Why OTC eye drops count for HSA and FSA

Over-the-counter eye drops count for HSA and FSA spending because of the CARES Act, signed in March 2020. Its section 3702 made over-the-counter medicines qualified medical expenses for these accounts without a prescription, for amounts paid after December 31, 2019, according to the IRS. Quell is an over-the-counter drug, so it generally qualifies, though your plan still sets its own rules.

What the CARES Act changed

The Coronavirus Aid, Relief, and Economic Security Act became Public Law 116-136 in March 2020. Section 3702 of the law is titled “Inclusion of certain over-the-counter medical products as qualified medical expenses.” It covers health savings accounts and the related accounts employers offer, including health flexible spending arrangements and health reimbursement arrangements.

The IRS explained the change in news release IR-2020-122, issued June 17, 2020: over-the-counter products and medications became reimbursable without a prescription, and the new rules apply to amounts paid after December 31, 2019. Before that, a prescription was the gate. An eye drop off the shelf needed a doctor’s note to be paid from one of these accounts; now it doesn’t.

Are eye drops FSA eligible?

Over-the-counter medicine is, under federal rules. IRS Publication 969, the guide to HSAs and other tax-favored health plans for 2025 returns, lists expenses incurred for over-the-counter medicine, whether or not prescribed, as covered expenses for health FSAs and HRAs.

Federal eligibility sets the outer edge. Your employer’s plan can be narrower. Some administrators keep their own lists of eligible items, and some ask for more paperwork than others. How to file an FSA claim for eye drops walks through the receipt and the claim itself.

Can I buy eye drops with an HSA?

Generally yes. A health savings account follows the same CARES Act rule on over-the-counter medicines, and unlike an FSA, an HSA balance doesn’t expire at the end of the year. You can pay with an HSA card if it’s accepted, or pay another way and take a distribution to reimburse yourself, keeping the receipt in case you ever need to show what the money paid for.

On this site, whether a particular HSA or FSA card is accepted at the payment page depends on the card and the plan. The confirmation email is the receipt either way.

Why an eye drop is a “medicine” for these rules

The CARES Act wording is about over-the-counter medicines and drugs, not about general wellness products. An over-the-counter drug in the United States carries a standardized Drug Facts panel, with active ingredients, a stated use, warnings and directions. Quell’s panel lists Glycerol (1.0%), Polysorbate 80 (1.0%) and Light Mineral Oil (0.5%) as its actives, and its Uses section reads: For use as a protectant against further irritation or to relieve dryness of the eye.

That panel is what tells a plan administrator the product is a drug, not a cosmetic or a gadget. It is reproduced word for word on the Drug Facts page if you ever need to show it.

The tax deduction is a different rule

One point catches people out. Paying from an HSA or FSA is not the same as claiming an itemized medical deduction on your tax return. IRS Publication 502, which covers that deduction for 2025 returns, still says that except for insulin, you can’t include in medical expenses the cost of a drug that isn’t prescribed. So an over-the-counter eye drop can be eligible for your FSA or HSA and still not be deductible on its own. If that distinction matters for your return, a tax professional can tell you how it applies to you.

Is shipping covered?

The law speaks to the medicine; shipping is the plan’s decision. Some reimburse it as part of the purchase and some don’t. Orders of 3 bottles or more ship free from this site, which takes the question off the table; otherwise shipping is a flat $10.00 and shows as its own line on the receipt.

What hasn’t changed

• The label still governs how you use the product: Apply 1 drop 3 times per day in each eye.
• An account paying for it doesn’t make it right for every eye. If you use other drops or wear contact lenses, the label doesn’t cover that; ask your eye doctor or pharmacist.
• The stop-use warning applies whoever paid: Stop use and ask a doctor if you feel eye pain or changes in your vision, if irritation or redness continues, or if the condition worsens or persists for 72 hours.

For the shorter version of all this, see can I use HSA or FSA funds for eye drops?