HSA eligibility ruling · Medical
Is Household Help HSA-Eligible? (2026)
No, it's not HSA-eligible.
Housekeeping and household help are not HSA-eligible, even when a doctor recommends them.
- Typical cost
- Household help is not eligible; only a documented nursing-care portion can be
- Basis
- Item-specific primary source
The exception
Do not use HSA funds for housekeeping, cleaning, or other household help. If a caregiver also provides nursing-type services, keep records that separate the medical-care portion.
Paying with HSA money anyway can mean income tax plus a 20% penalty if you're under 65.
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Publication 502 excludes the cost of household help, even if recommended by a doctor. Only nursing-type services can count, and when one worker does both, only the medical-care portion (and the related employment taxes) can count. See the Nursing Services decision.
Decision record and source basis
This ruling has a source packet that directly addresses the item or rule below. A product or retailer label does not override the expense purpose, eligibility conditions, or documentation requirement shown above.
Search coverage (4 product and plain-English terms)
cleaning service, house cleaning, housekeeper, maid service.
- IRS Publication 502: Household Help
Publication 502 excludes the cost of household help, even if recommended by a doctor, and points to the nursing-services rules for nursing-type care.
Source reviewed
- IRS Publication 969: HSA qualified medical expenses
HSA distributions are tax-free only for uncompensated qualified medical expenses incurred after the HSA was established, with supporting records retained.
Source reviewed
Frequently Asked Questions
Can I use my HSA for a housekeeper after surgery?
No. Housekeeping is not medical care, even when a doctor recommends help at home.
What if my caregiver also provides nursing care?
Only the nursing-type portion of the services can count. Keep records that separate that time and cost from housework.
Related HSA Expenses
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