What Can I Use My HSA For?
I have figured out that I cannot deduct my health insurance premiums from my HSA. Can I deduct the premiums from my vision and dental plans from my HSA?
Answer
You can use your Health Savings Account (HSA) for out-of-pocket medical costs, including dental and vision and dental and vision premiums. You can't use an HSA to pay health insurance premiums, and if dental and vision are included as part of your plan, rather than a standalone, you may not be able to use it for that.
You can typically ask whoever is in charge of your HSA for a list of things that are covered, here is a list of eligible and ineligible HSA expenses from Premera Blue Cross Blue Shield as an example.
A list of Common FSA and HSA Eligible Expenses defined by Internal Revenue Code § 213(d).
The following list of FSA and HSA Eligible expenses is from conexismarketing.com
| Expense Description | HSA Eligibility |
|---|---|
| Acupuncture | Yes |
| Adoption, medical expenses | Potentially |
| Alcohol and drug counseling | Yes |
| Alcohol and drug rehab | Yes |
| Alternative healers, dietary substitutes, drugs and medicines | Potentially |
| Ambulance transport | Yes |
| Artificial limbs | Yes |
| Artificial teeth | Yes |
| Bandages | Yes |
| Bariatric surgery (i.e., Lap-Band, gastric bypass) | Potentially |
| Batteries for durable medical equipment | Yes |
| Birth control drugs | Yes |
| Birth control OTC medicines | Yes |
| Birth control supplies | Yes |
| Blood pressure monitoring devices | Yes |
| Body scan / diagnostic testing | Yes |
| Braille books and magazines | Potentially |
| Breast pumps and lactation supplies | Yes |
| Breast reconstruction surgery following mastectomy | Yes |
| Burn garment | Yes |
| Capital expenses | Potentially |
| Carpal tunnel wrist supports | Yes |
| Chelation (EDTA) therapy | Yes |
| Childbirth classes | Potentially |
| Chiropractor services | Yes |
| Chondroitin sulfate | Potentially |
| Christian Science practitioners | Yes |
| Circumcision | Yes |
| Co-insurance, co-payments, and deductibles – medical, dental, and vision | Yes |
| COBRA premiums | Yes |
| Concierge medical fee | No |
| Condoms and other contraceptive devices | Yes |
| Contact lenses, equipment, and materials (e.g., Aosept, Allergan, Bausch & Lomb, Boston, Opti-Free, Renu) | Yes |
| Controlled substances in violation of federal law | No |
| Cosmetic prescriptions | No |
| Cosmetics and perfume | No |
| Counseling and therapy | Potentially |
| Counseling and therapy: marriage counseling | No |
| CPR classes | Potentially |
| Dental crowns (metal or porcelain) | Yes |
| Dental veneers | No |
| Dental visits (non-cosmetic) | Yes |
| Dentures | Yes |
| Deodorant | No |
| Diabetic supplies, test kits, and strips | Yes |
| Diagnostic services | Yes |
| Diapers or diaper service for newborns | No |
| Diet foods | No |
| Dietary supplements | Potentially |
| Disabled dependent's qualified dental or vision expenses | Yes |
| Disabled dependent's qualified medical expenses | Yes |
| DNA collection and storage | No |
| Doula (birthing coach) | Potentially |
| Drug overdose treatment | Yes |
| Dual-purpose expenses (items that have both a medical and general/personal/cosmetic purpose) | Potentially |
| Durable medical equipment | Yes |
| Ear piercing | No |
| Ear plugs | Potentially |
| Electrolysis or hair removal | No |
| Exercise equipment or programs | Potentially |
| Eye examinations, eyeglasses, equipment, and materials | Yes |
| Face creams and moisturizers | No |
| Facelifts | No |
| Feminine hygiene products (tampons, etc.) | No |
| Fertility treatments | Potentially |
| Fiber supplements (e.g., Benefiber, Metamucil) | Potentially |
| Flu shots | Yes |
| Fluoridation device | Yes |
| Foods | Potentially |
| Founder's fee | No |
| Gauze pads | Yes |
| Genetic testing | Potentially |
| Glucosamine | Potentially |
| Glucose monitoring equipment | Yes |
| Guide dog or other service animal aide | Potentially |
| Hair loss/replacement treatment (e.g., Rogaine) | Potentially |
| Hair removal and transplants | No |
| Hand lotion | No |
| Health club dues and fees | Potentially |
| Hearing aids and hearing aid batteries | Yes |
| Herbs and Herbal Supplements (e.g., St. John’s Wort) | Potentially |
| Hormone replacement therapy (HRT) | Potentially |
| Hospital services | Yes |
| Hot and cold packs | Yes |
| Household help | No |
| Illegal operations and treatments | No |
| Immunizations | Yes |
| Inclinator | Potentially |
| Incontinence supplies (e.g., Depends, Serenity) | Yes |
| Insulin (prescription and over-the-counter) | Yes |
| Insurance premiums (dental and vision premiums only) | Yes |
| Laboratory fees | Yes |
| Lactation consultant | Potentially |
| Lamaze classes | Yes |
| Lamaze classes | Yes |
| Language training | Potentially |
| Lasik eye surgery | Yes |
| Lead-based paint removal | Potentially |
| Lifetime care-advance payments | No |
| Lip balm (e.g., Burt’s Bees Lip Balm, Chapstick) | No |
| Lodging at a hospital or similar institution (patient only) | Yes |
| Lodging not at a hospital or similar institution | Yes |
| Lodging of a companion | Yes |
| Lodging while attending a medical conference | No |
| Long-term care premiums | Yes |
| Marijuana or other controlled substances in violation of federal law | No |
| Massage therapy | Potentially |
| Mastectomy-related special bras | Yes |
| Meals at a hospital or similar institution (patient only) | Yes |
| Meals not at a hospital or similar institution | No |
| Meals of a companion | No |
| Meals when attending a medical conference | No |
| Medic Alert bracelet or necklace | Yes |
| Medical conference admission | Potentially |
| Medical information plan changes | Yes |
| Medical monitoring and testing devices | Yes |
| Medical Newsletter | No |
| Medical records charges | Yes |
| Medical services | Yes |
| Medicare premiums | Yes |
| Medicated shampoo (to treat a specific medical condition like psoriasis; e.g., Dermarest shampoo) | Potentially |
| Mouthwash | No |
| Nasal strips (nose strips) | Potentially |
| Naturopathic healers | Potentially |
| Nebulizer | Yes |
| Nursing services for a baby | No |
| Nursing services provided by a nurse or other attendant | Yes |
| Nutritionist's professional expenses | Potentially |
| OB/GYN | Yes |
| Occlusal guards | Yes |
| Office visits - dental | Yes |
| Office visits - medical | Yes |
| Office visits - vision | Yes |
| Operations - dental | Yes |
| Operations - medical | Yes |
| Operations- vision | Yes |
| Optometrist | Yes |
| Organ donors | Yes |
| Orthodontia | Yes |
| Orthopedic shoes and inserts | Yes |
| Osteopath fees | Yes |
| OTC pregnancy tests/fertility monitors | Yes |
| Over-the-counter drugs used for general health or cosmetic purposes | No |
| Over-the-counter medicines used to treat a specific medical condition | Yes |
| Over-the-counter supplies | Yes |
| Ovulation Monitor | Yes |
| Oxygen | Yes |
| Physical exams | Yes |
| Physical therapy | Yes |
| Podiatrist | Yes |
| Pregnancy termination | Yes |
| Pregnancy test kits | Yes |
| Prescription drug discount programs | No |
| Prescription drugs imported from another country | No |
| Prescription drugs used for general health and cosmetic purposes | No |
| Prescription drugs used to treat a specific medical condition | Yes |
| Prescription drugs – dual-purpose (e.g., Propecia, Rogaine) | Potentially |
| Prescription eyeglasses | Yes |
| Propecia | Potentially |
| Prosthesis | Yes |
| Radial keratotomy | Yes |
| Reading glasses | Yes |
| Retin-A | Potentially |
| Reversal of tubal ligation or vasectomy | Yes |
| Rogaine | Potentially |
| Sales tax on qualified medical expenses (e.g., OTC medications) | Yes |
| School and education, special | Potentially |
| Schools and education, residential | No |
| Screening tests – medical, dental, vision | Yes |
| Shaving cream and lotion | No |
| Shipping and handling fees on eligible expenses | Yes |
| Sick-child facility | No |
| Skin moisturizers and lotion | No |
| Sleep deprivation treatment | Potentially |
| Smoking cessation programs | Yes |
| Snoring cessation aids and medications (e.g., Breathe Right Spray, Snoreeze) | Potentially |
| Special foods | Potentially |
| Sperm storage fees | Potentially |
| Sterilization procedures | Yes |
| Student health fee | No |
| Sunglasses (prescription) | Yes |
| Sunglasses and clips (non-prescription) | No |
| Supplies to treat medical condition | Yes |
| Surrogate expenses | No |
| Take-home drug test | No |
| Take-home pregnancy test | Yes |
| Take-home urinary tract infection test | Yes |
| Tanning salons and equipment | No |
| Teeth whitening | No |
| Telephone for hearing- impaired persons | Yes |
| Thermometers | Yes |
| Toiletries | No |
| Toothbrushes and toothpaste | No |
| Transplants | Yes |
| Transportation and travel expenses for person receiving medical dental, or vision care | Yes |
| Transportation of someone other than the person receiving medical, dental, or vision care | Potentially |
| Transportation to and from medical conference | Potentially |
| Tubal ligation | Yes |
| Umbilical cord, cord blood, and stem cells harvesting, freezing, and storage | Potentially |
| Vaccines | Yes |
| Varicose veins, treatment of | No |
| Vasectomy | Yes |
| Viagra | Yes |
| Virtual physical (body scan) | Yes |
| Vision discount programs | No |
| Vitamins | Potentially |
| Walker, wheelchair, or cane | Yes |
| Weight-loss programs and drugs prescribed to induce weight loss | Potentially |
| Wigs | Potentially |
| X-rays – medical or dental | Yes |
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Answer Rating:
How do I get more clarity on a potentially eligible expense? Is there someone who can elaborate on my specific situation?
Whoever provides your HSA (like HSA bank or whatever) will have a full list of eligible expenses. You can find more details from the IRS https://www.irs.gov/pub/irs-pdf/p502.pdf
“Insurance premiums Yes” was it a right answer? It suppose to be more specific. Is it only for dental and vision if separate from health insurance
Good catch. Dental and Vision insurance premiums ONLY for an HSA. The page has been notated.
Can use use HSA money for premium payment if you lose your job because of layover off due to company filing bankruptcy?
The general rule is you can’t use it on premiums, so I would have to say the answer is no. If you have no income you may have access to Medicaid, you can also switch to the marketplace, estimate low to get more upfront tax credits, and then pay them back if need be.
You can also withdraw money from your HSA at a penalty.
Can you use an HSA to pay for medical expenses of a minor dependent child?
Yes. You can use your HSA funds for the healthcare costs of any dependent, so long as they are your dependent at the time that you pay for the care. Below is from the IRS.
From same IRS form. “For this purpose, a child of parents that are divorced, separated, or living apart for the last 6 months of the calendar year is treated as the dependent of both parents whether or not the custodial parent releases the claim to the child’s exemption.”
So, sounds like can use for healthcare costs of your dependent regardless if claiming on your taxes that year or not. Correct?
Can I use my HSA to pay for my mother’s medication copays, or can it only be used for my medications?
If your mother is your dependent, than you should be able to use your HSA funds to cover her copays. Here is the IRS publication, see Qualified Medical Expenses.
Why is over the counter drugs not allowed that is one thing we need, you guys are saying are general health isn’t important enough. If I’m sick with a cold or flu why should I have to go all the way to the doctors to get a prescription to get the medicine? When I have this HSA that will take me a few seconds to go to CVS or Walgreens or Kroger and buy some medicine to cure me? What if I had no money to buy medicine and all I had was my HSA card I put money on this card to save for my health … GENERAL HEALTH should be approved … you guys are basically saying out normal health isn’t worth using this card for. Is it not called a HEALTH SAVINGS Card for a reason? For my health period?
You can use your HSA for over the counter medications as long as you have a written prescription from your doctor.
Can i use my HSA for eye exams and prescriptions glasses
Why is physical therapy listed but occupational therapy and speech language pathology isn’t?
What does potentially mean how long before that can be used
What about over the counter medicine prescribed by a dr????
I used my Hsa to buy an iPhone since my hearing aid would only work with Apple ios.
Really? You must have needed special approval, no? That is great to know though.
Can I use my HSA to pay eligible medical bills that were incurred for services that took place before the creation of the HSA? My company started an HSA in 2020 but I have outstanding medical debt from 2018 that I would like to use it for. Is this allowed?
You can use your HSA to pay for Medical debt any time after the HSA was opened. You cannot use your HSA to pay for debt incurred before the HSA was open.
More specifically, you can use your HSA for any qualified medical expense. If a qualified medical expense was incurred after your HSA was opened, then you can use your HSA to pay for it. However, if the qualified medical expense was incurred before your HSA was opened, then you can not use your HSA to pay for it.
In short, you cannot use your HSA to pay off your debt in the above case.
Can you use HSA money for dental implants without the money being taxed
Yes, I can’t see an instance where you wouldn’t be able to use HSA funds for dental implants. But you can always check with your HSA provider. They will have a list of services you can use your HSA for and can confirm for you.