HSA - Eligible Expenses

The following is a summary of common expenses claimed against Health Savings Accounts (HSAs) and Health Reimbursement Arrangements (HRAs). Due to frequent updates to the regulations governing these accounts and arrangements, this list does not guarantee reimbursement and is to be utilized as a guide for the submission of claims. For more information on IRS-qualified medical expenses, click here.

Important Update: CARES Act expands use of health accounts

The new CARES Act expands eligible expenses for HSAs, FSAs, and HRAs:

  • Feminine hygiene products are now qualifying medical expenses.

  • You can now use your HSA, FSA, or HRA for over-the-counter (OTC) medications without a prescription. See the Common Over-the-Counter (OTC) Medications section below for examples.

    • Many products being discussed in the news, such as lodging, disposable masks, and hand sanitizer, are considered qualifying medical expenses only with a prescription (Rx) or letter of medical necessity (LMN) from a doctor.

    • These changes will likely take effect gradually. Not all retailers will update at the same time, which may result in inconsistent shopping experiences. Such issues are likely to be resolved soon.

  • You can now use your HSA for telehealth services before reaching your deductible without impacting your eligibility for an HSA. You can use your HSA for telehealth for qualified expenses. Both instances are effective until Dec. 31, 2021.

Common IRS-Qualified Medical Expenses

  • Acupuncture
  • Ambulance
  • Artificial limbs
  • Artificial teeth*
  • Birth control treatment
  • Blood sugar test kits for diabetics
  • Breast pumps and lactation supplies
  • Chiropractor
  • Contact lenses and solutions*
  • Crutches
  • Dental treatments (including X-rays, cleanings, fillings, sealants, braces and tooth removals*)
  • Doctor’s office visits and co-pays
  • Drug addiction treatment
  • Drug prescriptions
  • Eyeglasses (Rx and reading)*
  • Fluoride treatments*
  • Feminine hygiene products
  • Fertility enhancement (including in-vitro fertilization)
  • Flu shots
  • Guide dogs
  • Hearing aids and batteries
  • Infertility treatment
  • Inpatient alcoholism treatment
  • Insulin
  • Laboratory fees
  • Laser eye surgery*
  • Medical alert bracelet
  • Medical records charges
  • Midwife
  • Occlusal guards to prevent teeth grinding
  • Orthodontics*
  • Orthotic Inserts (custom or off the shelf)
  • Over-the-counter medicines and drugs (see more information below)
  • Physical therapy
  • Special education services for learning disabilities (recommended by a doctor)
  • Speech therapy
  • Stop-smoking programs (including nicotine gum or patches, if prescribed)
  • Surgery, excluding cosmetic surgery
  • Vaccines
  • Vasectomy
  • Vision exam*
  • Walker, cane
  • Wheelchair

Common Over-the-Counter (OTC) Medicines

Examples include, but are not limited to:

  • Acid controllers
  • Acne medicine
  • Aids for indigestion
  • Allergy and sinus medicine
  • Anti-diarrheal medicine
  • Baby rash ointment
  • Cold and flu medicine
  • Eye drops*
  • Feminine antifungal or anti-itch products
  • Hemorrhoid treatment
  • Laxatives or stool softeners
  • Lice treatments
  • Motion sickness medicines
  • Nasal sprays or drops
  • Ointments for cuts, burns or rashes
  • Pain relievers, such as aspirin or ibuprofen
  • Sleep aids
  • Stomach remedies

Services That May Be Eligible with a Letter of Medical Necessity Completed

This list is not all-inclusive:

  • Weight-loss program only if it is a treatment for a specific disease diagnosed by a physician (e.g., obesity, hypertension, heart disease)
  • Compression hosiery/socks, antiembolism socks or hose
  • Massage treatment for specific ailment or diagnosis
  • CPR classes for adult or child
  • Improvements or special equipment added to a home or other capital expenditures for a physically handicapped person

Ineligible Expenses

Listed below are some services and expenses that are not eligible for reimbursement. This list is not all-inclusive:

  • Aromatherapy
  • Baby bottles and cups
  • Baby oil
  • Baby wipes
  • Breast enhancement
  • Cosmetics and skin care
  • Cotton swabs
  • Dental floss
  • Deodorants
  • Hair re-growth supplies and/or services
  • Health club membership dues
  • Humidifier
  • Lotion
  • Low-calorie foods
  • Mouthwash
  • Petroleum jelly
  • Shampoo and conditioner
  • Spa salts

Eligible Dependent Care Expenses

  • Au pair services
  • Babysitting services
  • Before- and after-school programs
  • Custodial or eldercare expenses, in-home or daycare center (not medical care)
  • Nursery school
  • Pre-kindergarten
  • Summer day camp (not educational in nature)

Ineligible Dependent Care Expenses

  • Clothing
  • Food/meals
  • Kindergarten and higher education/tuition expenses
  • Overnight camp



This list is not comprehensive. It is provided to you with the understanding that the Board of Pensions is not engaged in rendering tax advice. The information provided is not intended to be used to avoid federal tax penalties. For more detailed information, please click here. If tax advice is required, you should seek the services of a professional.