BANGKOK (AP) — Nearly all of the world’s 35,000 online pharmacies are being run illegally and consumers who use them risk getting ineffective or dangerous drugs, according to the U.S. Trade Representative’s annual report on “ notorious markets.” The report also singled out 19 countries over concerns about counterfeit or pirated products.

The report says 96% of online pharmacies were found to be violating the law, many operating without a license and selling medicines without prescriptions and safety warnings.

Their websites often look like legitimate e-commerce platforms, often with false claims that they are approved by the Food and Drug Administration, said the report, released Wednesday. The FDA and U.S. Drug Enforcement Administration have both issued warnings about risks of buying prescription medicines from such sources.

It cited a survey by the Alliance for Safe Online Pharmacies’ Global Foundation that found nearly one in four Americans who have used online pharmacies reported having encountered substandard, fake or harmful medicines.

Last year, Federal prosecutors reported that a network of illegal drug sellers based in the U.S., the Dominican Republic and India had packaged potentially deadly synthetic opioids into pills disguised as common prescription drugs and sold millions of them through fake online drugstores, federal prosecutors said Monday. At least nine people died of narcotics poisoning between August 2023 and June 2024 after consuming the counterfeit pills, the indictment said.

Apart from the risks of using drugs that may contain inert ingredients or those that could cause allergies, the medicines are sometimes made in unsanitary conditions, said the report, which did not give annual statistics for those who may have died or otherwise been harmed.

The USTR’s annual report cited examples from inside the United States, but and also mentioned risks of imported ingredients including fentanyl from China. Many of the illicit online pharmacies are based outside the U.S.

The “Notorious Markets List” did laud progress in fighting counterfeit and pirated goods.

In one case, U.S. authorities, industry groups and the police collaborated in shutting down a Hanoi, Vietnam-based piracy ring, Fmovies, and other related piracy sites, in July and August.

The report said the world’s then-largest pirated movies site had drawn more than 6.7 billion visits from January 2023 to June 2024.

In another Vietnam-linked case, two people operating pirate television platform BestBuyIPTV were convicted and ordered to pay fines and forfeit property.

The report also cited crackdowns on online piracy in Brazil and the United Kingdom and busts of sellers of counterfeit purses, clothing and shoes in Kuwait.

But problems remain with cyberlockers that thwart efforts to restrict piracy of movies and other content and of so-called “bulletproof” internet service providers, or ISPs, that promise people using them leeway for using pirate sites, it said.

One such ISP is Avito, a Russian-based ad platform that allegedly lets sellers advertise counterfeit products.

Baidu Wangpan, a cloud storage service of China’s largest search engine provider, Baidu, was named for allegedly failing to enforce or being slow to act on copyright protection.

The report also pointed to social-commerce site Pinduoduo and to Douyin Mall, a Chinese online platform owned by Tiktok owner ByteDance. It said the shopping platforms have sought to build up protections but that they still host many counterfeit goods.

It also named Shopee, a Singapore-based online and mobile e-commerce site, saying some country-focused platforms serving Southeast Asia and South American had better track records in fighting piracy than others.

IndiaMART, an big business-to-business marketplace in India, still offers a slew of counterfeit products, it said.

While a large share of theft of intellectual property has moved online, the report also highlighted real world locations notorious for selling counterfeit products, including markets in Turkey, bazaars in the United Arab Emirates and Saigon Square Shopping Mall in Vietnam’s Ho Chi Minh City.

The report said Bangkok’s MBK Center, a huge mall of about 2,000 stores, had actively cracked down on counterfeiting, though such products still can be found there.

Larry Hedrick, 61, a nonverbal man in need of constant care, was put into a tub of 134-degree water for 47 minutes at Hopemont Hospital in Terra Alta, West Virginia Attorney General Patrick Morrisey said Wednesday.

The Jan. 4, 2024 incident left Hedrick with second- and third-degree burns and blisters on his feet and legs. He was taken to a burn trauma unit in Pittsburgh but died on Jan. 12.

An investigation led by the state’s Medicaid Fraud Control Unit determined that certified nursing assistant Kylah Beard helped Hedrick into the water without checking the temperature gauge. After Hedrick suffered his injuries, registered nurse Delilah Clyburn-Hill failed to take appropriate treatment steps, including the use of pain medication, Morrisey said.

Both were charged with felony neglect of an incapacitated adult by a caregiver resulting in the incapacitated adult’s death. Both are scheduled to appear in Preston County Magistrate Court later this month.

An investigation into other employees who were tasked with caring for Hedrick is ongoing and could lead to additional indictments.

“This is a very disturbing case and there needs to be accountability for the horrific death of the victim, Mr. Larry Hedrick, who was supposed to be under the care of medical professionals,” said Morrisey, who will be sworn in as West Virginia’s governor next week.

NEW YORK (AP) — The first U.S. bird flu death has been reported — a person in Louisiana who had been hospitalized with severe respiratory symptoms.

State health officials announced the death on Monday, and the Centers for Disease Control and Prevention confirmed it was the nation’s first due to bird flu.

Health officials have said the person was older than 65, had underlying medical problems and had been in contact with sick and dead birds in a backyard flock. They also said a genetic analysis had suggested the bird flu virus had mutated inside the patient, which could have led to the more severe illness.

Few other details about the person have been disclosed.

A bird flu death was not unexpected, virus experts said. There have been more than 950 confirmed bird flu infections globally since 2003, and more than 460 of those people died, according to the World Health Organization.

The bird flu virus “is a serious threat and it has historically been a deadly virus,” said Jennifer Nuzzo, director of the Pandemic Center at the Brown University School of Public Health. “This is just a tragic reminder of that.”

Nuzzo noted a Canadian teen became severely ill after being infected recently. Researchers are still trying to gauge the dangers of the current version of the virus and determine what causes it to hit some people harder than others, she said.

“Just because we have seen mild cases does not mean future cases will continue to be mild,” she added.

In a statement, CDC officials described the Louisiana death as tragic but also said “there are no concerning virologic changes actively spreading in wild birds, poultry or cows that would raise the risk to human health.”

In two of the recent U.S. cases — an adult in Missouri and a child in California — health officials have not determined how they caught the virus. The origin of the Louisiana person’s infection was not considered a mystery. But it was the first human case in the U.S. linked to exposure to backyard birds, according to the CDC.

Louisiana officials say they are not aware of any other cases in their state, and U.S. officials have said they do not have any evidence that the virus is spreading from person to person.

The H5N1 bird flu has been spreading widely among wild birds, poultry, cows and other animals. Its growing presence in the environment increases the chances that people will be exposed, and potentially catch it, officials have said.

Officials continue to urge people who have contact with sick or dead birds to take precautions, including wearing respiratory and eye protection and gloves when handling poultry.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

As U.S. lawmakers debate issues around health care for transgender youth, it’s been difficult to determine the number of young people receiving gender-affirming medications, leaving room for exaggerated and false claims.

Now, a medical journal has published the most reliable estimate yet and the numbers are low, reflecting more clearly on medical practices now being weighed by the U.S. Supreme Court.

Fewer than 1 in 1,000 U.S. adolescents with commercial insurance received gender-affirming medications — puberty blockers or hormones — during a recent five-year period, according to the study released Monday.

At least 26 states have adopted laws restricting or banning gender-affirming medical care for transgender minors, and most of those states face lawsuits. A decision by the Supreme Court in a Tennessee case is expected later this year. President-elect Donald Trump has promised to roll back protections for transgender people.

“We are not seeing inappropriate use of this sort of care,” said lead author Landon Hughes, a Harvard University public health researcher. “And it’s certainly not happening at the rate at which people often think it is.”

The researchers analyzed a large insurance claims database covering more than 5 million patients ages 8 to 17.

The researchers found that no patients under age 12 were prescribed hormones, an indication that doctors are appropriately cautious about when to start such treatments, Hughes said.

“I hope that our paper cools heads on this issue and ensures that the public is getting a true sense of the number of people who are accessing this care,” he said.

The database included insurance plans in all 50 states, but did not include youth covered by Medicaid, the federal-state health insurance program for low-income people.

The study did not look at surgeries among transgender adolescents. Other researchers have found those procedures are extremely rare among young people.

Not all transgender youth proceed with medical treatments, said Dr. Scott Leibowitz, co-lead author of the adolescent standards of care for the World Professional Association for Transgender Health, a leading transgender health group.

Transgender adolescents “come to understand their gender at different times and in different ways,” he said, noting that the best care should include experts in adolescent identity development who can work with families to help figure out what’s appropriate for each young person.

Leibowitz, who has worked in gender clinics in several U.S. cities, said the study “adds to the growing evidence base about best practices when serving transgender and gender diverse youth.”

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

Murthy’s advisory comes as research and evidence mounts about the bad effects that alcohol has on human health, but his proposal for a label would require a rare approval from the U.S. Congress.

Americans should be better informed about the link between alcohol and cancer, in particular, Murthy argues in his advisory, noting alcohol consumption is to blame for nearly one million preventable cancer cases in the U.S. over the last decade. About 20,000 people die every year from those alcohol-related cancer cases, according to his advisory.

Bottles of beer, wine and liquor already carry warning labels that say pregnant women should not drink and that alcohol consumption can impair someone’s ability to drive a car. But Murthy’s proposed label would go even further, raising awareness about the risk for cancer, too.

“It’s pretty crazy that there’s a lot more information on a can of peas than on a bottle of whiskey,” said Dr. Timothy Naimi, who directs the Canadian Institute for Substance Use Research at the University of Victoria in British Columbia. “Consumers have the right to basic information about health risks, serving size and drinks per container.”

Consuming alcohol raises the risk of developing at least seven types of cancer diseases, including liver, breast and throat cancer, research has found. His advisory also notes that as a person’s alcohol consumption goes up, so does the risk for developing those illnesses.

“For individuals, be aware that cancer risk increases as you drink more alcohol,” Murthy wrote Friday on X. “As you consider whether or how much to drink, keep in mind that less is better when it comes to cancer risk.”

Even with the surgeon general’s advisory and new research that shows the dangers of drinking, it’s unlikely Congress would act swiftly to enact a new warning on alcohol products.

It’s been nearly four decades since Congress approved the first government warning label on alcohol, the one that says pregnant women shouldn’t drink and warns about the dangers of driving while drinking. No updates have been made since then.

Before that, Congress approved a label on cigarettes cautioning users that smoking is hazardous to health, a move that’s credited with helping America substantially reduce its bad habit.

But any effort to add a cancer warning label to alcohol would face significant push back from a well-funded and powerful beverage industry, which spends nearly $30 million every year lobbying Congress.

Other research around alcohol, including reports that moderate drinking can be associated with lower risks of heart disease compared to no alcohol consumption, should be considered, said Amanda Berger of the Distilled Spirits Council of the United States.

“Many lifestyle choices carry potential risks, and it is the federal government’s role to determine any proposed changes to the warning statements based on the entire body of scientific research,” Berger said in a statement.

The surgeon general’s advisory comes as the government is in the process of updating dietary guidelines, including those around alcohol, that will form the cornerstone of federal food programs and policy. The updated guidelines are expected later this year.

The current guidelines recommend women have one drink or fewer per day while men should stick to two or fewer.

After large drops during the pandemic, life expectancy in the United States should recover to 2019 levels this year nationally and in 26 states — but not as fast as it should compared with similar countries, according to a new study.

Bad habits such as junk food, smoking and illicit drug use are preventing longer lifespans even as technology brings major progress in diseases such as cancer and heart disease, according to a new study by the Institute for Health Metrics and Evaluation at the University of Washington.

By 2050, U.S. life expectancy is projected to increase from 79.1 years to 80.4 years for babies born in that year, a modest improvement that would drop the United States behind nearly all other high-income countries, according to the study.

Poverty and inadequate health insurance are slowing progress in some states. Wealthier, more urban and better-educated states are doing better and are more likely to adopt policies that save lives, from curbing gun access to offering income supports for young mothers. Nine of the 10 states (all but North Dakota) with the longest life expectancies for babies born this year are dominated by Democrats, and all 10 have expanded Medicaid under the Affordable Care Act. All 10 states with the shortest life expectancies are controlled by Republicans (though Kentucky has a Democratic governor), and they include five of the 10 states that have not expanded Medicaid.

A Stateline analysis of data from the study shows how some states have risen, and some have tumbled, in terms of life expectancy.

In 1990, for example, New York and West Virginia were nearly tied at Nos. 39 and 41 among states’ life expectancy rankings. But the two have since taken sharply different paths — New York rose to No. 3 in 2024 and is projected to have the longest life expectancy of any state by 2050, passing Hawaii and Massachusetts.

West Virginia outranks only Mississippi in 2024 and is projected to be last among states in 2050.

New York has benefited from good health care availability in New York City hospitals as well as state policies such as strict gun laws that have curbed suicides, and harm reduction policies to curb overdose deaths with supervised use sites and other controversial programs, said Brett Harris, president of the New York State Public Health Association and an associate professor in the University of Albany’s Department of Health Policy.

Harris said she’s not surprised that New York state, despite its ascent in life expectancy among states, would still drop from No. 33 to No. 41 by 2050 if ranked as a nation, according to the analysis.

“I think part of that is how individualistic we are in this country, the idea of always trying to get ahead, versus more of a community-based environment in other countries,” Harris said. “Their social policies tend to be better for health outcomes. If you live in more of a family environment versus an individualistic environment, that builds in more support.”

West Virginia’s sparse population and rural poverty make it harder to get health care. It’s also hard to get past community and political skepticism about health measures, said Brian Huggins, health officer for Monongalia County, West Virginia. Huggins has worked with other county health officials to advocate for stricter anti-smoking laws and to maintain school vaccination mandates in the face of opposition.

“It hurts to see West Virginia ranked at the bottom. We’re a proud state,” said Huggins, adding that life expectancy there also is hampered by lack of economic opportunity that drives young, healthy residents to move away. A plethora of concerns include a lack of sidewalks that make healthy walking more hazardous, and a dietary culture that does not include vegetables; both promote obesity.

Huggins also has seen conditions abroad. While stationed in Germany for the U.S. Army, he saw generous health provisions for Germans, such as two-week retreats with massages and sauna baths for those feeling stressed or burned out at work.

“Their goal in Germany is they want you back at work. Prevention and keeping a healthy workforce are their priority because that contributes to the economy,” said Huggins. “On the other hand, they have built a tax system to support this. You pay like an 18% tax on everything you buy there — that would not be something Americans would necessarily accept.” Germany’s valued-added tax, now 19%, applies to most goods and services.

Life expectancy dropped two years in a row during the COVID-19 pandemic, including a national drop of more than 1.8 years between 2019 and 2020, from 79.1 to 77.3 years. Recovery will not be complete until this year, according to the projections, with slow progress predicted until 2050 — when the national life expectancy will be about 80.4 years.

Some of the states that recovered fastest from the pandemic were North Dakota, Rhode Island and Massachusetts, where life expectancy gained about a year between 2019 and 2024. Twenty-four states still haven’t regained their 2019 life expectancy.

The District of Columbia, which is not a state, had a lower life expectancy than all 50 states in 1990, but this year it ranks 23. Ali Mokdad, an author of the study and the chief strategy officer for population health at the University of Washington, said D.C.’s improvement is at least partly due to an influx of more affluent and well-educated people since 1990.

Most states that were in the top 10 in 1990 have fallen out: Colorado (from No. 7 to 11), Iowa (from No. 4 to 17), Kansas (from No. 8 to 36), Nebraska (from No. 9 to 19), South Dakota (from No. 10 to 21) and Utah (falling from No. 2 to 12).

Those new to the top 10 in 2024 compared with 1990 are: Massachusetts (from No. 13 to 2), New York (as mentioned from No. 39 to 3), California (from No. 24 to 4), New Jersey (from No. 26 to 6), Rhode Island (from No. 19 to 8), and Washington state (from No. 14 to 10).

Urban concentrations of people are important to long life because of the availability of top-flight care, said Mokdad.

“I’m very close to the hospital [in Seattle] and I have health insurance. But is that true for everyone in Washington state? You might live two or three hours from Seattle, so even for people of my income and education level it’s not the same,” Mokdad said.

Quality care and insurance also are important, Mokdad said, to ensure that problems such as obesity and high blood pressure are noted and controlled.

“You see obesity in many areas, especially the Southern states, has increased tremendously and while smoking has dropped in rich areas, it has stuck around in other communities. This is explaining many of these [state differences] — what we call preventable risk factors,” Mokdad said.

“There’s an increase in life expectancy but a lot of people are still left behind,” Mokdad said.

The program, launched this year, is the first nationally to mimic some in 140 other nations that offer cash subsidies for child health, according to the article. The success of similar, temporary child tax credits early in the pandemic has prompted other states to adopt or expand their own tax credits for young mothers.

“We increasingly know that what happens in early childhood can impact life expectancy,” said Dr. Mona Hanna, a Flint pediatrician who founded the program, called Rx Kids. It relies on state help, in the form of permission to use federal funds, as well as private donations.

Michigan included $20 million in its state budget for next year to expand the program to other cities as well as to mostly white, rural counties in the state’s Upper Peninsula. The program grants $1,500 to expectant mothers plus $500 a month for the first year of the baby’s life.

“This is a concrete solution to conquer these place-based disparities and inequities,” Hanna said. “The stress of being born into poverty can lead to things like prematurity and low birth weight. Moms are more likely to have stress and maybe smoke. I see it every day. Families can’t make it to the doctor because they don’t have transportation. They have trouble eating healthy food because it’s too expensive.”

Rural areas in West Virginia could benefit from similar programs to address the state’s issues with poverty, aging and reliance on declining industries like coal, said Darren Liu, a health policy professor at the School of Public Health at West Virginia University.

To get more access to care for rural residents, the state should expand telemedicine, deploy more mobile clinics and offer student loan forgiveness for health care workers in rural areas, Liu told Stateline in an email.

Huggins, the county health officer in West Virginia, said money is a problem despite new federal guidelines that mandate many health screenings at no cost for insured patients. Often low-income patients get screenings but can’t afford to treat disabling conditions such as the knee and back pain they get from manual labor jobs.

“Because of the barriers that insurance companies put up, because they have to be profitable, I think that’s another reason why West Virginia is ranking low,” Huggins said. “That’s a barrier that we have to try to figure out. Almost any insurance now has well over a $1,000 deductible.”

©2024 States Newsroom. Visit at stateline.org. Distributed by Tribune Content Agency, LLC.

Initially she agreed to promote one health-related GoFundMe page a day after Marcus sent her a DM asking for her help, TMZ reported. Upon reading some of the hard-luck stories, Bell’s heart melted, and in true Princess Anna of Annendale style she gave $100,000.

“This was amazing,” she wrote to Marcus, who posted screen shots of their conversation. “But I wanna do more — how can I give $100,000 to people who need it for medical bills? I want to make sure we do it in the best way, how do we do it??”

In a heartwarming message exchange, the two worked out a system for her to donate the second half of each fundraising appeal once the first half had been raised.

“For example, the next one needs around $50k raised, so once it hits $25k from followers, you donate $25k and we move on to the next one?” Marcus wrote.

“YES!! TOMMY LETS DO IT!” was Bell’s exuberant reply.

And do it they did, raising enough money in just 20 minutes to help a family fund a third-grade girl’s leukemia treatment. They then did the same for a man also suffering from the same cancer.

Bell’s response was more than Marcus could have imagined.

“I first reached out to Kristen with the meager hope she might share one of my fundraising posts, like she frequently does,” the influencer told People. “I never imagined she’d respond with a $100,000 pledge to help me and the QQ community achieve change — that she’d respond not with a quick answer, but a real question: How can we use this money to do good?”

Both collaborators acknowledged that they could not fix a broken health care system, but are determined to operate within it to help save lives.

“Something needs to be done, and this is my something,” Bell told People.

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A post shared by Quentin Quarantino (@quentin.quarantino)

The “Frozen” actress joins several celebs who have doled out money to the medically needy. They include John Oliver, who famously paid $60,000 to buy and forgive $15 million in medical debt in 2016, and philanthropist Mackenzie Scott, who has donated three times to the nonprofit organization Undue Medical Debt (formerly RIP Medical Debt), the same organization Oliver worked through.

More than 100 million adults in the U.S. are saddled with a collective total of $220 billion in medical debt, according to the organization.

With News Wire Services

Cases from the week of Dec. 5 were up from the maximum of 65 outbreaks reported for the first week of December in past years. There were 69 outbreaks in the last week of November, the CDC said.

New York has been no exception. Local health care facilities have advised residents to be on the lookout for patients presenting with norovirus symptoms such as nausea, stomach pain, body ache, headache and fever.

“The State Health Department is aware of several gastrointestinal illness investigations occurring, some of which have been confirmed to be due to Norovirus across New York State,” New York State Department of Health spokesperson Danielle De Souza told the Daily News in a statement. “The Department is assisting partners in the investigation of these outbreaks.”

She noted that the state does not keep statistics on cases, since so many go unreported.

Norovirus is commonly known as stomach flu, though it is not a flu virus. Either way, its hallmark is a sudden onset of vomiting and diarrhea. Outbreaks often occur in close quarters such as on cruise ships and in places like nursing homes, jails and schools.

Direct contact can transmit it, but so can contaminated food, water or surfaces. Symptoms tend to set in 12 to 48 hours later.

Norovirus is the leading cause of foodborne illness in the U.S. with 2,500 outbreaks annually, according to the CDC. The peak season tends to fall between November and April.

Most people are asymptomatic within a few days. However, even after that, contagion can persist for days, health experts say.

Diligent handwashing is the most-recommended protective measure, as is steering clear of raw oysters and other shellfish.

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The recall was issued on Christmas Eve, and the cause of the cat’s dead was determined to be bird flu contracted from a batch of Northwest Naturals brand two-pound Feline Turkey Recipe raw frozen pet food, the Oregon Department of Agriculture (ODA) said.

The Portland-based company immediately issued a voluntary recall of the single batch. The product comes in two-pound plastic bags and carries “best if used by” dates of May 21, 2026, and June 23, 2026. It was sold nationwide via distributors in Arizona, California, Colorado, Florida, Georgia, Illinois, Maryland, Michigan, Minnesota, Pennsylvania, Rhode Island, and Washington, plus British Columbia, Canada, the company said.

Customers who bought the pet food should throw it away immediately and seek a refund from their point of purchase, the company said, echoed by state agriculture officials.

“We are confident that this cat contracted H5N1 by eating the Northwest Naturals raw and frozen pet food,” ODA State Veterinarian Dr. Ryan Scholz said in a statement. “This cat was strictly an indoor cat; it was not exposed to the virus in its environment, and results from the genome sequencing confirmed that the virus recovered from the raw pet food and infected cat were exact matches to each other.”

The testing was conducted by the U.S. Department of Agriculture’s (USDA) National Veterinary Services Laboratories and the Oregon Veterinary Diagnostic Laboratory at Oregon State University, agriculture officials said. It revealed contamination with the H5N1 strain of the Highly Pathogenic Avian Influenza (HPAI) virus, the bird flu variant that is racing through the wild bird population, poultry farms, dairy farms and zoos.

The virus has also jumped to humans, with 65 cases documented by the U.S. Centers for Disease Control and Prevention so far. Most of those are through poultry workers exposed to infected animals, the CDC says, and the risk to the wider human population remains low.

The people living with the infected cat were being monitored, Oregon health officials said, but had not shown signs of illness.

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A big shopping deadline is drawing near for some people, and it has nothing to do with the holidays.

Millions of people use flexible spending accounts to help pay for health care, and some may lose money left in those accounts if they don’t spend it by year’s end.

There are many ways to spend that use-it-or-use it balance — think raiding the local drugstore — but it’s important to understand FSA rules before going on a shopping spree.

Here are some things to consider.

What are flexible spending accounts?

FSAs let you set aside money from your paycheck before taxes to cover a wide range of medical expenses like copays, deductibles, eyeglasses and other supplies. They are set up through your employer, and individuals can set aside up to $3,300 in these accounts.

Figuring out the right amount to set aside can be tricky because it involves forecasting how much care you might need. And you have to use the money by a certain point or you lose it.

What are the deadlines?

They can vary by employer or plan administrator. In some cases, you may have to spend the money by Dec. 31 or you will lose it.

But many plans offer a grace period in the new year to let people use their remaining funds or they allow participants to carry over some of the leftover balance.

“Make sure you understand the clock and the rules,” said David Feinberg of Justworks, a technology company that helps small businesses with benefits.

There are limits. The IRS, for instance, limits the balance carried over to $660 for 2025. Any amounts over that could be lost if they are still in your account by the plan deadline.

How can I spend my FSA balance?

Think of medical expenses not covered by insurance.

The IRS keeps a huge list of eligible expenses for both FSAs and health savings accounts. But companies can limit the expenses they’ll reimburse, so employees should check with their employers.

Eligible expenses can include travel costs to the doctor’s office, eyeglasses, bandages, sunscreen, condoms and tampons.

FSA dollars may even be used to cover things like gym memberships or electric massagers if you have a doctor’s note stating that they are medically necessary.

But they don’t cover things like health insurance premiums or certain cosmetic procedures like teeth whitening.

Do you have any receipts from health care you could submit, like the copayment for a doctor’s office visit? That would qualify.

Some plan administrators watch for stockpiling. Don’t buy a crate of aspirin to use up your balance. Limit purchases to about a year’s supply.

Items can be bought in stores or online.

What is an HSA and how does it differ?

Health savings accounts, or HSAs, also allow you to set aside money before taxes. The difference is that you won’t lose the balance, you can keep the account if you leave your job, and some plans let you invest the money.

HSAs can only be paired with high-deductible insurance plans. Account holders can contribute several thousand dollars each year, depending on the type of coverage they have.

FSAs work with more types of coverage. And the help they offer can be more immediate. The money you decide to set aside over the course of the year is available right away.

That can help people facing a big medical expense like a surgery at the start of a year, said Nicky Brown of Health Equity, which manages about 3 million FSAs.

 The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.