items sit in a gray area, and the administrator will ask for a letter of medical necessity: a short note from the prescriber saying what the item is for and roughly how long it is needed.
Two things worth knowing. They are routine, and the request is not a rejection. And they are far easier to get at a scheduled appointment than by chasing a phone call in late December, so if you think you might need one, ask at the next visit rather than when the deadline is a week away.
If you are spending down a balance
Buy what will genuinely be used. A deadline makes people buy things they do not need, and an unopened case in a closet is not a saving, it is a slower way of losing the money.
The sensible version is to work out your real monthly usage, cover the months ahead with what remains, and stop there. Our piece on how long a case should last is the arithmetic for that, and it takes about a minute.
If you are looking for where to start, incontinence care and nutrition and feeding are the two areas most of these questions land on.
Where to check for certain
- IRS Publication 502 is the actual list of what counts as a medical expense. It is drier than this page and more authoritative.
- Healthcare.gov on flexible spending accounts explains the basics of how an FSA works in plain language.
- Your plan administrator, whose own rules are the ones that will be applied to your claim. Their number is on the back of the card.
The short version
Supplies bought for a medical reason are often the kind of expense these accounts exist for. We take FSA and HSA cards for selected eligible items. Keep an itemized receipt every time. Ask for a letter of medical necessity at an appointment, not at a deadline. Check your plan's year-end rule now rather than in December, because grace period, carryover and neither are all common.
