HSA Eligible Expenses

An eligible expense is any healthcare expense approved by the IRS for reimbursement through an HSA. Eligible expenses can be incurred by the employee, their spouse or their eligible dependents. Expenses that happen before the HSA is opened are not eligible.

Services and items that are eligible

 

Here's a sample list of eligible expenses with an HSA. Use the HSA Store tool (above) to see if an item is eligible or log in to the participant portal and click Tools & Support to find the EBIA Healthcare Expense Table for more details.

• Acupuncture
• Alcoholism/drug addiction treatment
• Artificial limbs
• Artificial teeth
• Birth control pills
• Braille books/magazines
• Breast pumps
• Childbirth classes
• Chiropractors
• Christian Science practitioners
• Coinsurance amounts
• Contact lenses/lens solution
• Contraceptives
• Crutches
• Deductibles
• Dental treatment
• Ear plugs (prescribed)
• Eye exams/eyeglasses
• Fertility treatments
• Fitness classes (prescribed)
• Fluoridation treatments
• Fluoridation device
• Guide dog (for the impaired)
• Hearing aid/batteries
• Hospital services
• Laboratory fees
• LASIK surgery
• Learning disability
• Medical monitoring devices
• Medical records charges
• Medical services
• Prescriptions
• Norplant insertion/removal
• Operations/surgery
• Optometrist
• Orthodontia
• Osteopathy
• Patterning exercises
• Physical exams (non-employment)
• Pre-existing conditions
• Private hospital room
• Psychiatric care (prescribed)
• Physical therapy
• Sales tax (on eligible expenses)
• Smoking cessation (prescribed)
• Speech training
• Sterilization
• Sunscreen
• Transplants
• Vaccines
• Weight loss programs (prescribed)
• Wheelchair
• X-ray fees

Insurance Premiums

• COBRA premiums
• Premiums while you are receiving unemployment compensation
• Long-term care insurance premiums
• Retiree healthcare premiums, including Medicare (but not supplemental policies like Medigap)

Over-the-counter items eligible under an FSA - Updated with Coronavirus Aid, Relief, & Economic Security (CARES) Act 
Non-prescribed, over-the-counter medicine and medical supplies are now covered as qualified medical expenses for health FSA, HSA, and HRA (if applicable). This includes over-the-counter menstrual care products. The changes take place retroactive to January 1, 2020 with no expiration date. This provision reverses laws put in place as part of the Affordable Care Act in 2011, which stated that over-the-counter expenses were only eligible for reimbursement with a prescription. See the full article

Services and items that are not eligible

Here's a sample list of ineligible expenses for HSA funds. Items that are not eligible expenses are primarily elective and not necessary products and services. If used for a specific medical condition, some items may become eligible with a doctor’s letter. Go to the EBIA Healthcare Expense Table to see a complete list by logging in to the participant portal and clicking Tools & Support.

• Administrative/physician fees
• Annual subscription/retainer fees
• Cosmetic services
• Controlled substances
• Dancing or swimming lessons
• Diapers or diaper service
• Face lifts
• Genetic testing
• Hair transplants
• Illegal operations/treatments  
• Insurance premiums for Medicare supplemental policies, like Medigap
• Maternity clothes    
• Payroll-deducted premiums
• Physical exams (for employment)
• Prescription discount program fees
• Rogaine
• Student health fees
• Teeth bleaching
• Varicose vein treatment
• Vision discount membership fees
• Vitamins
• Warranties
• Weight loss foods