Limited Purpose FSA Eligible Expenses

Short answer

A limited-purpose FSA covers only dental and vision expenses under IRS Publication 502, paired 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

A limited-purpose FSA (also called a dental and vision FSA) is a spending account paired with a high-deductible health plan (HDHP) and an HSA. An HSA is "a tax-exempt trust or custodial account you set up with a qualified HSA trustee to pay or reimburse certain medical expenses you incur". A limited-purpose FSA reimburses only "prevention and alleviation of dental disease" and eligible vision expenses under IRS Publication 502. Dental care, vision exams, glasses, contacts and related supplies are covered. Medical expenses outside dental and vision, such as prescriptions, primary care visits, mental health care and OTC medicines, aren't covered by a limited-purpose FSA. These'd be paid from your HSA, a separate health plan, or out of pocket. Some dental and vision expenses are reimbursable without documentation. Others require a letter of medical necessity from a licensed clinician explaining a diagnosed condition. A third category, such as cosmetic dental or vision procedures, isn't reimbursable by any account.

How to read the list

Every eligible vision and dental item falls into one of three categories. Knowing which category an item lands in tells you what to do before you buy.

Reimbursable outright

These dental and vision expenses are qualified medical expenses under IRS Publication 502 and don't need a letter. They're reimbursable as long as they aren't covered by a separate dental or vision insurance plan.

Reimbursable with a letter

These expenses require a letter of medical necessity. A licensed clinician reviews your situation, confirms a diagnosed medical condition, and explains in one sentence how the purchase treats it. If the honest explanation is about cosmetic improvement with no medical condition, the answer is not reimbursable. Request your letter before you buy, because the letter's date has to be on or before the purchase date.

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 for cosmetic appearance alone isn't reimbursable because it doesn't treat a condition. Whitening for a documented discoloration caused by medication side effects or disease (such as internal staining from a medication) may be reimbursable with a letter that explains the medical cause. 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

The plan document and summary plan description that your employer provides govern what your specific limited-purpose FSA covers. The plan can be more restrictive than the IRS rules, requiring prior authorization for certain expenses or excluding categories the IRS permits. One employer's limited-purpose FSA might exclude orthodontia, while another allows it. A second plan might require pre-approval for major dental work or implants.

For example: Employer A's limited-purpose FSA covers routine and preventive dental care but requires pre-approval for orthodontia and implants. Employer B's plan covers all dental expenses including orthodontia with no pre-approval. In both cases, the same IRS rules define what qualifies, but the employer's plan document adds the administrative requirements. For 2026, the health FSA salary-reduction limit is "$3,400", with a maximum carryover of $680. Check your plan document or your administrator to confirm whether a specific expense is covered and what pre-authorization is required.

How reimbursement gets paid

Reimbursement flows out of your limited-purpose FSA to you. You pay the dental or vision provider with any card (credit, debit or BNPL), Burst files the reimbursement claim with your administrator, and the administrator pays you by deposit to your bank account or by check. You never submit the claim yourself. If a dental or vision expense requires a letter of medical necessity, request it before you buy, because the letter's date has to be on or before the purchase date.

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, eyeglasses, contact lenses, contacts solution and prescription sunglasses are reimbursable outright from a limited-purpose FSA. No letter is needed for these routine vision expenses.

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?

Cosmetic teeth whitening is not reimbursable. Whitening for a documented discoloration caused by medication or disease may be reimbursable with a letter of medical necessity. Cosmetic dental procedures with no medical purpose are never covered.

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))