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HSA Eligible Expenses

 »  HSA Eligible Expenses

Below is a list of eligible and ineligible medical expenses. Eligible over-the-counter expenses are also included. This is only a brief summary to be used as a quick reference, and is not limited to these expenses alone. For more details, please refer to IRS Publication 502 or contact your personal tax advisor. The following premiums are considered eligible medical expenses. Premiums for any other type of insurance are not considered eligible expenses.

  1. Long-term care insurance (contract based on the limited premiums provided in IRS Publication 502).
  2. Health care continuation coverage (such as coverage under COBRA).
  3. Health care coverage while receiving unemployment compensation under federal or state law.
  4. Medicare and other health care coverage if you are 65 or older (does not include premiums for Medicare supplemental policies such as Medigap).


  5. Note: Items 2 and 3 can be for your spouse or a dependent meeting the requirement for that type of coverage. Item 4 is only applicable for the account holder, and not for coverage of your spouse or dependent.
The Internal Revenue Service requires that you keep sufficient records to show that the:
  • Withdrawals were exclusively to pay or reimburse qualified medical expenses.
  • Qualified medical expenses had not been previously paid or reimbursed from another source.
  • Medical expenses had not been taken as an itemized deduction for any previous tax year.


  • Neither Health Services Administration, LLC nor American Fidelity Assurance Company are providing tax advice. Individuals with an interest in HSAs should contact their personal tax advisor.
* Dual-purpose items require a doctor's diagnosis of a medical condition and evidence that the item is recommended to treat the diagnosed condition.

Common Eligible and Ineligible Expenses
EXPENSE ELIGIBLE? DUAL PURPOSE?
Abortion Yes, if legal abortion.
Acne treatment - over the counter Yes, if treating medical condition such as acne vulgaris (but see Retin A). Yes
Acupuncture Yes, if treating medical condition. Yes
Adoption - medical expenses incurred before adoption is finalized Yes, if child was legal dependent when services provided.
Advanced reimbursements No (but see Orthodontia expenses and Prenatal expenses).
Alcoholism treatment Yes, for inpatient treatment (including meals and lodging) at a center for alcohol addiction.
Allergy medicine Yes
Ambulance Yes
Analgesics Yes
Antacid Yes
Antihistamine Yes
Anti-itch creams Yes
Antiobiotic sprays or ointments (for first aid) Yes
Artificial limbs and teeth Yes
Aspirin Yes
Autopsy No
Babysitting/child care No
Bandages Yes
Behavioral modification programs Possibly (see Schools and education, special). Yes
Birth control pills Yes
Birthing classes/childbirth classes/Lamaze Yes, if classes relate to childbirth and not child rearing. Expenses for a coach, doula or significant other are not eligible. Yes
Blood pressure monitoring devices Yes
Blood sugar test kit and test strips Yes
Body scan Yes, for diagnostic purposes.
Breast pumps No, unless medical need. Yes
Breast reconstruction surgery following mastectomy Yes, if mastectomy was done following cancer.
Calamine lotion Yes
Carpal tunnel wrist supports Yes
Chelation therapy Yes, if used to treat medical condition such as lead poisoning. Yes
Childbirth classes Yes, if classes relate to childbirth and not child rearing. Expenses for a coach, doula or significant other are not eligible. Yes
Chiropractors Yes
Chondroitin Yes, if used to treat medical condition and not to maintain good health. Yes
Christian Science practitioners Yes, fees paid to Christian Science practitioners for medical care will qualify. Yes
Circumcision Yes
COBRA premiums Yes
Cold medicine Yes
Cold/hot packs Yes
Condoms Yes
Co-insurance amounts, co-payments and deductibles Yes, if the underlying service/item qualifies.
Contact lenses, solutions and equipment Yes, if the lenses are needed for a medical condition.
Contraceptives Yes
Cosmetic procedures or surgery No, except for amounts paid for surgery necessary to improve a deformity arising from a congenital abnormality, personal injury from an accident or trauma, or a disfiguring disease.
Cosmetics No, including face cream, moisturizer, deodorant, hand/body lotion, make-up, shampoo, toothpaste, mouthwash or any other item used for ordinary cosmetic purposes.
Cough suppressants Yes
Counseling Yes, for medical reason; no, for marriage counseling. Yes
Crutches Yes, for rental or purchase.
Decongestants Yes
Deductibles Generally, yes (see Co-insurance amounts, co-payments and deductibles).
Dental treatment Yes, but see restrictions for Teeth whitening and bleaching
Dentures and denture adhesives Yes
Dependent daycare expenses No
Diabetic supplies Yes
Diagnostic services Yes
Diaper rash ointment/cream Yes
Diapers or diaper service No, unless used to relieve the effects of a diagnosed medical condition, such as urinary incontinence in adults. Yes
Diarrhea medicine Yes
Dietary supplements No, if taken as a supplement to a normal diet:, yes, if recommended by medical practitioner to treat a specific medical condition. Yes
DNA collection and storage Generally no, but temporary storage may be reimbursable if collected as part of a diagnosis, treatment or prevention of existing or imminent medical condition. Yes
Drug addiction treatment Yes, for inpatient treatment (includes meals and lodging) at a therapeutic drug center.
Drug overdose treatment Yes
Drugs and medicines Yes, if legally obtained and generally accepted as medicines and drugs and are used to treat a medical condition. This includes prescription drugs and over-the-counter drugs. Certain over-the-counter medicines may require a doctor's statement for necessity. Yes
Ear plugs Yes, if treating medical condition. Yes
Egg donor fees Yes
Eggs and embryos storage fees Possibly, with respect to temporary storage, but only to the extent necessary for immediate conception. Yes
Electrolysis or hair removal Generally, no.
Eye examinations, eyeglasses and related equipment and materials/cleaners Yes
Face creams, moisturizers No
Face lifts No
Feminine hygiene products No (but see Incontinence supplies and Menstrual pain relievers).
Fertility treatments (e.g., surgery, in vitro fertilization (IVF), gamete intrafallopian transfer (GIFT) and shots) Yes, to the extent procedure is intended to overcome an inability to have children. Expenses for IVF surrogate not deductible unless the surrogate is a tax dependent.
Fiber supplements No, for general health purposes, but may be allowed if prescribed by a doctor to treat a specific medical condition.
First aid cream and first aid kits Yes
Fitness programs Yes, but only if prescribed by a doctor for treatment of obesity or other medical condition. Yes
Flu shots Yes
Food and Food Substitutes No
Funeral expenses No
Gambling addiction treatment Yes, for inpatient treatment (including meals and lodging) at a center for gambling addiction.
Gauze pads Yes
Genetic testing Yes, if for determination of possible birth defects; no if for sex determination. Yes
Glucosamine Yes, if primarily for medical treatment. Yes
Glucose monitoring equipment Yes, including blood glucose meters and test strips for diagnostic purposes.
Guide dog or other animal aide Yes, includes expenses related to purchase, training and care of animal used by vision-impaired or hearing-impaired person.
Hair removal/transplant No, usually cosmetic.
Health club dues and fees No, for general health purposes, but may be allowed if prescribed by a doctor to treat a specific medical condition. Yes
Health care continuation coverage (such as coverage under COBRA) Yes
Health care premiums while receiving unemployment compensation under federal or state law Yes
Hearing aids Yes, including batteries.
Hemorrhoid treatment Yes
Herbal supplements See Dietary supplements. Yes
Home care Yes, if expenses qualify as nursing services; no, if for long term care. Yes
Hormone replacement therapy Yes, if primarily for medical care. Yes
Hospital services Yes
Illegal operations and treatments No
Immunizations Yes
Incontinence supplies Yes, used specifically to treat incontinence. Yes
Infertility treatments See Fertility treatments.
Insect bite creams and ointments Yes
Insulin Yes
Insurance premiums No, unless long-term care, health care continuation, health care coverage while receiving unemployment compensation under federal or state law, or Medicare.
Laboratory fees Yes, if part of medical care or diagnosis.
Lamaze class See Childbirth classes. Yes
Language training for dyslexic/disabled child Yes Yes
Laser eye surgery/Lasik Yes, for correction of eye function.
Late fees on medical bills No
Laxatives Yes
Learning disability, instructional fees Yes, includes expenses for special school or specially trained teacher (prescribed by doctor) for a child who has severe learning disability caused by mental or physical impairment.
Liquid bandage Yes
Lodging at hospital or similar institution Yes, if there to receive medical care.
Lodging not at hospital or similar institution Yes, up to $50/night, provided: (1) lodging is primarily for and essential to medical care; (2) medical care is provided in a hospital or medical facility related to or equivalent to licensed hospital; (3) lodging is not lavish; and (4) no element of personal pleasure, recreation or vacation in the travel.
Lodging of a companion Yes, if accompanying a patient for medical reasons and all of the conditions described under Lodging not at a hospital are also met. Yes
Lodging while attending a medical conference No
Long term care services Yes, but subject to limits on age.
Long term care premiums Yes
Marijuana or other controlled substances No, even if legal in certain states.
Massage therapy No, unless prescribed by a doctor to treat medical condition. Yes
Mastectomy-related bras No, unless prescribed for mental health treatment. Yes
Medic-alert bracelet/necklace Yes, if recommended by a medical practitioner in connection with treating a medical condition. Yes
Medical conference admission/transportation/meals Yes Yes
Medicare Premiums Yes, for Medicare part A, B, C, and D.
Medicare Supplemental Policies No
Medical monitoring and testing devices Yes, including blood pressure monitors, syringes, glucose kits, etc.
Medical records charges Yes, for the cost for transferring or photocopying records.
Medical services Yes, if legal medical service is recommended by physician, surgeon, specialist or other medical practitioner.
Menstrual pain relievers Yes
Mentally handicapped, special home for The cost of keeping a mentally handicapped person in a special home (not a relative's home) on a psychiatrist's recommendation to help that person adjust from life in a mental hospital to community living may apply. Yes
Missed appointment fee No
Motion sickness pills Yes
Nasal strips or sprays Yes, if used to treat sinus problem or sleep apnea. Yes
Naturopathic healers, dietary substitutes and drugs and medicines Possibly, non-traditional healing treatments provided by professionals may be eligible if provided to treat a specific medical condition. Yes
Nicotine gum or patches Yes
Norplant insertion or removal Yes
Nursing services provided by a nurse or other attendant Yes, so long as services are of a kind generally performed by a nurse. Yes
Nursing services for a baby No, if baby is normal and healthy.
Nutritionist's professional expenses Possibly, if treatment relates to a specifically diagnosed medical condition. Yes
Nutritional supplements No, for general health purposes; yes, if recommended by a medical practitioner to treat a specific medical condition.. Yes
Obstetrical expenses Yes
Occlusal guards to prevent teeth grinding Yes
Optometrist Yes
Organ donor Yes, including surgical, hospital and laboratory services as well as transportation expense for donor.
Orthodontia expenses Yes
Over-the-counter medicines See Drug and Medicines. Yes
Ovulation monitor Yes
Pain relievers Yes
Patterning exercises Yes, for exercises for a mentally handicapped child.
Physical exams Yes
Physical therapy Yes
Physician access retainer No
Pregnancy test kit Yes
Prenatal expenses Yes, the IRS recently indicated that prenatal expenses paid up front might be reimbursed in the year during which the lump sum amount was contracted, despite the fact that all expenses have not yet been incurred.
Prenatal vitamins Yes, if taken due to pregnancy. Yes
Prescription drugs and medicines obtained from other countries No
Prescription drug discount programs No, a fee paid to get a drug discount card will not qualify; the cost of the prescription may qualify.
Propecia No, if for cosmetic purposes (i.e., to treat male pattern baldness); yes, if used to treat medical condition such as alopecia. Yes
Prosthesis Yes
Psychiatric care Yes, if for medical care.
Psychoanalysis or psychologist Yes, if for medical care and not for the general improvement of mental health, to relieve stress or personal enjoyment. Yes
Radial keratotomy Yes
Retin-A No, unless treating a specific medical condition, such as acne Yes
Rogaine No, unless prescribed to treat a specific medical condition. Yes
Safety glasses No, unless prescription lenses.
Schools and education, residential Possibly, if the school or program is to treat behavioral, emotional and/or addictive conditions and if the primary purpose of the program is medical care. Yes
Schools and education, special Possibly, if the main reason for using the school is its resources for relieving the disability of a mentally impaired or physically disabled person. Includes Braille, lip-reading and remedial language training; no, if the main purpose of the school is disciplinary. Yes
Screening tests Yes, if used for medical diagnosis.
Seeing-eye dog Yes, including veterinary fees.
Sinus medication Yes
Sleep deprivation treatment Possibly, if person is under care of a medical practitioner.
Smoking cessation (stop-smoking) programs Yes, as well as prescription and/or over-the-counter drugs and medicines used to stop smoking.
Spermicidal foam Yes
Sperm, storage fees Possibly, for temporary storage to the extent necessary for immediate conception. Yes
St. John's Wort Yes, if used primarily for medical care (i.e., depression) and not for general good health. Yes
Sterilization procedures Yes, if legally performed operation.
Sunglasses Yes, if they are prescription lenses.
Sunscreen with high SPF Yes, if SPF is generally 30 or higher and used to prevent a sunburn. Would also qualify if used by a person who has or has had skin cancer or another diagnosed skin disease that is affected by sun exposure. Does not include tanning lotions, make-up or moisturizers, etc., that contain a lower dose of SPF. The receipt must show SPF level.
Suntan lotion/clothing to block sun No
Supplies to treat medical condition Yes, if the medical supply is used to diagnose or treat a specific medical condition and is not a personal comfort item.
Surrogate expenses Generally no, even if for medical care of surrogate or unborn child.
Taxes on medical services and products Yes, to the extent imposed on reimbursable medical care or products.
Teeth whitening/bleaching No
Telephone equipment for hearing impaired-person Yes, for expense of buying and repairing special telephone equipment for hearing-impaired person. Yes
Television equipment for hearing-impaired person Yes, but reimbursable amount is limited to the cost that exceeds cost of regular item. Yes
Thermometers Yes
Throat lozenges Yes
Toothache and teething pain relievers. Yes
Toothbrushes or toothpaste No, even if dentist recommends special ones to treat medical condition.
Transplants Yes, for surgical, hospital and labor services and transportation expenses for donors.
Transportation to and from medical conference Yes, for admission and transportation expenses to a medical conference relating to the chronic disease of the individual. Yes
Transportation expenses for person to receive medical care Yes, if travel is primarily for, and essential to, medical care. Includes parking and tolls. Car mileage is reimbursed at the current rate set by the IRS each year.
Transportation expenses for someone other than the person receiving medical care Yes, in some cases for the following: (1) a parent who must go with a child who needs medical care; (2) a nurse or other person who gives injections, medication, or other treatment required by a patient who is traveling to get medical care and is unable to travel alone; and (3) an individual who travels to visit a mentally ill dependent, if such visits are recommended as part of treatment. Yes
Vasectomy/vasectomy reversal Yes
Veneers Generally no, as they are usually for cosmetic purposes.
Viagra Yes, if prescribed by a physician to treat a medical condition.
Vitamins No, if taken as a supplement to a normal diet; yes, if recommended by a medical practitioner to treat a specific medical condition. Yes
Walkers Yes, if used to relieve sickness or disability.
Weight-loss programs and/or drugs prescribed to induce weight loss Yes, if prescribed by a doctor to treat obesity or other medical condition. Yes
Wheelchair Yes
X-ray fee Yes, if received for medical reasons.

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