The contributions you make to a flexible spending account (FSA) are not tax-deductible because the accounts are funded through salary deferrals. However, contributing to an FSA does reduce your taxable wages since the account is funded with pretax dollars.

The maximum amount of salary deferral in an FSA for the 2018 tax year was $2,650, and for 2019 is $2,700. (In recent years, the maximum has been increased $50 per year.)

How to Use an FSA

An FSA is intended to help employees cover health-related costs that are not included in their insurance plans.

The specifics vary but plans generally can be used to help cover a deductible or pay for prescription glasses. Some can be used for alternative treatments like acupuncture. With a doctor's prescription, you may be able to use the FSA to help pay for a gym membership or massage therapy.

First aid products are generally covered, including items like bandages and thermometers. Many over-the-counter medications and remedies are covered but only if you have a doctor's prescription for them. These include common products like aspirin, cold medicine, antacids, acne cream, ear wax removers, and wart removers.

You can't use the FSA for some other common household items like toothpaste or shaving cream.

Someone at the IRS presumably made lists of which common household items are health products and which are merely healthful products.

Vitamins and herbal remedies are not covered; nor is plastic surgery or teeth whitening.

How an FSA Works

Just like a 401(k) retirement plan, an FSA account is funded through salary deferrals in pretax money. You cannot claim a tax deduction for your contributions because the money was not taxed in the first place.

When you have an FSA, you are setting aside part of your salary so that you will be reimbursed for eligible medical or dependent care expenses during the year instead of paying out-of-pocket.

You decide once a year, during your benefits enrollment period, what percentage or amount of your salary you would like to defer into the FSA, up to a maximum. The money deferred is considered pretax, and it reduces your gross income.

For example, if your annual salary is $40,000 and you decide to contribute $2,000 to your FSA, your gross income would then be $38,000. Your $2,000 FSA contribution is paid in pre-tax dollars and therefore cannot be taken as a tax deduction.

Key Takeaways

  • An FSA is intended to help employees cover health-related costs that are not included in their insurance plans.
  • Contributing to an FSA does reduce your taxable wages since the account is funded with pretax dollars.
  • With a doctor's prescription, you may be able to use the FSA to help pay for a gym membership or massage therapy.

Don't Over-Fund Your FSA

One word of caution: Employees need to avoid over-funding their FSA accounts. Any balance remaining in the account is commonly forfeited at the end of the year, although some plans have a grace period to submit claims or allow remaining money to be rolled over.

At the very least, keep an eye on the balance in your FSA and make sure you use it by the annual deadline. If the annual deadline is approaching, you can hit the pharmacy aisle and get some of the many over-the-counter remedies and products that an FSA covers. But don't go overboard. The regulations specifically prohibit stockpiling products that can't reasonably be used up in the year.