HSA-Eligible Expenses (2026)

Chiropractor

Chiropractic care is an HSA-eligible expense when provided by a licensed chiropractor for medical purposes.

Acupuncture

Acupuncture treatments by a licensed practitioner are HSA-eligible medical expenses.

Physical Therapy

Physical therapy prescribed by a doctor is an HSA-eligible medical expense.

Doctor Visits

Office visits to a licensed physician are HSA-eligible medical expenses.

Urgent Care

Urgent care visits and associated fees are HSA-eligible expenses.

Emergency Room

Emergency room visits and all associated medical costs are HSA-eligible.

Ambulance

Ambulance services are HSA-eligible transportation expenses.

Specialist Visits

Visits to medical specialists (dermatologist, cardiologist, etc.) are HSA-eligible.

Dermatologist

Dermatology visits for medical skin conditions are HSA-eligible.

Surgery

Medically necessary surgeries are HSA-eligible expenses.

Hospital Stays

Inpatient hospital stays for medical care are HSA-eligible.

Anesthesia

Anesthesia fees during medical procedures are HSA-eligible.

Massage Therapy

Massage therapy is HSA-eligible only when prescribed by a doctor for a medical condition.

Gym Membership

Gym memberships can be HSA-eligible with a Letter of Medical Necessity from a licensed provider for a diagnosed condition.

Personal Training

Personal training can be HSA-eligible with a Letter of Medical Necessity from a licensed provider for a diagnosed condition.

Cosmetic Surgery

Elective cosmetic surgery is NOT HSA-eligible.

Botox / Botulinum Toxin

Botox is conditionally HSA-eligible when used to treat a diagnosed medical condition, but cosmetic Botox for wrinkles is not eligible.

Also: Botox, botulinum toxin, onabotulinumtoxinA, Dysport

Weight Loss Programs

Weight loss programs are HSA-eligible only when prescribed by a doctor for a specific disease like obesity.

Pregnancy Care

Prenatal care, labor, delivery, and postnatal care are all HSA-eligible medical expenses.

Fertility Treatment

IVF, IUI, fertility medications, and related treatments are HSA-eligible.

Peloton & Exercise Equipment

Peloton and exercise equipment can be HSA-eligible with a Letter of Medical Necessity for a diagnosed condition.

Hair Loss Treatment

Hair loss treatments like Rogaine are HSA-eligible only with a letter of medical necessity.

Egg Freezing

Egg freezing is HSA-eligible when medically necessary, but elective freezing is a gray area.

Vasectomy

Vasectomy procedures are HSA-eligible medical expenses.

Tubal Ligation

Tubal ligation (getting tubes tied) is an HSA-eligible medical expense.

Speech Therapy

Speech therapy by a licensed speech-language pathologist is HSA-eligible.

Occupational Therapy

Occupational therapy prescribed for a medical condition is HSA-eligible.

Service Animal

Costs of buying, training, and maintaining a service animal for a disability are HSA-eligible.

Allergy Shots (Immunotherapy)

Allergy shots (allergen immunotherapy) are HSA-eligible medical expenses.

Lead Paint Removal

Lead paint removal can be HSA-eligible if done to prevent a child from lead poisoning.

Special Education

Special education for children with learning disabilities is HSA-eligible when recommended by a doctor.

Organ Transplant

Organ transplant costs - including donor expenses - are HSA-eligible.

Nursing Home

Nursing home costs are HSA-eligible if the primary reason for being there is medical care.

Assisted Living

Assisted living costs are HSA-eligible only for the portion attributable to medical care.

Home Health Care

Home health care services for medical needs are HSA-eligible.

Long-Term Care Insurance Premiums

Qualified long-term care insurance premiums are HSA-eligible up to age-based IRS limits.

Breast Reconstruction

Breast reconstruction surgery after mastectomy is HSA-eligible.

Dyslexia Treatment

Dyslexia treatment and specialized tutoring recommended by a doctor are HSA-eligible.

Hair Transplant

Hair transplants are NOT HSA-eligible - the IRS considers them cosmetic procedures.

Hormone Therapy

Hormone replacement therapy prescribed by a doctor is HSA-eligible.

Hypnotherapy

Hypnotherapy is HSA-eligible when provided by a licensed practitioner for a medical condition.

In Vitro Fertilization (IVF)

IVF - egg retrieval, fertilization, embryo transfer, and related costs - is HSA-eligible.

Joint Replacement Surgery

Hip, knee, shoulder, and other joint replacement surgeries are HSA-eligible.

Lactation Consultant

Visits with a certified lactation consultant are HSA-eligible.

Midwife Services

Licensed midwife services for prenatal care, labor, and delivery are HSA-eligible.

Nursing Services

Private nursing care and visiting nurse services are HSA-eligible.

Pediatrician

Pediatrician visits for children's medical care are HSA-eligible.

Podiatrist

Podiatrist visits for foot and ankle conditions are HSA-eligible.

Telemedicine & Virtual Visits

Telemedicine and virtual doctor visits are HSA-eligible medical expenses.

Varicose Vein Treatment

Medical treatment for varicose veins - sclerotherapy, laser treatment, stripping - is HSA-eligible.

Blood Transfusion

Blood transfusions and blood storage are HSA-eligible medical expenses.

Transplant Donor Expenses

Medical expenses for organ donors - surgery, testing, recovery - are HSA-eligible.

Medical Conference

Admission to a medical conference about a chronic condition you have is HSA-eligible.

Medical Records Fees

Fees to obtain copies of medical records are HSA-eligible.

Medical Transportation

Transportation costs to and from medical appointments are HSA-eligible.

Coinsurance & Deductibles

Health insurance deductibles, coinsurance, and copays are all HSA-eligible.

Childbirth & Lamaze Classes

Childbirth preparation classes (Lamaze, Bradley, etc.) are HSA-eligible.

Smoking Cessation Programs

Doctor-recommended smoking cessation programs and counseling are HSA-eligible.

Dental Cleaning

Routine dental cleanings and exams are HSA-eligible expenses.

Dental Fillings

Dental fillings for cavities are HSA-eligible expenses.

Dental Crowns

Dental crowns and caps are HSA-eligible expenses.

Root Canal

Root canal therapy is an HSA-eligible dental expense.

Dental Implants

Dental implants are HSA-eligible expenses for tooth replacement.

Braces & Orthodontics

Braces and orthodontic treatment are HSA-eligible expenses.

Dentures

Dentures (full and partial) are HSA-eligible dental expenses.

Dental Surgery

Dental and oral surgery procedures are HSA-eligible expenses.

Dental X-Rays

Dental X-rays and imaging are HSA-eligible diagnostic expenses.

Teeth Whitening

Teeth whitening is NOT HSA-eligible - the IRS considers it a cosmetic procedure.

Invisalign

Invisalign clear aligners are HSA-eligible as orthodontic treatment.

Dental Veneers

Dental veneers are NOT HSA-eligible - the IRS treats them as cosmetic.

Electric Toothbrush

Electric toothbrushes are NOT HSA-eligible - they're general health items.

Night Guard (Dental)

Dental night guards for teeth grinding (bruxism) or TMJ are HSA-eligible.

Clarinet (Orthodontic Treatment)

A clarinet is HSA-eligible only when prescribed by a dentist to treat teeth misalignment.

Cosmetic Dentistry

Purely cosmetic dental procedures - bonding for appearance, gum contouring, smile makeovers - are NOT HSA-eligible.

Fluoride Treatment

Professional fluoride treatments at the dentist are HSA-eligible.

Orthodontic Wax

Orthodontic wax used with braces is HSA-eligible.

Retainer (Dental)

Dental retainers - fixed and removable - are HSA-eligible orthodontic expenses.

Dental Sealants

Dental sealants applied by a dentist to prevent cavities are HSA-eligible.

Dental Bridge

Dental bridges to replace missing teeth are HSA-eligible.

Dental Anesthesia & Sedation

Anesthesia and sedation for dental procedures are HSA-eligible.

Night Guard Replacement

Replacement dental night guards for teeth grinding are HSA-eligible.

Eye Exam

Eye exams by an optometrist or ophthalmologist are HSA-eligible.

Prescription Glasses

Prescription eyeglasses (frames and lenses) are HSA-eligible.

Contact Lenses

Prescription contact lenses and supplies are HSA-eligible.

Contact Lens Solution

Contact lens cleaning and storage solution is HSA-eligible.

LASIK Eye Surgery

LASIK and other corrective eye surgery is HSA-eligible.

Reading Glasses

Over-the-counter reading glasses are HSA-eligible.

Eye Drops

Medicated and lubricating eye drops are HSA-eligible.

Contact Lens Insurance

Contact lens insurance and warranty plans are NOT HSA-eligible.

Eye Patches

Medical eye patches for treating amblyopia or post-surgery recovery are HSA-eligible.

Optometrist

Optometrist visits for eye exams and vision care are HSA-eligible.

Prescription Sunglasses

Prescription sunglasses are HSA-eligible just like regular prescription glasses.

Vision Therapy

Vision therapy prescribed by an eye doctor for eye coordination or focusing problems is HSA-eligible.

Prescription Medications

Prescription drugs from a licensed pharmacy are HSA-eligible.

Over-the-Counter Medications

OTC medications are HSA-eligible without a prescription since the CARES Act.

Insulin

Insulin is HSA-eligible without a prescription.

Sunscreen

Sunscreen with SPF 15+ is HSA-eligible since the CARES Act.

Vitamins & Supplements

Vitamins are only HSA-eligible if prescribed to treat a specific medical condition.

Menstrual Products

Tampons, pads, menstrual cups, and other period products are HSA-eligible since the CARES Act.

Ozempic

Ozempic is HSA-eligible when prescribed by a doctor for diabetes or weight management.

Condoms

Condoms are HSA-eligible since the CARES Act of 2020.

Birth Control

Prescription birth control - pills, IUDs, implants, patches, and rings - is HSA-eligible.

Nicotine Patches & Smoking Cessation

Smoking cessation products - patches, gums, lozenges, and programs - are HSA-eligible.

Melatonin

Melatonin supplements are HSA-eligible since the CARES Act of 2020.

Probiotics

Probiotics are HSA-eligible only with a letter of medical necessity from a doctor.

CBD Oil

CBD oil and CBD products are NOT HSA-eligible - they're not FDA-approved medications.

Acne Medication

Prescription acne medications and OTC acne treatments are HSA-eligible.

Flu & Cold Medicine

OTC flu and cold medicines are HSA-eligible since the CARES Act of 2020.

Prenatal Vitamins

Prenatal vitamins are HSA-eligible during pregnancy - no prescription needed.

EpiPen

EpiPens and epinephrine auto-injectors are HSA-eligible prescription medications.

Pregnancy Test

Home pregnancy tests are HSA-eligible since the CARES Act of 2020.

Ovulation Test

Ovulation predictor kits and fertility monitors are HSA-eligible since the CARES Act.

Baby Formula

Baby formula is NOT HSA-eligible - the IRS classifies it as food, not medicine.

Diaper Cream

Medicated diaper cream and diaper rash ointment are HSA-eligible OTC treatments.

Pedialyte

Pedialyte and electrolyte replacement solutions are HSA-eligible OTC medicines.

Saline Nasal Spray

Saline nasal spray and nasal rinses are HSA-eligible OTC products.

Wart Remover

OTC wart removal products are HSA-eligible since the CARES Act of 2020.

Motion Sickness Medicine

Motion sickness medications like Dramamine are HSA-eligible since the CARES Act.

Anti-Itch Cream

Anti-itch creams like hydrocortisone and calamine lotion are HSA-eligible since the CARES Act.

Sleep Aids

OTC sleep aids like ZzzQuil and Unisom are HSA-eligible since the CARES Act.

Digestive Aids

OTC digestive medications like Pepto-Bismol, Tums, and Gas-X are HSA-eligible since the CARES Act.

Hand Sanitizer

Hand sanitizer is HSA-eligible since the CARES Act - it's classified as an OTC medical product.

Lice Treatment

OTC and prescription lice treatment products are HSA-eligible.

Lip Balm with SPF

Lip balm with SPF 15 or higher is HSA-eligible - same rule as sunscreen.

Nasal Strips

Breathe Right nasal strips and similar products are HSA-eligible OTC medical products.

Pain Relievers (OTC)

OTC pain relievers - Tylenol, Advil, Aleve, aspirin - are HSA-eligible since the CARES Act.

Prescription Skin Care

Skin care products prescribed by a doctor for a medical condition are HSA-eligible.

Iron Supplements (Prescribed)

Iron supplements are HSA-eligible when prescribed by a doctor for iron-deficiency anemia.

Therapy & Counseling

Psychotherapy and counseling by licensed professionals are HSA-eligible.

Psychiatrist

Psychiatrist visits and psychiatric medications are HSA-eligible.

Substance Abuse Treatment

Substance abuse and addiction treatment programs are HSA-eligible.

Drug Addiction Treatment

Drug addiction treatment - inpatient rehab, outpatient programs, medication-assisted treatment - is HSA-eligible.

Blood Work & Lab Tests

Blood tests and laboratory work are HSA-eligible diagnostic expenses.

X-Rays

Medical X-rays are HSA-eligible diagnostic expenses.

MRI

MRI scans are HSA-eligible diagnostic imaging expenses.

CT Scan

CT scans are HSA-eligible diagnostic imaging expenses.

COVID Test

COVID-19 tests - both at-home rapid tests and lab PCR tests - are HSA-eligible.

Genetic Testing

Medical genetic testing ordered by a doctor is HSA-eligible, but consumer DNA kits for ancestry are not.

Allergy Testing

Allergy tests - skin prick, blood panels, and patch tests - are HSA-eligible diagnostic expenses.

Body Scan

Full-body scans are HSA-eligible when ordered by a doctor for a medical reason.

Lab Fees

Laboratory fees for medical tests - processing, analysis, and specimen collection - are HSA-eligible.

Paternity Test

Paternity tests are NOT HSA-eligible - they're not considered medical treatment.

Ultrasound

Medical ultrasounds - pregnancy, diagnostic, and therapeutic - are HSA-eligible.

Hearing Test (Audiometry)

Hearing tests and audiological evaluations are HSA-eligible diagnostic expenses.

Annual Physical

Annual physical exams are HSA-eligible preventive care expenses.

Vaccinations

Vaccines and immunizations are HSA-eligible preventive care expenses.

Physical Exam

Physical exams - sports physicals, employment physicals, wellness exams - are HSA-eligible.

First Aid Supplies

First aid supplies like bandages and antiseptics are HSA-eligible.

Thermometer

Thermometers are HSA-eligible medical equipment.

Blood Pressure Monitor

Home blood pressure monitors are HSA-eligible medical equipment.

Blood Glucose Monitor

Glucose monitors and diabetic testing supplies are HSA-eligible.

Diabetic Supplies

Diabetic supplies including test strips and lancets are HSA-eligible.

Crutches

Crutches and mobility aids are HSA-eligible medical equipment.

Hearing Aids

Hearing aids and hearing aid batteries are HSA-eligible.

Breast Pump

Breast pumps and breastfeeding supplies are HSA-eligible without a prescription.

CPAP Machine

CPAP machines and supplies for sleep apnea are HSA-eligible with a diagnosis.

Air Purifier

Air purifiers are HSA-eligible only with a letter of medical necessity for asthma or severe allergies.

Humidifier

Humidifiers are HSA-eligible only with a letter of medical necessity for a respiratory or skin condition.

Fitness Tracker

Fitness trackers like Apple Watch, Fitbit, and Whoop are NOT HSA-eligible.

Compression Socks & Stockings

Compression socks are HSA-eligible with a letter of medical necessity for a diagnosed condition.

Wheelchair

Wheelchairs - manual and electric - are HSA-eligible medical equipment.

Nebulizer

Nebulizers and nebulizer medications are HSA-eligible for respiratory conditions.

Breastfeeding Supplies

Breastfeeding supplies - pumps, storage bags, nursing pads, and lactation consulting - are HSA-eligible.

Knee Brace

Knee braces and orthopedic supports are HSA-eligible medical supplies.

Hot & Cold Packs

Reusable hot and cold therapy packs are HSA-eligible medical supplies.

Medical Alert System

Medical alert systems (Life Alert, etc.) are generally NOT HSA-eligible.

Wound Care Supplies

Wound care supplies - gauze, steri-strips, wound wash, and surgical dressings - are HSA-eligible.

Orthopedic Shoes

Orthopedic shoes are HSA-eligible only with a prescription or letter of medical necessity.

Cane

Canes and walking sticks for medical use are HSA-eligible.

Walker

Walkers and rollators are HSA-eligible durable medical equipment.

Hospital Bed

Hospital beds for home use are HSA-eligible durable medical equipment.

Catheter Supplies

Catheters and catheter supplies are HSA-eligible medical supplies.

Ostomy & Colostomy Supplies

Ostomy bags, colostomy supplies, and related products are HSA-eligible.

Prosthetics & Artificial Limbs

Prosthetic limbs, eyes, teeth, and other artificial body parts are HSA-eligible.

Home Modifications for Disability

Home modifications for medical accessibility - ramps, grab bars, wider doorways - are HSA-eligible.

Car Modifications for Disability

Vehicle modifications for a disability - hand controls, wheelchair lifts, etc. - are HSA-eligible.

Elastic Bandages (ACE Wraps)

Elastic bandages like ACE wraps are HSA-eligible medical supplies.

Heating Pad

Heating pads - electric, microwavable, and chemical - are HSA-eligible medical supplies.

Incontinence Supplies

Adult incontinence products - diapers, pads, protective underwear - are HSA-eligible.

Face Masks (N95, Surgical)

N95 masks, surgical masks, and KN95 masks are HSA-eligible medical supplies.

Oxygen Equipment & Supplies

Oxygen tanks, concentrators, and supplies are HSA-eligible medical equipment.

Pregnancy Support Belt

Pregnancy support belts and maternity belly bands for medical relief are HSA-eligible.

Scoliosis Brace

Scoliosis braces (back braces) prescribed by a doctor are HSA-eligible.

Stethoscope

Stethoscopes purchased for personal medical monitoring are HSA-eligible.

Surgical Stockings

Surgical stockings (TED hose) prescribed after surgery are HSA-eligible.

Traction Equipment

Traction devices prescribed for spinal or orthopedic conditions are HSA-eligible.

Wig (Medical Hair Loss)

Wigs for hair loss from disease (chemo, alopecia) are HSA-eligible with a prescription.

Tongue Depressors

Tongue depressors and similar basic medical supplies are HSA-eligible.

Diabetic Shoes

Therapeutic shoes for diabetic foot conditions are HSA-eligible with a prescription.

Braille Books & Materials

The cost of Braille materials that exceeds the cost of regular print versions is HSA-eligible.