Short answer: You can use HSA funds tax-free to pay for IRS-qualified medical expenses for yourself, your spouse, and your tax dependents.
Health Savings Account funds may be used tax-free for qualified medical expenses as defined by the IRS. These expenses can be for you, your spouse, or your tax dependents, even if they are not covered under your health plan.
Common qualified expenses include doctor visits, hospital services, lab work, surgeries, prescription medications, and insulin. Dental and vision care are also eligible, such as cleanings, fillings, braces, eye exams, glasses, and contact lenses.
HSA funds may also be used for mental health and substance use treatment, physical therapy, chiropractic care, and certain medical equipment and supplies, such as crutches, CPAP machines, and blood pressure monitors.
Certain over-the-counter medications and menstrual products are eligible without a prescription. However, cosmetic or general wellness items typically do not qualify unless they are primarily used to treat a medical condition.
Most health insurance premiums are not qualified medical expenses. Limited exceptions include COBRA premiums, certain long-term care insurance premiums, and health coverage paid while receiving unemployment compensation.
The IRS maintains a detailed list of medical expenses that may qualify, but eligibility can depend on the facts and circumstances. When in doubt, it is important to confirm whether an expense qualifies before using HSA funds.
Sources
- IRS, Publication 502 – Medical and Dental Expenses: https://www.irs.gov/publications/p502
- IRS, FAQs on Health Savings Accounts – Qualified Medical Expenses: https://www.irs.gov/faqs/health-savings-accounts-hsas
Content history
Originally published: March 27, 2025
Last reviewed: January 26, 2026