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?


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
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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Diana Riddle on

Answer Rating:

How do I get more clarity on a potentially eligible expense? Is there someone who can elaborate on my specific situation?

ObamaCareFacts.com on

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

Zoya on

“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

ObamaCareFacts.com on

Good catch. Dental and Vision insurance premiums ONLY for an HSA. The page has been notated.

Sharon on

Can use use HSA money for premium payment if you lose your job because of layover off due to company filing bankruptcy?

ObamaCareFacts.com on

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.

Will Wallace on

Can you use an HSA to pay for medical expenses of a minor dependent child?

[email protected] Erin on

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.

Qualified medical expenses are those incurred by the following persons.

You and your spouse.
All dependents you claim on your tax return.
Any person you could have claimed as a dependent on your return except that:

The person filed a joint return,
The person had gross income of $4,000 or more, or
You, or your spouse if filing jointly, could be claimed as a dependent on someone else’s 2015 return.

Greg Burns on

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?

Ben on

Can I use my HSA to pay for my mother’s medication copays, or can it only be used for my medications?

[email protected] Erin on

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.

Demetrius Thomas on

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?

Craig on

Can i use my HSA for eye exams and prescriptions glasses

Karen Polastri on

Why is physical therapy listed but occupational therapy and speech language pathology isn’t?

Michelle on

What does potentially mean how long before that can be used

Reta Jones on

What about over the counter medicine prescribed by a dr????

Mike on

I used my Hsa to buy an iPhone since my hearing aid would only work with Apple ios.

ObamaCareFacts.com on

Really? You must have needed special approval, no? That is great to know though.

Elena Adamo on

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?

ObamaCareFacts.com on

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.

Michael T Charles on

Can you use HSA money for dental implants without the money being taxed

ObamaCareFacts.com on

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.