Health Expenses Covered by HSA or FSA

You probably know that you can use your health savings account (HSA), health flexible spending arrangement (FSA), Archer medical savings account (Archer MSA), or health reimbursement arrangement (HRA) to pay for medical expenses like prescription medicines and drugs. But did you know that certain nutritional, wellness, and general health expenses can also be covered by your HSA or FSA?

What counts as qualifying medical expenses for my HSA or FSA?

The IRS defines qualifying medical expenses as “the costs of diagnosis, cure, mitigation, treatment, or prevention of disease, and for the purpose of affecting any part or function of the body.”

While medical expenses that are purely beneficial to general health are not considered qualified expenses, you might be surprised at some of the costs that meet IRS requirements.

Here are nine qualified medical expenses you may not know about and how to tell if you qualify for them.

1. Physical, dental, and eye exams

Most taxpayers know that the cost of physical exams is a qualified medical expense, but don’t forget that dental and eye exams can also be paid or reimbursed by your HSA, FSA, Archer MSA, or HRA. This is because eye and dental exams are intended to determine if a disease or illness is present.

2. Programs to treat substance use disorders

Programs that treat substance use disorders, such as alcohol and drug-related use, also qualify because they treat a disease. This can include programs like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) if they are required for your treatment. You can sometimes even use your HSA, FSA, Archer MSA, or HRA to pay for transportation expenses to attend these programs.

Rehabilitation center costs for treating an addiction or medical condition are also eligible, as are inpatient services like meals and boarding.

3. Smoking cessation products and programs

You can use your HSA, FSA, Archer MSA, or HRA funds to pay for smoking cessation programs because they treat a disease — tobacco use disorder. Such programs include counseling, medicine, coaching, consultations, and more.

Not only that, but you can also use your health account to purchase smoking cessation products like nicotine gum, patches, and lozenges.

4. Therapy

Therapy costs can also be eligible medical expenses; it just depends on the purpose of the therapy. To qualify, the therapy must be a treatment for a disease. For example, the cost of therapy to treat a diagnosed mental illness is an eligible medical expense, while the cost of marriage counseling is not.

5. Nutritional counseling

Nutritional counseling is considered a qualified medical expense only if it treats a specific disease diagnosed by your doctor. This can include counseling for illnesses such as obesity or diabetes. General nutritional counseling, not meant to treat a diagnosed disease, does not qualify.

6. Weight-loss programs

Your HSA, FSA, Archer MSA, or HRA can also be used to pay for certain weight-loss programs. To qualify, the program must treat a specific disease diagnosed by your doctor, such as obesity, hypertension, diabetes, or heart disease.

The cost of food or beverages purchased for weight loss or other health reasons can also qualify. To be eligible, the product needs to meet the following three requirements:

The food or drink does not satisfy normal nutritional needs.

The food or beverages must treat an illness (like those mentioned above).

Your doctor specifies that a specific food or beverage is needed for your treatment.

When deducting food or beverage expenses, you can only deduct the amount that exceeds the cost of a similar product that “satisfies normal nutritional needs.” For example, if you purchase a specific beverage that costs $20 and a comparable drink for everyday nutritional needs costs $8, you can only deduct the excess of $12.

7. Gym memberships

The cost of gym memberships can be a qualified medical expense under certain circumstances. To be eligible, you must have purchased the membership for the purpose of treating a specific diagnosed disease (obesity, hypertension, heart disease, etc.) or to affect a particular structure or function of the body, like physical therapy.

The cost of a gym membership purely for your general health does not qualify as a medical expense. Similarly, the cost of exercise to improve your general fitness, such as swimming or dance lessons, does not qualify.

8. Over-the-counter drugs and menstrual care products

You can also use your HSA, FSA, Archer MSA, or HRA to pay for over-the-counter medications without a prescription. This includes medicines for colds and flu, pain relief, allergies, heartburn, and more.

In addition to nonprescription medications, qualified medical expenses now include menstrual care products such as tampons, pads, liners, and cups.

9. Nutritional supplements

Nutritional supplements can be a qualified medical expense if your doctor or another medical practitioner recommends them as treatment for a specific medical condition. In other words, you can’t simply purchase some vitamins or supplements for your general health because you read that they might be good for you — you must be using the supplements as recommended by your doctor to treat a specific diagnosis.

The bottom line: Maximize your HSA, FSA, Archer MSA, or HRA.

Health savings accounts like the ones mentioned above often cover more expenses than most people realize. Don’t hesitate to contact your account provider if you’re unsure if something is a qualified medical expense. It never hurts to ask.

And remember to save all receipts for qualified medical expenses just in case the IRS asks for them!

This article is for informational purposes only and not legal or financial advice.

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