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HSA Eligible Expenses
What you can (and can't) pay for with your HSA - the complete guide
The IRS maintains a broad list of qualified medical expenses you can pay for with HSA funds. Here are the most common—plus some surprises.
Medical Care
| Expense |
Eligible? |
Notes |
| Doctor visits & copays |
✓ |
Primary care, specialists |
| Hospital stays |
✓ |
Including room and board |
| Surgery |
✓ |
|
| Lab tests & X-rays |
✓ |
|
| Physical therapy |
✓ |
When medically necessary |
| Chiropractic care |
✓ |
|
| Mental health services |
✓ |
Therapy, psychiatry |
| Substance abuse treatment |
✓ |
|
Prescriptions & Medications
| Expense |
Eligible? |
Notes |
| Prescription drugs |
✓ |
|
| Insulin |
✓ |
No prescription required |
| Over-the-counter medications |
✓ |
Pain relievers, allergy meds, cold medicine (since CARES Act 2020) |
| First aid supplies |
✓ |
Bandages, antiseptic, thermometers |
Dental Care
| Expense |
Eligible? |
Notes |
| Cleanings & exams |
✓ |
|
| Fillings & crowns |
✓ |
|
| Braces & orthodontia |
✓ |
|
| Dentures |
✓ |
|
| Root canals |
✓ |
|
| Teeth whitening |
✗ |
Cosmetic |
Vision Care
| Expense |
Eligible? |
Notes |
| Eye exams |
✓ |
|
| Prescription glasses |
✓ |
|
| Contact lenses & supplies |
✓ |
|
| LASIK surgery |
✓ |
|
| Reading glasses |
✓ |
Even non-prescription |
Women's Health
| Expense |
Eligible? |
Notes |
| Menstrual products |
✓ |
Tampons, pads, cups (since CARES Act) |
| Pregnancy tests |
✓ |
|
| Fertility treatments |
✓ |
IVF, egg/sperm storage |
| Breast pumps |
✓ |
|
| Contraceptives |
✓ |
|
Family & Children
| Expense |
Eligible? |
Notes |
| Baby monitors (medical) |
Depends |
Only if prescribed for apnea, etc. |
| Pediatric care |
✓ |
|
| Vaccines |
✓ |
|
| Lactation supplies |
✓ |
|
Surprising Eligible Expenses
These are often overlooked:
| Expense |
Eligible? |
Notes |
| Sunscreen (SPF 15+) |
✓ |
|
| Acne treatments |
✓ |
|
| Motion sickness bands |
✓ |
|
| Hearing aids & batteries |
✓ |
|
| CPAP machines & supplies |
✓ |
|
| Service animal costs |
✓ |
Training, food, vet care |
| Smoking cessation programs |
✓ |
|
| Weight loss programs |
✓ |
Only if prescribed for specific condition (obesity, heart disease) |
| Telehealth visits |
✓ |
|
| Long-term care premiums |
✓ |
Subject to age-based limits |
Common Non-Eligible Expenses
| Expense |
Eligible? |
Why Not |
| Gym memberships |
✗ |
General health, not medical |
| Vitamins/supplements |
✗ |
Unless prescribed for deficiency |
| Cosmetic procedures |
✗ |
Teeth whitening, elective surgery |
| Health insurance premiums |
Usually ✗ |
Exception: COBRA, Medicare, long-term care |
| Toiletries |
✗ |
Toothpaste, shampoo, etc. |
The Receipt Rule
For all HSA withdrawals, keep documentation showing:
- Date of the expense
- Amount paid
- Type of service/product
- Provider name
You don't need to submit receipts unless audited—but you must have them available. Store receipts indefinitely, as there's no time limit on reimbursing yourself. To be reimbursed tax-free, the expense must have occurred after your HSA was established.
Sources: IRS Publication 502 (qualified medical expenses), IRS Publication 969 (HSA distribution rules).
Never lose another receipt.
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