Limited Purpose FSA Eligible Expenses

Short answer

A limited-purpose FSA, or LPFSA, trades full FSA coverage for dental and vision expenses only under IRS Publication 502, which is what lets it pair with a high-deductible health plan and an HSA. Eye exams, eyeglasses, contacts, dental cleanings, fillings and orthodontics are eligible. Prescriptions, doctor visits, OTC medicines and all other medical expenses aren't covered by a limited-purpose FSA.

This guide lists what a limited-purpose FSA reimburses by category. Dental and vision expenses fall into one of three categories: reimbursable outright, reimbursable with a letter, or not reimbursable. Medical expenses outside dental and vision can't be reimbursed from this account. They'd be covered by your HSA or other health plan instead.

What a limited-purpose FSA covers

Think of a limited-purpose FSA as the dental-and-vision half of a two-account setup, with an HSA covering the rest. The IRS defines an HSA as "a tax-exempt trust or custodial account you set up with a qualified HSA trustee to pay or reimburse certain medical expenses you incur". Your limited-purpose FSA only reaches "prevention and alleviation of dental disease" and vision care that IRS Publication 502 treats the same way. Dental cleanings, exams, glasses, contacts and related supplies draw from this account. Anything outside dental and vision, such as prescriptions, primary care visits, mental health care and OTC medicines, has to come from your HSA, a separate health plan or your own pocket, never from the limited-purpose FSA. Inside the dental and vision scope, most purchases clear without paperwork. A smaller set needs a licensed clinician to name a diagnosed condition before the purchase qualifies. A third set, cosmetic dental and vision work, sits outside both accounts entirely.

How to read the list

Because a limited-purpose FSA only touches dental and vision, every item below sorts into one of three outcomes. Which one an item lands in tells you whether to just buy it, line up a letter first, or look to your HSA instead.

Reimbursable outright

For dental and vision purchases, this is the default outcome. IRS Publication 502 already treats these as qualified medical expenses, so your limited-purpose FSA pays them with no letter attached. The one catch: a separate dental or vision insurance plan has to not already be covering the same cost.

Reimbursable with a letter

A smaller set of dental and vision purchases needs a letter of medical necessity first. A licensed clinician looks at your specific situation, names the diagnosed condition, and writes one sentence tying the purchase to treating it. When the honest version of that sentence is really about looking better rather than a medical condition, the letter doesn't get written and the purchase isn't reimbursable. Because the letter has to carry a date on or before your purchase, line it up before you buy.

Not reimbursable

These expenses are cosmetic or outside the scope of a limited-purpose FSA. No letter can change this category.

Vision expenses

Vision expenses are reimbursable when they correct a vision problem or treat a diagnosed eye condition. Eye exams identify refractive errors and other vision issues, so they're reimbursable outright. Eyeglasses, contact lenses, contact lens solution and cases all correct a vision problem and are reimbursable. Prescription sunglasses correct vision just as eyeglasses do, so they're reimbursable. LASIK and other corrective surgeries that permanently improve vision are reimbursable. Corneal reshaping (orthokeratology) is a non-surgical vision-correction procedure that's also reimbursable. Reading glasses are reimbursable outright even without a prescription, the same as prescription eyewear. Blue light glasses aren't reimbursable because they're marketed for comfort rather than treating a diagnosed eye condition. Cosmetic eye procedures, such as eyelid lifts or brow lifts, aren't reimbursable because their primary purpose is appearance rather than vision correction or treating disease.

Dental expenses

Dental expenses are reimbursable when they treat, prevent or manage a dental condition. Routine preventive care, such as cleanings and exams, prevents dental disease and is reimbursable outright. Diagnostic procedures like X-rays identify dental problems so they can be treated, so they're reimbursable. Fillings, whether amalgam, composite or ceramic, repair cavities and are reimbursable. Root canals treat infected teeth and eliminate pain, so they're reimbursable. Crowns and bridges restore damaged teeth and replace missing teeth, so they're reimbursable. Extractions remove problematic teeth and are reimbursable. Braces and other orthodontic treatments correct misalignment and bite problems, which are dental conditions, so they're reimbursable under IRS rules, though some employer plans may require pre-approval. Dentures replace missing teeth and restore chewing function, so they're reimbursable. Dental implants replace missing teeth surgically and are reimbursable. Gum disease treatment and scaling clean infected gum tissue and prevent further disease, so they're reimbursable. Oral surgery addresses dental and jaw problems. Teeth whitening is cosmetic dentistry and isn't reimbursable, even when the discoloration has a medical cause such as a medication side effect. No letter changes that outcome. Veneers placed purely for aesthetics are cosmetic dentistry and aren't reimbursable. Cosmetic bonding for appearance isn't reimbursable. Toothbrushes, toothpaste, floss and mouthwash are daily hygiene items, not medical treatment, and aren't reimbursable. An electric toothbrush can be reimbursable with a letter when it treats a diagnosed gum condition such as periodontitis.

Expenses not covered by limited-purpose FSAs

A limited-purpose FSA covers only dental and vision care. All other medical expenses must be paid from your HSA, a separate health plan, or out of pocket. This includes prescriptions, doctor visits, OTC medicines, medical equipment, mental health care, physical therapy, fitness and wellness, and any medical service that's not classified as dental or vision care under IRS Publication 502.

What changes by plan

IRS Publication 502 sets the outer boundary of what counts as a dental or vision expense, but your employer's plan document and summary plan description decide what your limited-purpose FSA actually pays inside that boundary. A plan is allowed to be tighter than the IRS baseline: it can leave out categories the IRS would otherwise permit, or add a pre-authorization step the IRS doesn't require. Orthodontia is a common example. One employer's limited-purpose FSA reimburses it freely, another only after pre-approval, and a third leaves it out.

The $3,400 figure matters here too: a limited-purpose FSA counts against the same annual limit as a general-purpose health FSA. For 2026, the IRS caps salary-reduction contributions to a health FSA at "$3,400", and a plan that allows carryover can carry up to $680 into next year. None of that changes which dental or vision items qualify. For the plan-specific pre-approval rules, your summary plan description or your administrator has the answer, not the IRS.

How reimbursement gets paid

The money comes out of your limited-purpose FSA and lands with you. Pay your provider however you normally would (credit, debit or BNPL all work), and Burst handles the claim from there. Burst files it with your administrator, and the administrator pays you out of your limited-purpose FSA by deposit or check. You're not the one submitting paperwork to your plan. The one thing to sequence correctly is the letter, when an item needs one: line it up dated before your purchase, since a letter can't cover a purchase it postdates.

Getting it reimbursed with Burst

If what you're buying needs a letter of medical necessity, Burst writes it and files the claim. $35 once, about two minutes to request, reviewed by a licensed clinician, typically in your inbox within 24 hours. Burst files the reimbursement claim with your FSA, HSA or HRA administrator, and the administrator pays you out of your account by deposit or check. No letter, no charge. Claim denied, money back. The letter has to be dated on or before the purchase it covers, so request it before you buy.

Request my letter for $35

Frequently asked questions

What is the main difference between a limited-purpose FSA and a regular health FSA?

A limited-purpose FSA covers only dental and vision expenses, while a regular health FSA covers all qualified medical expenses (doctor visits, prescriptions, medical equipment, etc.). A limited-purpose FSA is designed to pair with an HSA under a high-deductible health plan arrangement.

Can I use my limited-purpose FSA for prescriptions or doctor visits?

No. A limited-purpose FSA covers only dental and vision care. Prescriptions, doctor visits and other medical expenses are not eligible from a limited-purpose FSA. Those expenses would be covered by your HSA, a separate health plan, or paid out of pocket.

Does a limited-purpose FSA cover OTC products like pain relievers or sunscreen?

No. OTC medicines and other non-dental, non-vision expenses are not covered by a limited-purpose FSA. These would be reimbursable from your HSA or other health plan, not from your limited-purpose FSA.

Are eye exams and eyeglasses covered by a limited-purpose FSA?

Yes. Eye exams, prescription eyeglasses, contact lenses, lens solution and prescription sunglasses all clear your limited-purpose FSA outright, no letter required.

Are orthodontia and braces covered?

Orthodontia and braces are eligible under IRS rules, but your specific plan document governs whether your employer's limited-purpose FSA covers them. Some plans cover all orthodontia, while others require pre-approval or have limits. Check your plan document or contact your administrator.

Can I use my limited-purpose FSA for teeth whitening?

No. Teeth whitening is cosmetic dentistry under IRS rules, even when the discoloration has a medical cause such as a medication side effect. No letter of medical necessity changes that outcome for a limited-purpose FSA.

How does a limited-purpose FSA work with my HSA?

A limited-purpose FSA is designed to pair with an HSA under a high-deductible health plan arrangement. The limited-purpose FSA covers only dental and vision expenses, while your HSA covers all other qualified medical expenses, such as prescriptions, doctor visits and medical equipment. This allows you to take advantage of both accounts' tax-free benefits for different categories of care. The two accounts work independently, and balances are tracked separately.

Keep reading: What Can I Use My HSA Funds On?, HSA and FSA Eligible Items in 2026: Complete Guide, What Can I Use My FSA Funds On?, and all guides on this topic.

Sources

• IRS Publication 502 - Medical and Dental Expenses (Dental and vision care eligibility, the definition of dental disease prevention and alleviation, and which vision and dental procedures qualify as medical expenses)

• IRS Publication 969 - Health Savings Accounts and Other Tax-Favored Health Plans (Limited-purpose FSA definition and rules, paired with an HDHP and HSA)

• IRS, 2026 Tax Inflation Adjustments (The 2026 health FSA salary-reduction limit ($3,400) and maximum carryover ($680))