How to Claim HSA Expenses From Previous Years (Even Years Later)

Did you pay a HSA expense out of pocket years ago but forgot to reimburse yourself? Have you been wondering if you can claim HSA expenses from previous years?

The good news is that you may still be able to use your HSA to reimburse yourself today, but there are a few caveats. Read on to learn more about time limits, IRS requirements, why delayed reimbursement might work, and how to reimburse yourself years down the line.

Some HSA funds allow you to accrue interest on your available balance making an HSA a potential investment vehicle. While it’s not a traditional investment option, many HSA owners use their HSA as an investment tool because it offers a triple tax advantage. That means your contributions, earned interest, and withdrawals are completely tax free.

For this reason, some HSA holders tend to allow their HSA funds to accumulate and opt to rather pay for medical expenses out of pocket. That said, a day may come where you might decide you need some extra cash on hand in which case an HSA reimbursement would come in handy.

The question is, can you claim HSA expenses from previous years? In most cases yes, you can claim HSA expenses from previous years, but there are a few important rules you need to keep in mind. First, you need to check if the expense was incurred after your HSA was established and then you need to check if your expense meets the requirements for a qualified medical expense.

At the moment there are no IRS rules requiring you to reimburse yourself in the same year you incurred the expense. This means you could pay a $500 medical bill out of pocket today, leave your HSA untouched, and potentially reimburse yourself for that $500 several years from now.

From an investment perspective, this becomes a handy tool if you’re looking for some tax free savings without losing the option for reimbursement. This intentional HSA-maximization strategy is referred to as the “shoe box rule.” However, this method can also come in handy if you’ve just forgotten to reimburse yourself from a previous year’s expense and want to know if you can submit now.

If you plan on claiming reimbursement, you’ll need to ensure that the expense hasn’t already been reimbursed by insurance or another tax-advantaged account, and you can’t also claim it as an itemized medical deduction.

There is no specific HSA reimbursement time limit. In theory, you could reimburse HSA expenses from 10 years ago.

The important date is when your HSA was established.

For example, if you established your HSA in 2020 and paid a qualified $1,000 medical expense in 2021, you could potentially reimburse yourself in 2026 or later. An expense from 2019, however, wouldn't qualify because it occurred before the HSA was established.

State law can affect when an HSA is considered established, so if you have older expenses you’ll need to confirm your account's establishment date.

Unfortunately any expenses incurred before establishing your HSA can’t be reimbursed, regardless of whether you claim it during the same year that the expense was incurred or years later. The IRS last-month rule also won’t make the expense claimable. That’s because it doesn’t retroactively turn medical expenses incurred before the HSA was established, into qualified HSA expenses.

Having an HSA-eligible high-deductible health plan (HDHP) at the time also doesn't make it possible to claim for an expense incurred before you set up your HSA.

As per the IRS Publication 502, expenses that are used to treat, prevent, or mitigate a health condition or illness are eligible for HSA reimbursement. These expenses can include doctor visits, dental treatment, prescription medications, certain over-the-counter products, and eligible vision expenses.

Keep in mind that qualified expenses can generally include expenses for yourself, your spouse, and qualifying dependents, subject to IRS requirements.

General health expenses have a little more red tape than pure medical expenses.

Health expenses like fitness equipment, supplements, and adaptive footwear typically aren’t eligible for HSA reimbursement on their own. However, the IRS does allow reimbursements for dual-use products when the purchase is supported by appropriate documentation. Dual-use products are products or services that can be used for general health but can also be prescribed to treat, prevent, or mitigate a health condition. These types of expenses can also be reimbursed if you have a Letter of Medical Necessity to validate the purchase.

Products or services purchased solely for general health aren't eligible for reimbursement so if you’re trying to claim for an expense from years ago you’ll need to check whether you have a Letter of Medical Necessity and an itemized receipt.

You generally cannot use delayed HSA reimbursement for:

• Expenses incurred before your HSA was established
• Expenses that don't qualify under HSA medical-expense rules
• Expenses already reimbursed by insurance, an FSA, HRA, another HSA, or another source
• Expenses already claimed as an itemized medical deduction
• An expense you've already reimbursed yourself for

HSA receipt requirements are especially important when you're claiming an expense years after you originally paid for it. To claim a delayed HSA reimbursement you should be able to show that the distribution covered a qualified medical expense, that another source did not reimburse the expense, and that you didn't previously take it as an itemized medical deduction.

You’ll also need to keep itemized receipts or invoices showing the merchant or provider, expense, date, and amount. You may also need EOBs, proof of payment, prescriptions, and in the case of a dual-use product, a LMN.

If you are delaying reimbursement, keep the documentation for as long as the expense remains unreimbursed.

Digital copies can be useful because paper receipts may fade or get lost. And it would be a good idea to also track which expenses you've reimbursed to avoid accidentally claiming one twice.

If you lost your receipt you can try your healthcare provider's portal, pharmacy history, insurer records, EOBs, email receipts, or the business who sold you the products.

Unfortunately a credit card or bank statement alone may not be sufficient proof for the reimbursement because it doesn’t show what you purchased and whether it qualified. If you can’t substantiate an old expense, claiming reimbursement may create problems if the IRS later questions the distribution so it’s best to only claim if you have all the required documents.

The process is relatively simple:

1. Confirm the expense occurred after your HSA was established.

2. Verify that it's a qualified medical expense.

3. Make sure insurance or another account didn't reimburse it.

4. Confirm you didn't claim it as an itemized medical deduction.

5. Locate and save your supporting documentation.

6. Request a distribution from your HSA provider.

7. Keep your expense and reimbursement records together.

The withdrawal process depends on your provider so it’s best to check with your administrator what their process is. Keep in mind each administrator will also have their own distribution method which could include an ACH transfer, checks, or other reimbursement tools.

You generally report the HSA distribution for the year you receive it so you don't reopen the tax return for the year in which you originally paid the medical expense.

So for example, if you made the purchase in 2020 but only claimed your reimbursement in 2026, you’ll report the reimbursement on your 2026 tax return.

When submitting your tax return you’ll need to report your HSA distribution on Form 8889 but don't worry, qualified distributions used to reimburse eligible medical expenses are generally excluded from taxable income.

Remember that you can’t also claim the underlying expense as an itemized medical deduction.

Yes. Your HSA belongs to you, so changing employers or health plans doesn't make the account disappear.

Even if you're no longer eligible to contribute to an HSA, you can generally continue using existing funds for qualified medical expenses. Any previous qualified expenses may also remain eligible for reimbursement if they meet the usual requirements.

Moving funds between HSAs through a qualifying rollover or trustee-to-trustee transfer can also preserve the continuity of the HSA for older qualified expenses, but this is subject to the applicable rules in Publication 969.

Delaying reimbursement is entirely dependent on your financial situation and investment plans. Some HSA owners deliberately pay medical expenses with other funds and leave money invested in their HSA since certain HSAs accrue tax free interest.

This is a great option if you want your HSA to grow over time, giving you a large balance to work with in the future. Since HSAs roll over every year and you can claim for reimbursements at any time, with the right paperwork, this is a great investment option.

Waiting isn't automatically the better option, though. You need to consider your current cash flow, investment risk, and whether you're comfortable maintaining records for years. Additionally, some people prefer to use their HSA to invest in their health today and plan for their financial future with other tax-advantaged accounts like 401s or Roth IRAs.

There is no requirement to delay HSA reimbursement so if you need the money now, reimbursing an eligible expense now may make more sense.

Suppose Maya established her HSA in 2020. In 2021, she paid a $1,200 qualified dental bill with her regular credit card and saved the itemized invoice.

She didn't receive reimbursement from insurance or another account and didn't claim the expense as an itemized deduction.

In 2026, Maya decides to reimburse herself from her HSA. She requests a $1,200 distribution and keeps the original invoice and reimbursement record with her tax documents.

Even though five years passed, the reimbursement can still qualify because the expense occurred after her HSA was established and met the other HSA reimbursement rules.

Eligibility can become less obvious with health purchases that aren't automatically considered qualified medical expenses.

Truemed* helps qualified consumers determine whether purchases such as fitness expenses, supplements, footwear, and other health-related products may qualify for HSA/FSA spending based on medical necessity.

You can also get a LMN from our network of independent clinicians or browse our marketplace for HSA eligible items.

*Truemed is for qualified customers. See terms at truemed.com/disclosures.