Cold and flu season has a way of sneaking up on you, and so do the costs that come with it. Between the trips to the pharmacy, the urgent care copay, and potential time away from work, staying healthy isn’t always cheap. Luckily, if you have a Health Savings Account (HSA) or Flexible Spending Account (FSA), you may already have a built-in way to cover many of those expenses with pre-tax dollars. If you’ve ever found yourself asking, “how can I use my HSA funds this time of year?”, then this guide is for you. In it, we’ll break down exactly what’s covered, what’s not, and how to get the most out of every dollar in your account. 

HSA vs. FSA: What’s the Difference? 

Before diving into what’s eligible, it helps to understand the accounts themselves.  

Both accounts let you set aside money before it’s taxed and use it toward qualified medical expenses. Because you’re spending pre-tax dollars, every dollar in these accounts goes further than one coming straight out of your regular paycheck. 

The real differences come down to eligibility, flexibility, and ownership. HSAs are only available to people enrolled in a High Deductible Health Plan, but they come with meaningful long-term benefits. The account belongs to you (not your employer), unused funds roll over year after year, the balance can be invested, and the account stays with you if you change jobs. 

FSAs are available to a broader range of employees, regardless of health plan type. The trade-off is that the account is employer-owned, which is why most FSAs follow a use-it-or-lose-it rule. Unspent funds generally don’t carry over, though some employers offer a limited rollover or a short grace period. 

The good news is that when it comes to cold and flu season, both accounts cover the same types of eligible expenses. 

What Cold and Flu Expenses Are HSA and FSA Eligible? 

Thanks to the CARES Act of 2020, the list of HSA and FSA-eligible expenses expanded significantly, and sick-season spending is one of the biggest beneficiaries. Here’s what you can use your funds for: 

Over-the-Counter Medications: Prior to the CARES Act, OTC medications needed a prescription to qualify. That’s no longer the case. You can now use your funds on common cold and flu remedies without a doctor’s note, things like DayQuil, NyQuil, Sudafed, acetaminophen, ibuprofen, cough suppressants, expectorants, and children’s cold and flu medications. The one requirement worth knowing: the product needs to contain an active medicinal ingredient and be labeled to treat a specific symptom. 

Flu Shots: Your HSA or FSA can cover the cost of your flu shot if insurance doesn’t fully pick it up at the pharmacy or doctor’s office. This extends to your dependents as well. 

Doctor and Urgent Care Copays: If things progress to the point of needing a visit to your primary care physician or an urgent care center, your copay is covered under both account types. 

Prescription Medications: Antivirals like Tamiflu and antibiotics prescribed for secondary infections are fully eligible. It’s also worth running the prescription through a tool like GoodRx beforehand, since the cash price occasionally comes in lower than the insurance copay. 

Telehealth Visits: If you’d rather stay home, telehealth appointments are HSA and FSA eligible as well. 

Nasal Sprays, Saline Rinses, and Humidifiers: Beyond medications, several symptom-relief products also qualify. Nasal sprays, saline rinses, and humidifiers are all covered, which is highly useful when congestion is the main issue. 

What’s NOT Covered (and Why It Matters) 

Not everything in the cold and flu aisle qualifies, and it’s an easy assumption to get wrong. 

Dietary supplements and herbal remedies (vitamin C tablets, zinc lozenges, elderberry syrup, herbal teas marketed for immune support, etc.) are not HSA or FSA eligible. Neither are general wellness products that lack a recognized active medicinal ingredient. The category feels related, but under IRS rules, it doesn’t qualify. 

The standard the IRS applies is fairly clear: a product must primarily serve a medical purpose, meaning it has to diagnose, treat, or prevent a specific illness or condition. “Immune support” is considered too broad to meet that bar, but “temporary relief of nasal congestion” is not. 

A reliable way to check before you buy is to look for an active ingredient label and a National Drug Code (NDC) on the packaging. If both are present, you’re generally safe to use your HSA or FSA funds. If they’re not, it’s worth setting that product aside and putting your account balance toward something that actually counts. 

How to Actually Use Your HSA or FSA to Pay for Eligible Expenses 

If you’re still asking “How can I use my HSA or FSA funds?”, the process is more straightforward than most people expect. 

In most cases, your account comes with a dedicated debit card. You use it at checkout like any other card, and most major pharmacies, grocery stores, and retailers automatically recognize eligible items at the register, so there’s no extra steps required on your end. 

For online shopping, sites like FSAstore.com and HSAstore.com carry only verified eligible products, which removes any guesswork about what qualifies. Many major retailers have also added dedicated HSA/FSA sections to their websites, making it easy to filter for qualifying items before you buy. 

If you’re paying a provider directly and your HSA or FSA card isn’t accepted at the time of payment, you’re not out of luck. Most account providers allow you to submit a reimbursement request through their portal after the fact and recover those costs. 

Make the Most of Your HSA and FSA This Cold and Flu Season 

Here are a few practical ways to get more out of your account before, during, and after cold and flu season. 

Check your balance before benefit enrollment season. Reviewing what you actually spent this year can help you right-size next year’s contribution so you’re not scrambling to spend down a surplus or coming up short when you need it. This is especially important for FSA holders, since any funds you over-contribute and don’t spend are forfeited at year’s end. 

Be strategic based on your account type. HSA funds roll over. FSA funds usually don’t. If you have an FSA, cold and flu season is a smart time to stock up on eligible products and put that balance to work before it lapses. If you have an HSA, there’s no pressure to spend because anything you don’t use carries forward indefinitely and can even be invested for long-term growth, making it a meaningful resource well into retirement. 

Use your HSA card for dependents too. A lot of people don’t realize their HSA and FSA funds cover eligible expenses for spouses and tax dependents, not just themselves, which means stocking up on cold medicine for the kids counts too. 

Use your HSA or FSA card directly at checkout. As mentioned, most pharmacies and major retailers accept these cards at the register. Paying out of pocket and submitting for reimbursement later is an option, but it’s an extra step you can usually avoid. 

Pair your HSA/FSA with GoodRx on prescriptions. If you end up with a prescription, comparing your insurance copay price against GoodRx before paying can sometimes save you even more on top of the tax savings from your account. 

Save your receipts. Your plan administrator may ask for documentation at some point. Holding onto receipts for HSA and FSA purchases is a straightforward habit that protects you if any questions come up later. 

Guidance that Goes Beyond Flu Season  

Knowing how to use your HSA and FSA funds strategically is just one piece of a smarter financial picture. At PaulHood, we help hardworking Americans make the most of every tax advantage available to them, not just in April, but all year long. Whether you’re navigating benefit elections, planning around medical expenses, or just trying to keep more of what you earn, we’re here to walk with you every step of the way. 

Ready to see how year-round tax guidance can work for you? Book a free demo with PaulHood today.