Short answer: Yes. Many over-the-counter items—such as pain relievers, allergy medications, and first aid supplies—are FSA-eligible without a prescription under current federal law.
Healthcare Flexible Spending Accounts (FSAs) may be used to pay for a wide range of over-the-counter (OTC) medical items. Federal law allows most OTC medications and supplies to be reimbursed through an FSA without requiring a prescription.
Commonly eligible OTC items include pain relievers, cold and flu medications, allergy treatments, antacids, first aid supplies, thermometers, and sunscreen with an SPF of 15 or higher. Menstrual care products, such as pads, tampons, and menstrual cups, are also eligible expenses.
Many retailers and pharmacies automatically recognize eligible OTC items at checkout, allowing employees to use an FSA debit card directly. However, eligibility ultimately depends on IRS rules and the employer’s plan design, and employees should retain receipts in case substantiation is required by the FSA administrator.
Because eligibility lists can evolve and plan administration may vary, employees should consult their plan materials or FSA administrator if there is any uncertainty about whether a specific item qualifies.
FSA eligibility rules for OTC items are administered by the Internal Revenue Service.
Sources
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Internal Revenue Service, Publication 969, Health Savings Accounts and Other Tax-Favored Health Plans
https://www.irs.gov/publications/p969 -
Internal Revenue Code, Section 125
Content history
Originally published: March 25, 2025
Last reviewed: January 25, 2026