What expenses can I use my HSA for?

You can use your HSA to cover out-of-pocket medical expenses, dental and vision care, over-the-counter medications, and medical equipment, among other things.

What products are HSA-eligible?

Over-the-counter medications are often HSA-eligible, as are things like crutches, hearing aids, thermometers, eyeglasses, and first aid kits.

What is surprisingly HSA-eligible?

Home and car modifications, mattresses, and weight loss programs could be HSA-eligible if you have a doctor's note stating that these things are necessary to address a medical condition. Certain travel-related costs, like food and lodging, may also be HSA-eligible if the purpose of the travel is to get medical care.

Can I get toilet paper with my HSA?

No. Toilet paper is considered a household product and does not qualify as an HSA-eligible expense.

Can I use my HSA for dental expenses?

Yes. You can use your HSA to cover dental cleanings and checkups, as well as common procedures such as fillings, root canals, bridges, crowns, and orthodontic treatments. You can't use your HSA for everyday items such as toothpaste, dental floss, or over-the-counter mouthwash. Cosmetic procedures, such as teeth whitening, also aren't covered.

Can I use my HSA for my spouse or someone else?

Yes. You can use your HSA for your spouse and anyone you claim as a dependent for tax purposes, even if your high-deductible health plan does not cover them.

Can I use my HSA for massage?

Sometimes. If you have a letter from your doctor stating that massage is medically necessary, then you can use your HSA to cover the cost. Your doctor must explain why it's required, how frequently you need treatment, and how long the treatment is expected to last.

Can I use my HSA for vision?

Yes. Vision costs, including eye exams and procedures, eyeglasses, contact lenses, and prescription sunglasses, are HSA-eligible expenses.

Can I use my HSA for Botox?

Typically no. HSA funds can't be used for cosmetic procedures. Unless you're receiving it for medical purposes -- for example, to treat migraine headaches -- you can't use your HSA for Botox.

Can I use my HSA for therapy?

You can use your HSA to cover talk therapy costs if it's to treat a medical or mental condition. Therapy that's used for general mental well-being or stress relief doesn't qualify. Treatment for alcohol or substance misuse is an eligible expense.

Can I use my HSA for physical therapy?

Yes. Physical therapy is an approved medical expense.

Can I use my HSA for a gym membership?

Typically no. Unless you have a letter from your doctor stating that the membership is necessary to treat an injury or underlying health condition, such as obesity, a gym membership isn't a qualifying medical expense.

Can I use my HSA for vitamins?

Vitamins and supplements generally aren't eligible if they're used to maintain general health. If you have a letter from your doctor stating that a vitamin or supplement is necessary to treat a condition, such as a vitamin deficiency, then the expense may be eligible. Prenatal vitamins are HSA-eligible expenses.

Can I use my HSA for LASIK?

Yes. You can use your HSA for laser vision-correcting surgeries, such as LASIK.

HSA-Eligible Expenses in 2025 and 2026 that Qualify for Reimbursement

Learn what counts as an eligible health savings account expense.

By Kailey Hagen – Updated Feb 11, 2026 at 5:55 PM EST | Fact-checked by Parker Hicks

Key Points

HSAs offer tax benefits for saving funds dedicated to healthcare expenses.
To use an HSA, one must be enrolled in a high-deductible health plan.
HSA funds cover a wide range of medical expenses including dental and vision care.

One of the biggest financial challenges people face is covering the high costs of healthcare. Especially as you get older, your healthcare costs tend to rise much faster than inflation. Having a nest egg set aside to cover out-of-pocket health expenses is crucial.

An infographic defining and explaining HSA eligible expenses. — Image source: The Motley Fool

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Health savings accounts (HSAs) encourage individuals to save for future healthcare expenses. Congress created health savings accounts in 2003 to provide tax advantages to individuals who set aside money for their healthcare expenses.

To contribute to an HSA, you need to have a high-deductible health plan (HDHP). That's because HSAs are for those whose health insurance doesn't cover any costs until the insured has already paid a substantial amount. Another HSA rule pertains to maximum annual contribution limits, which are set annually by the Internal Revenue Service (IRS).

Keep reading to find out exactly what types of expenses are covered by HSAs.

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What is an HSA-eligible expense?

The IRS has a broad list of expenses related to medical, dental, and vision care that it considers qualified expenses for HSAs. As long as you spend your HSA funds on any of these IRS-approved expenses, it won't tax the distribution.

Many HSA-eligible expenses are those not ordinarily covered by regular insurance. You can use your HSA to fund copayments and to pay for eligible expenses for yourself and also for your spouse and your dependents. Expenses incurred by adult dependents are eligible, provided the recipient is covered by an HDHP and not otherwise insured.

Your HSA must be formally "established" before any expenses can be eligible. State law determines when your HSA is officially established. In most states, if you become eligible for an HSA on Jan. 1, but your first contribution (deducted from your paycheck) doesn't reach your HSA administrator until Jan. 10, then your HSA isn't considered established until Jan. 10.

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List of HSA-eligible expenses

Here are some common IRS-approved HSA-eligible expenses. Please note that this list is not exhaustive. Always check with your plan provider if you have questions about whether an expense is covered.

Abortion
Acne laser treatment
Acupuncture
Ambulance fees and emergency care
Artificial limbs
Birth control pills, injections, and devices, such as IUDs
Blood pressure monitors
Body scans
Breast pumps and lactation supplies
Breast reconstruction surgery following cancer
Canes and walkers
Childbirth expenses, such as care from a midwife or obstetrician
Childbirth classes for the expectant mother
Chiropractic care
Contact lenses and saline solution
Crutches
Dental care, including cleanings, sealants, fluoride treatments, X-rays, fillings, braces, extractions, and dentures
Diabetes supplies, such as blood sugar test kits and insulin
Diabetes education, including nutrition counseling
Eye exams
Eye surgery, including laser surgery
Eyeglasses, including prescription and reading glasses, and prescription sunglasses
Blue-light-blocking glasses
First-aid kits
Flu shots
Guide dogs to assist with disabilities
Food, grooming, and veterinary care for guide dogs
Hearing aids and batteries
Hospital expenses for both inpatient and outpatient services
Infertility treatment, including in vitro fertilization; egg, sperm, and embryo storage; fertility monitors; and sperm washing
Egg donor expenses related to infertility treatment
Inpatient drug and alcohol treatment
Insulin
Lab fees
Long-term-care premiums, up to a qualifying amount based on your age
Medical alert bracelets
Medical records fees
Medicare premiums if you're 65 or older, excluding Medicare supplemental policies
Night guards to treat teeth grinding
Nursing care, whether provided in your home or a nursing home
Occupational therapy
Oxygen and oxygen equipment
Physical exams
Physical therapy
Prescription medications
Psychiatrist care
Psychologist care
Smoking-cessation programs and drugs, including nicotine patches and gums
Speech therapy
Surgery, excluding elective cosmetic surgery
Thermometers
Tubal ligation (female sterilization) and tubal ligation reversal
Ultrasounds
Vaccines
Vasectomy (male sterilization) and vasectomy reversal
Wheelchairs
X-rays

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Under the Coronavirus Aid, Relief, and Economic Security Act (CARES) Act that passed in March 2020, additional expenses became HSA-eligible. Many of these are over-the-counter (OTC) medications and products that previously were HSA-eligible only with a prescription:

Acid reducers
Acne treatment
Allergy and sinus medications
Anti-allergy medications
Breathing strips
Cough, cold, and flu medications
Eye drops
Feminine hygiene products, such as pads, tampons, and menstrual cups
Heartburn medications
Insect repellent and anti-itch creams
Laxatives
Lip treatments for cold and canker sores
Medicated shampoos and soaps
Nasal sprays
Pain relievers
Skin creams and ointments, including cleansers, toners, and moisturizers
Sleep aids
Sunscreen and OTC remedies (like aloe gel) to treat the effects of sun exposure

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HSA-eligible expenses with a diagnosis

Under the IRS rules, the following expenses may be HSA-eligible if you have a doctor's note indicating that the product or service is necessary to treat a medical condition. Whenever you have an expense that requires a diagnosis to be HSA-eligible, be sure to obtain the necessary documentation from your medical provider.

Breast implant removal, if the implant is defective or causing medical problems
Car modification expenses for additional features, such as hand controls or a wheelchair lift, for people with disabilities
CBD and hemp oil
Cosmetic procedures, if they're used to correct a deformity or scar stemming from an injury or disease
Electric toothbrushes, excluding any replacement brushes
Fluoride toothpaste and rinses
Home improvements to accommodate a medical condition, such as widening a doorway or adding a ramp to make a home wheelchair-accessible
Massage therapy and chairs
Mattresses, mattress boards, and special cushions and pillows
Meals and lodging, if the costs are incurred during medical treatment
Premiums paid for special clothing that provides relief from a diagnosed condition, excluding the "standard" cost of clothing
Special education or tutoring services for people with learning disabilities
Special home modifications for someone with an intellectual or physical disability
Vitamins and dietary supplements
Weight-loss programs, health club dues, and exercise equipment
Wigs, for diseases that cause hair loss

If you need an item or service that is not listed here, you can determine if it's HSA-eligible by searching the HSA Store online.

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Ineligible expenses for HSAs

The IRS typically disallows using funds from an HSA for the following types of expenses:

Child care for a healthy child
Cosmetic procedures, unless they correct a deformity or treat an underlying medical condition
Employment-related physical exams
Funeral expenses
Health insurance premiums, unless you have COBRA continuation coverage or receive unemployment benefits
Imported medications that aren't FDA-approved
Infant formula, even when the mother can't breastfeed
Late payment charges and missed appointment fees
Life insurance premiums
Long-term disability premiums
Marijuana, even if a doctor prescribes it
Maternity clothes
Toiletries

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Eligible expenses for FSAs vs. HSAs

Both an HSA and a flexible spending account (FSA) are tax-advantaged accounts designed to help you save money for medical expenses. The same medical expenses are eligible for coverage with HSAs and health FSAs. Other, less common types of FSAs can be used to cover dependent care or adoption-related expenses, rather than medical costs.

The key difference between an HSA and a health FSA isn't which expenses are covered, but rather who controls the money in the account. An HSA is like a 401(k) plan in the sense that you own the account's funds. You can contribute to an FSA only if your employer offers one, and the employer owns the account. If you leave your job for any reason, you'll usually forfeit the money in an FSA. Funds in an FSA typically cannot be rolled over from one year to the next, and you also typically can't contribute to both an HSA and an FSA at the same time.

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Is funding an HSA a good idea?

Contributing to an HSA confers tax advantages, and you can also benefit from employer contributions to an HSA on your behalf. If your employer provides health insurance through an HDHP plan but doesn't offer an HSA, you can establish one independently through an HSA provider such as HSA Bank or Fidelity.

If you contribute to an HSA, it's important to pay attention to which of your expenses qualify since the penalties for using HSA funds for non-qualifying expenses are steep. Ineligible distributions are considered as taxable income, and, if you're younger than 65, your HSA is charged a 20% penalty on the ineligible amount withdrawn.

HDHPs can be expensive if you have, or expect to incur, major medical bills. But if you are in good health and have an HDHP, then supplementing it with an HSA can be a great way to save for future medical expenses and supplement your retirement savings.

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HSA-eligible expenses frequently asked questions (FAQ)

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About the Author

Kailey Hagen, CFP®, is a contributing Motley Fool retirement analyst covering Social Security, Medicare, and retirement planning. Before The Motley Fool, Kailey was a research analyst for Reviews.com focusing on credit and banking products. She is a Certified Financial Planner® and holds a bachelor’s degree in English from the University of Wisconsin-Madison.

TMFKailey

The Motley Fool has a disclosure policy.

HSA-Eligible Expenses in 2025 and 2026

Learn what counts as an eligible health savings account expense.

Key Points

What is an HSA-eligible expense?

List of HSA-eligible expenses

HSA-eligible expenses with a diagnosis

Ineligible expenses for HSAs

Eligible expenses for FSAs vs. HSAs

Related investing topics

Rules for 403(b) Withdrawals in 2026

Student Loans: Everything You Need to Know

How Treasury Bonds Work and How to Invest in Them

Investment Guide for Teens & Parents With Teens

Is funding an HSA a good idea?

HSA-eligible expenses frequently asked questions (FAQ)

What expenses can I use my HSA for?

What expenses can I use my HSA for?

What products are HSA-eligible?

What products are HSA-eligible?

What is surprisingly HSA-eligible?

What is surprisingly HSA-eligible?

Can I get toilet paper with my HSA?

Can I get toilet paper with my HSA?

Can I use my HSA for dental expenses?

Can I use my HSA for dental expenses?

Can I use my HSA for my spouse or someone else?

Can I use my HSA for my spouse or someone else?

Can I use my HSA for massage?

Can I use my HSA for massage?

Can I use my HSA for vision?

Can I use my HSA for vision?

Can I use my HSA for Botox?

Can I use my HSA for Botox?

Can I use my HSA for therapy?

Can I use my HSA for therapy?

Can I use my HSA for physical therapy?

Can I use my HSA for physical therapy?

Can I use my HSA for a gym membership?

Can I use my HSA for a gym membership?

Can I use my HSA for vitamins?

Can I use my HSA for vitamins?

Can I use my HSA for LASIK?

Can I use my HSA for LASIK?

About the Author

Read Next

Premium Investing Services

What is an HSA-eligible expense?

List of HSA-eligible expenses

HSA-eligible expenses with a diagnosis

Ineligible expenses for HSAs

Eligible expenses for FSAs vs. HSAs

Rules for 403(b) Withdrawals in 2026

Student Loans: Everything You Need to Know

How Treasury Bonds Work and How to Invest in Them

Investment Guide for Teens & Parents With Teens

Is funding an HSA a good idea?

HSA-eligible expenses frequently asked questions (FAQ)

What expenses can I use my HSA for?

What expenses can I use my HSA for?

What products are HSA-eligible?

What products are HSA-eligible?

What is surprisingly HSA-eligible?

What is surprisingly HSA-eligible?

Can I get toilet paper with my HSA?

Can I get toilet paper with my HSA?

Can I use my HSA for dental expenses?

Can I use my HSA for dental expenses?

Can I use my HSA for my spouse or someone else?

Can I use my HSA for my spouse or someone else?

Can I use my HSA for massage?

Can I use my HSA for massage?

Can I use my HSA for vision?

Can I use my HSA for vision?

Can I use my HSA for Botox?

Can I use my HSA for Botox?

Can I use my HSA for therapy?

Can I use my HSA for therapy?

Can I use my HSA for physical therapy?

Can I use my HSA for physical therapy?

Can I use my HSA for a gym membership?