Does FSA Cover Contacts and Other Vision Expenses?

A Flexible Spending Account (FSA) is an employer-sponsored benefit that allows individuals to set aside pre-tax money from their paycheck to pay for eligible healthcare expenses. This tax-advantaged account reduces taxable income, saving money on qualified medical costs. FSAs have a “use-it-or-lose-it” nature, meaning funds typically must be spent by the end of the plan year or they are forfeited, though some plans offer a grace period or limited carryover option.

Eligible Vision Expenses

Many common vision-related expenses qualify for FSA coverage, as they are considered medical care for diagnosis, treatment, or prevention of disease, or for affecting any body function, as defined by IRS Publication 502, Section 213. Prescription contact lenses, including daily, weekly, and monthly disposables, along with toric and multifocal lenses, are eligible. Products for their care and maintenance, such as cleaning solutions, saline solutions, and contact lens cases, also qualify.

Eye exams performed by a medical professional to diagnose conditions or obtain a prescription for corrective lenses are covered. Prescription eyeglasses, including frames and lenses, and prescription sunglasses are eligible expenses. Corrective vision procedures, such as LASIK or PRK surgery, are eligible if medically necessary. To establish eligibility for these items, a valid prescription from an eye care professional, such as an optometrist or ophthalmologist, is required.

Using Your FSA Funds

Accessing FSA funds for eligible vision expenses involves two methods: using an FSA debit card or submitting a claim for reimbursement. Many FSA plans provide a debit card that can be used directly at the point of sale. Some merchants have systems that can automatically verify purchase eligibility, simplifying the process. It is important to retain itemized receipts, as the FSA administrator may request documentation to substantiate the transaction.

If a debit card is not used, you can submit a claim for reimbursement. This involves paying for the expense and then submitting documentation to your FSA administrator. Required documentation includes an itemized statement or Explanation of Benefits (EOB) from the provider, which must show:

• The date of service
• The provider’s name
• A detailed description of the service or item purchased
• The patient’s name
• The total cost

Claims can be submitted through the administrator’s online portal, mobile app, or by mail, with processing times often ranging from a few business days to a week.

Excluded Vision Expenses

While FSAs cover a broad range of vision care, certain items and services are not eligible for reimbursement. Cosmetic contact lenses, used solely to change eye color or for aesthetic purposes without providing vision correction, are not covered. Non-prescription sunglasses or other eyewear that do not correct vision are excluded. These items are considered for general health benefits or cosmetic reasons, rather than addressing a specific medical condition or vision impairment.

Vision insurance premiums are not eligible expenses for FSA reimbursement. Items or services that are merely beneficial to general health or are purely elective and not medically necessary fall outside the scope of FSA eligibility.