HSA Eligible Expenses: Search Tool

Wondering what your HSA actually covers? Let us help! Our search tool gives you a straight answer on 230+ common health expenses. Search any item, or filter by category to browse what's automatically covered, what requires documentation, and what doesn't qualify.

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Per the IRS, a qualified medical expense is anything that diagnoses, treats, mitigates, cures, or prevents a specific illness or disease. General health and wellness items — even beneficial ones — do not qualify.

Eligible expenses are sourced from IRS Publication 502, IRS Publication 969, the CARES Act, and the One Big Beautiful Bill Act. Every entry includes its IRS source. If an item isn't specifically named in IRS guidance, we note that as well.

Each item in our database falls into one of three categories:

✓ Auto Eligible: These expenses qualify without a prescription, doctor's note, or any other documentation. The IRS has explicitly listed them — or they became eligible through the CARES Act's 2020 OTC expansion. Keep your receipt, and you're good to go.

⚠ LMN Required: These expenses fall into a gray zone. Some require a Letter of Medical Necessity (LMN) — a signed statement from a licensed physician connecting the expense to a specific diagnosed medical condition. Others fall into a genuine gray area where IRS guidance is ambiguous. For guidance specific to your situation, consult a qualified professional.

✕ Not Eligible: These expenses don't qualify under current IRS guidance — most are personal care, general wellness, or cosmetic. Some have narrow exceptions noted.

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HSA Eligible Expenses:

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Frequently Asked Questions

What is a Letter of Medical Necessity (LMN)?

An LMN is a signed statement from a licensed healthcare provider that connects a specific expense to a diagnosed medical condition. It explains why the item or service is medically necessary for your treatment, prevention, or care. An LMN doesn't guarantee eligibility — the expense must still meet IRS guidelines relating to the diagnosis, cure, mitigation, treatment, or prevention of disease under IRC Section 213(d) — but it's often the key to unlocking expenses that otherwise wouldn't qualify. Full breakdown here →

Why do different websites give different HSA eligibility answers?

The IRS sets the framework through IRC Section 213(d) and Publication 502, but doesn't publish an exhaustive list of every possible expense. That leaves room for interpretation on gray-area items — and different websites, brands, and benefits platforms fill that gap differently based on their own reading of IRS guidance. Some sites also conflate HSA rules with FSA rules, which are governed differently. When something falls outside the clearly auto-eligible category, refer to IRS Publication 502 directly or consult a qualified tax professional. More on why eligibility is confusing →

How does the IRS actually determine what's eligible?

HSA eligibility is rooted in IRC Section 213(d), which defines a qualified medical expense as anything that diagnoses, treats, mitigates, cures, or prevents a specific illness or disease. IRS Publication 502 builds on that with a detailed — but not exhaustive — list of examples. Publication 969 covers the HSA-specific rules. Together, these sources drive almost every eligibility decision. See all our IRS sources →

What changed with the One Big Beautiful Bill Act?

Signed July 4, 2025, the OBBBA added two meaningful changes for HSA holders. First, Direct Primary Care (DPC) membership fees — up to $150/month per individual or $300/month per family — are now eligible HSA expenses starting January 1, 2026. Second, telehealth coverage before your deductible is now permanent, retroactive to plan years beginning January 1, 2025. Proposed changes, such as gym memberships, did not make it into the final bill.

Can I use my HSA for over-the-counter medications?

Yes — the CARES Act of 2020 permanently removed the prescription requirement for OTC medicines and drugs. Pain relievers, allergy medicine, cold and flu products, antacids, sleep aids, and more are all eligible without a prescription. The expansion covers medicines and drugs specifically — OTC devices like nasal strips qualify under a different IRS basis.

Do I need to save my receipts?

Yes. You'll need receipts for two reasons: reimbursement and audits. When submitting expenses for HSA reimbursement, your administrator may require itemized receipts as proof of purchase. The IRS can also audit HSA distributions, and you're responsible for proving every withdrawal was for a qualified medical expense. Keep itemized receipts for all HSA purchases. For LMN-supported expenses, keep the LMN on file too. There's no requirement to submit receipts at the time of purchase, but you'll need them if you're ever asked.

For informational purposes only — not medical or financial advice. We make every effort to confirm eligibility, but rules can change and may vary by HSA administrator. Always verify with your administrator before purchasing.

Sources: IRS Publication 502, IRS Publication 969, CARES Act 2020, and the One Big Beautiful Bill Act (2025). Last updated May 2026.