Yes, deductibles are eligible for reimbursement with a Flexible Spending Account (FSA) or Health Savings Account (HSA).
Why Are Deductibles FSA/HSA Eligible?
A deductible is the amount you must pay out of pocket for healthcare services before your insurance begins covering costs. Because deductibles represent your personal financial responsibility for receiving medical care, they qualify as eligible expenses under IRS Code Section 213(d).
According to IRS Publication 502, medical expenses that are not reimbursed by insurance—including deductibles—are eligible for FSA and HSA reimbursement.
This includes:
Medical plan deductibles, such as those for primary care, specialists, surgeries, or hospital stays
Dental insurance deductibles, including for exams, cleanings, fillings, or other covered dental procedures
Vision plan deductibles, such as for eye exams, corrective lenses, or eye surgeries
Prescription (Rx) plan deductibles, applied before coverage for medications begins
If the underlying service is eligible, the portion you pay toward your deductible is reimbursable.
What’s Not Covered?
The following are not eligible:
Deductibles for services that do not qualify as eligible medical expenses (e.g., cosmetic surgery)
Expenses reimbursed by another plan or benefit (such as secondary insurance)
Insurance premiums — see the clarification below for important differences between FSAs and HSAs.
FSA vs. HSA: A Note On Insurance Premiums
While FSAs do not allow reimbursement for insurance premiums, HSAs offer limited exceptions. HSA funds can be used to pay certain types of insurance premiums, but only in specific situations, such as:
Health insurance premiums while receiving unemployment benefits
COBRA continuation coverage
Long-term care insurance premiums, subject to annual IRS limits
Medicare premiums, but only for Medicare Part A, B, C, or D (not Medigap policies) and only if you're age 65 or older
Unless one of these exceptions applies, insurance premiums are not eligible under either FSA or HSA rules.
For a full breakdown of what qualifies as a reimbursable medical expense, refer to IRS Publication 502.
How to Use Your FSA or HSA for Deductibles
You can use your FSA or HSA card to pay for medical, dental, vision, or Rx expenses that apply to your deductible at the time of service. If you pay out of pocket:
Request an itemized receipt showing the service, date, and amount applied to your deductible
Save your Explanation of Benefits (EOB) from your insurer for documentation
Submit a reimbursement request through your FSA or HSA administrator if needed
For more details on eligible healthcare expenses, refer to IRS Publication 502.
