FSA vs. HSA: How to Use Pre-Tax Dollars for Vision Care

What is a Flexible Spending Account (FSA)?

As the name suggests, a flexible spending account, or FSA, gives you flexibility in how you pay for healthcare. An FSA is an employer-sponsored benefit that lets you contribute pre-tax money to use on eligible medical expenses. Employers offer FSAs alongside their workplace health insurance plans, and in some cases, you may be able to enroll in an FSA even if you are not covered under the employer’s health plan. Contributions are usually deducted directly from your paycheck, and you can use these funds for qualified health costs, including vision care.   

Once you choose how much to contribute to your FSA, that amount generally stays in place for the plan year unless you experience a qualifying life event that allows you to make changes. For 2026, the IRS allows employees to contribute up to $3,400 to a health FSA, though your employer may set a lower limit. Some employers also permit you to carry over a portion of unused funds into the next plan year. In 2026, the maximum allowed health FSA carryover is $680, if your employer offers this option.

What Can an FSA Be Used for in Vision Care?

An FSA can be a smart way to manage routine and specialized vision expenses. In most cases, you can use FSA dollars for many of the same products and services you receive at EyeCare Associates. Common FSA-eligible eye care expenses include:

• Comprehensive eye exams 

• Glasses, including lenses and frames 

• Prescription sunglasses 

• Contact lenses, solution, cleaners, and cases 

• Certain eye drops prescribed or recommended by your eye doctor 

• Eligible eye surgeries like LASIK or cataract surgery 

EyeCare Associates offers a wide range of eye care services, glasses, and contact lenses that can often be paid for with FSA funds. If you are unsure whether a particular service or product qualifies, our team can help you review your options before you check out. 

What is a Health Savings Account (HSA)?

A health savings account (HSA) is another type of tax-advantaged account you can use to pay for qualified medical expenses, including vision care. Like FSAs, HSAs are funded with pre-tax dollars, which can help lower your taxable income. However, there are some important differences in how HSAs work.

  One key distinction from an FSA is that you must be enrolled in a high-deductible health plan (HDHP) that meets IRS requirements in order to contribute to an HSA. For 2026, an HSA-qualified HDHP must have at least:

• A minimum deductible of $1,700 for individual coverage or $3,400 for family coverage 

• A maximum out-of-pocket limit (including deductibles, copays, and coinsurance) of $8,500 for individuals or $17,000 for families 

Another major difference is ownership. An HSA belongs to you, not your employer. Any money you do not use stays in your account and rolls over from year to year, and the account remains yours even if you change jobs or health plans (you simply cannot continue contributing if you are no longer in an HSA-eligible plan).

What Can an HSA Be Used for in Vision Care?

HSA funds can typically be used for many of the same vision expenses as FSA dollars. Vision care received at EyeCare Associates is generally considered a qualified medical expense when it is medically necessary. In most cases, HSA funds can be applied to all the same vision costs as FSAs, such as exams and prescription eyewear.   

Because HSA funds do not expire at the end of the year, some patients prefer to reserve these dollars for larger one-time procedures, like LASIK, or to save them for future eye care needs as their vision changes with age. This flexibility can make an HSA a useful long-term tool for managing both current and future vision expenses.

Comparing Tax-Free Accounts: The Differences for Vision Care

Both FSAs and HSAs can make vision care more affordable, but they operate differently behind the scenes. Here is a simple comparison with a focus on eye care:

Who can have the account?

• FSA: Only if your employer offers one. 

• HSA: Only if you are enrolled in an HSA-eligible HDHP. 

Who owns the account?

• FSA: The employer owns the account and unused funds may be forfeited or subject to grace period/carryover rules. 

• HSA: You own the account, meaning funds roll over year to year and move with you if you change jobs. 

Use it or lose it?

• FSA: Usually yes, except for limited grace periods or carryovers (up to the IRS limit if your employer allows it). 

• HSA: No. Funds remain in your account until you use them. 

Contribution limits for 2026?

• FSA: Up to $3,400 per year if your employer allows the maximum. 

• HSA: Up to $4,400 for self-only coverage or $8,750 for family coverage, plus a $1,000 catch-up contribution if you are 55 or older. 

How to Pay for Eye Care with an FSA

If you have an FSA and want to use it for vision care at EyeCare Associates, here are a few simple steps to follow:

1. Check Your FSA Balance and Deadlines: Log into your FSA account portal or talk with your HR or benefits team to see how much money you have available and when your plan year ends. Ask whether your plan offers a carryover amount or grace period and how those features work. 

2. Schedule Your Eye Exam: Book a comprehensive eye exam at your nearest EyeCare Associates location. Routine eye exams help keep your prescription up to date and allow your eye doctor to detect problems early, when they are often easier to manage. 

3. Use FSA Funds at Your Appointment: You can usually use FSA dollars to pay for exam copays, glasses, contact lenses, and other covered eye care services. Bring your FSA card if you have one, or save your itemized receipts and submit them to your FSA administrator for reimbursement. 

4. Plan Ahead for Year-End: If your plan follows a calendar year, consider using remaining FSA funds before December 31, or your specific plan end date. Many patients use leftover dollars toward a backup pair of glasses, prescription sunglasses, lens upgrades, or an extra supply of contact lenses. 

How to Pay for Eye Care with an HSA

Health Savings Accounts offer added flexibility for timing and long-term planning. Here is how to use an HSA for your eye care at EyeCare Associates:

1. Confirm That Your Expense is HSA-Eligible: Most medically necessary vision costs, including eye exams, prescription eyewear, and many eye surgeries, qualify as eligible expenses. If you are unsure, review your HSA administrator’s list of approved expenses or contact them with questions. 

2. Pay Directly with Your HSA Debit Card: At checkout, you can often pay for eligible services and products using your HSA debit card. This allows you to use pre-tax dollars right away for exam copays, glasses, contact lenses, and qualifying procedures. 

3. Pay Out-of-Pocket and Reimburse Yourself Later: Some patients prefer to pay with personal funds and reimburse themselves from their HSA at a later time. This approach can help you keep more money invested in your HSA for potential long-term growth. Be sure to save your receipts and follow your HSA administrator’s reimbursement rules. 

4. Use Your HSA for Larger Vision Expenses: Because HSA funds roll over year after year, many people choose to reserve some of this money for larger one-time procedures or premium lens options. This can be especially helpful when planning for laser vision correction, cataract surgery, or other age-related eye care needs.