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HSA Qualified Medical Expenses

Qualified medical expenses and your HSA

Paying for qualified medical expenses, such as doctor’s visits and prescription medications, is simple with your Wells Fargo Health Savings Account (HSA). The money you contribute to your HSA is tax-deductible, and you can withdraw money free of income taxes if you use it to pay for qualified medical expenses — not only for yourself, but also for your spouse and tax dependents.

What expenses qualify for reimbursement from my HSA?

The IRS defines qualified medical expenses as amounts paid for the “diagnosis, cure, mitigation, treatment, or prevention of disease, or for the purpose of affecting any structure or function of the body.” Qualified medical expenses are eligible for reimbursement through your HSA as long as they are not reimbursed through insurance or other sources. See the IRS’s complete list of qualified medical and dental expenses (PDF*).

Examples of qualified medical expenses

Qualified Medical Expenses (A-G)
Qualified Medical Expenses (H-Z)
  • Acupuncture
  • Alcoholism treatment 
  • Ambulance services
  • Artificial limb or prosthesis
  • Artificial teeth
  • Birth control pills
  • Braille books/magazines (portion of costs)
  • Car adaptations (for persons with disabilities)
  • Chiropractors
  • Christian Science practitioners
  • Contact lenses (including saline solution and cleaner)
  • Crutches
  • Dental treatment (x-rays, fillings, extractions, dentures, braces, etc.) 
  • Diagnostic devices (such as a blood sugar test kit)
  • Doctor’s fees
  • Drug addiction treatment
  • Eyeglasses (including eye examinations)
  • Eye surgery (including laser eye surgery)
  • Fertility enhancement (including in-vitro fertilization)
  • Guide dog (for visually-impaired or hearing-impaired)
  • Hearing aids and hearing aid batteries
  • Hospital services (including meals and lodging)
  • Insulin
  • Laboratory fees
  • Lactation assistance supplies
  • Prescription medicines or drugs
  • Nursing home 
  • Nursing services
  • Operations or surgery
  • Psychiatric care
  • Psychologist
  • Telephone equipment for hearing-impaired
  • Telephone equipment for visually-impaired
  • Therapy or counseling
  • Transplants
  • Transportation for medical care
  • Vasectomy
  • Wheelchair
  • X-rays

Examples of other expenses that do not qualify for reimbursement through an HSA

Non-qualified expenses (A – G)
Non-qualified expenses (H – Z)
  • Acid controllers
  • Allergy and sinus medications
  • Babysitting, childcare, and nursing services for a normal, healthy baby
  • Controlled substances obtained in violation of federal law
  • Cosmetic surgery
  • Cold, cough, and flu medications
  • Dancing lessons
  • Diaper service
  • Electrolysis or hair removal
  • Funeral expenses
  • Hair transplant
  • Health club dues
  • Household help
  • Illegal operations and treatments
  • Maternity clothes
  • OTC medications (without a doctor’s prescription)
  • Pain relief medications
  • Personal use items
  • Sleep aids and sedatives
  • Swimming lessons
  • Teeth whitening
  • Vacation or travel
  • Veterinary fees
  • Weight loss programs for improvement of appearance, general health, or sense of well-being

A special note on insurance premiums

Insurance premiums are generally not considered qualified medical expenses. However, the following types of insurance premiums typically do qualify:

  • Continuation coverage under federal law (i.e., COBRA)
  • Qualified long-term care insurance contract
  • Any health plan maintained while an individual is receiving unemployment compensation under federal or state law
  • For accountholders age 65 and over (i.e., those eligible for Medicare), premiums for any health insurance (including Medicare and Medicare Part D premiums) other than a Medicare supplemental policy

Important reminders about qualified medical expenses

  • Items that are merely beneficial to an individual’s general good health, such as vitamins or dietary supplements, are not qualified medical expenses. 
  • Drugs must be purchased legally. 
  • Remember to save your receipts and your doctor’s prescriptions for over-the-counter (OTC) medicines for tax purposes. 
  • There may be situations when your doctor recommends a treatment that will be good for your health, but it still may be considered ineligible, such as a vacation. 
  • As the HSA owner, you are ultimately responsible for determining whether a health care expense is eligible for reimbursement from your HSA. 
  • Wells Fargo does not determine whether expenses qualify for tax-free reimbursement. Wells Fargo does not provide tax advice. Consult your tax advisor if you have questions about whether an expense can be paid from your HSA.
  • If an HSA expenditure is not used for a qualified medical expense, you will be required to pay income tax and a 20% penalty on the amount used. (The 20% penalty tax does not apply to payments made after your death or disability, or after you reach age 65.)
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