HSA Eligible Expenses Checker
Search 135+ IRS Section 213(d) expense categories to check whether a medical expense qualifies for HSA reimbursement. Results reflect current IRS guidance including CARES Act changes (OTC medications and menstrual products eligible without prescription) and 2026 OBBBA updates (Direct Primary Care fees and telehealth services now qualify). Free to use, no account required.
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How to read your results
Qualifies as an HSA-eligible expense under IRC Section 213(d). You can pay for this with HSA funds or reimburse yourself from your HSA.
Eligible only with a Letter of Medical Necessity from your doctor for a specific diagnosed condition. Learn more: What is a Letter of Medical Necessity?
Does not qualify as an HSA-eligible expense. Using HSA funds for this expense may result in income tax plus a 20% penalty (IRC Section 223(f)(4)).
For informational purposes only. Not tax advice. Consult a qualified tax professional before making HSA decisions. Eligibility may depend on individual circumstances, including whether a Letter of Medical Necessity is required. HSA IQ does not guarantee the accuracy of eligibility determinations.
Frequently asked questions
What medical expenses are HSA eligible?
HSA-eligible expenses are defined under IRC Section 213(d) as costs for the diagnosis, cure, mitigation, treatment, or prevention of disease. This covers a broad range of medical, dental, vision, and mental health expenses -- from doctor visits and prescription drugs to lab work, surgery, hearing aids, and therapy. As of 2026, Direct Primary Care fees (up to $150/month individual, $300/month family) also qualify under the OBBBA. For a detailed breakdown by category, see our complete 2026 eligible expense guide. Learn more about deferring HSA reimbursement: The HSA Shoebox Strategy Explained.
Are over-the-counter medications HSA eligible?
Yes. Since the CARES Act of 2020, over-the-counter medications are HSA eligible without a prescription. This includes pain relievers, allergy medicine, cold and flu remedies, antacids, and similar products. Menstrual products (tampons, pads, menstrual cups) also became eligible under the same legislation. Insulin has always been eligible without a prescription. For the full list of eligible categories, see our 2026 eligible expense guide.
Do I need a prescription to use my HSA?
For most medical services and provider visits, no -- you just need documentation showing the expense qualifies under IRC Section 213(d). For over-the-counter medications, no prescription is required since the CARES Act. However, some items that fall in the gray zone between medical and personal use -- such as gym memberships, vitamins, and massage therapy -- require a Letter of Medical Necessity (LMN) from a licensed healthcare provider to confirm the expense is treating a specific diagnosed condition.
What is a Letter of Medical Necessity?
A Letter of Medical Necessity (LMN) is a written statement from a licensed healthcare provider confirming that a specific product, service, or treatment is medically necessary to treat a diagnosed condition. The IRS requires an LMN for expenses that could be either medical or personal in nature -- gym memberships, nutritional supplements, ergonomic equipment, and similar items. Without an LMN, these expenses are not HSA eligible. Most LMNs are valid for 12 months and can be obtained during a regular appointment with your provider. Learn more about LMNs and how to get one.
Are dental and vision expenses HSA eligible?
Yes. Dental and vision expenses are broadly HSA eligible. Dental coverage includes cleanings, fillings, crowns, bridges, dentures, orthodontics, root canals, and dental X-rays. Vision coverage includes eye exams, prescription eyeglasses, prescription sunglasses, contact lenses and supplies, and laser eye surgery (LASIK, PRK). Teeth whitening and non-prescription sunglasses are not eligible.
Are gym memberships, vitamins, and supplements HSA eligible?
Only with a Letter of Medical Necessity. Gym memberships, personal training, fitness equipment, vitamins, and nutritional supplements are not automatically HSA eligible. They become eligible when a licensed healthcare provider documents that the expense is medically necessary to treat a specific diagnosed condition -- such as obesity, diabetes, cardiovascular disease, or a diagnosed nutritional deficiency. A general wellness goal does not qualify. Learn how to get a Letter of Medical Necessity.
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