What can you pay for with the money in your health savings account (HSA)? The federal government decides which expenses qualify.

Qualified expenses include:

  • Copays for medical expenses and drugs
  • Coinsurance and deductibles determined by your health plan
  • Doctor and hospital visits, including surgeries
  • Chiropractor and podiatrist visits
  • Prescription drugs
  • Birth control and sterilization
  • X-rays and lab tests
  • Vaccinations and immunizations
  • OTC (over-the-counter) items (see details about OTC items below)
  • Vision expenses such as glasses or contact lenses
  • Dental and orthodontia expenses
  • Hearing tests, hearing aids, and other hearing loss expenses
  • Long-term hospital or nursing care
  • Treatment for alcoholism or drug abuse
  • Quitting tobacco therapy
  • Wheelchairs, artificial limbs
  • COBRA and Medicare plan premiums (and, if you are unemployed, other types of health insurance premiums)

Items not qualified for reimbursement from your HSA

  • Cosmetic surgery, plastic surgery
  • Funeral expenses
  • Health club dues
  • Tooth whitening

Find the complete list of expenses that qualify for tax-free reimbursement in IRS Publication 502.

Over-the-counter (OTC) item reimbursement

Some medications and health-related supplies require a prescription before you can use your HSA money for reimbursement.

OTC items that require a doctor's prescription

  • Acid controllers
  • Allergy and sinus medications
  • Antibiotic products
  • Anti-diarrheals
  • Anti-gas products
  • Anti-itch/insect bite products
  • Anti-parasitic treatments
  • Baby rash ointments/creams
  • Cold sore remedies
  • Cough, cold and flu remedies
  • Digestive aids
  • Feminine anti-fungal/itch drugs
  • Hemorrhoid treatments
  • Laxatives
  • Motion sickness products
  • Pain relief products
  • Respiratory treatments
  • Sleep aids and sedatives
  • Stomach remedies

OTC items that do NOT require a doctor's prescription

  • Insulin
  • First Aid supplies like Band-Aids, elastic bandages/wraps
  • Condoms
  • Walking aids such as braces/supports, walkers, canes and/or crutches
  • Catheters
  • Contact lens supplies/solutions
  • Denture adhesives
  • Diagnostic tests/monitors
  • Ostomy products
  • Reading glasses
  • Wheelchairs