The Ultimate List of 100+ HSA-/FSA-Eligible Expenses

A health savings account (HSA) helps you save money on healthcare by letting you use pre-tax dollars to pay for HSA-eligible expenses—things like doctor visits, prescriptions, and a whole lot more. Translation: HSAs lower your taxable income and your out-of-pocket healthcare costs at the same time. Flexible spending accounts (FSAs), a cousin of HSAs, work similarly.

But here’s what most people don’t realize: Your HSA funds can be used for way more than just doctor visit copays and prescriptions. We’re talking everything from mental health care to red light therapy and even fitness trackers, so long as it’s needed to treat or manage a medical condition.

Knowing what counts as an FSA- or HSA-eligible expense can help you stretch your health dollars further, and that’s exactly what this guide is here to do. We break down more than 100 HSA-approved items by category so you can see what qualifies and learn how to get the most out of every tax-free dollar.

Understanding HSA Eligibility

To qualify as an HSA-eligible expense, a product or service has to primarily serve a medical purpose. In other words, things you can buy with an HSA must help diagnose, treat, prevent, or manage a health condition that you have, not just make you feel good, ease everyday stress, or support general health.

The IRS defines this more broadly than you may expect, so eligible expenses range from doctor visits and surgeries to mental health therapy, dental care, and prescription medications. But here’s the twist: Plenty of preventive and other health-focused purchases also count, especially if you have a letter of medical necessity (LMN) from your doctor that shows the item or service is part of a specific treatment or prevention plan.

The bottom line: If it’s tied to improving, maintaining, or supporting your health in a medically recognized way—and you’ve got documentation to back it up—there’s a good chance it qualifies. Let your health goals lead the way, just make sure the IRS rules are riding shotgun.

Expenses that Typically Require a Letter of Medical Necessity

A letter of medical necessity is a document from a healthcare provider explaining why a product or service is medically necessary for a patient’s treatment or health condition,” says Brian Miller, licensed insurance agent and COO and co-founder of OneHealth. “It’s often required to approve HSA, FSA, or HRA reimbursements for certain expenses.”

In other words, it’s your ticket to unlocking HSA eligibility for health-supportive items that aren’t traditionally seen as "medical.” The LMN proves they’re being used for a valid, provider-supported reason. Examples of typically LMN-required purchases include:

• Supplements
• Occupational therapy
• Speech therapy
• Massage therapy
• Fitness memberships and equipment
• Saunas
• Sleep aids
• Acupuncture

On the other hand, standard medical services (think doctor visit copays, necessary surgeries, or dental and vision checkups) and prescribed medications generally don’t require an LMN, says Miller.

Need an LMN? We make it easy. Find your product in Truemed’s marketplace, and we’ll walk you through the steps.

Top Categories of HSA-Eligible Expenses

So, what can you often buy with an HSA or FSA? Below, we’ve organized 100+ items that are typically HSA-eligible into easy-to-browse categories, from traditional medical care to unexpected health tools that might surprise you. Use this list to double-check what you’ve already bought, plan smarter purchases in the future, or finally put that HSA card to use beyond the pharmacy aisle.

Just keep this golden rule in mind: “To qualify, equipment must be primarily for medical use,” says Miller, so make sure your purchases meet that key requirement.

Medical Treatments and Services

1. Health insurance premiums

2. Primary care visits

3. Specialist consultations (like a visit to a dermatologist or cardiologist)

4. Surgery (inpatient or outpatient)

5. Lab tests and bloodwork

6. Imaging (like MRIs, X-rays, and CT scans)

7. Physical therapy

8. Urgent care and ER visits

9. Ambulance rides

10. Hospital stays

11. Telehealth consultations

12. Nursing homes and long-term care

Prescription Medications

All prescribed drugs (both name-brand and generic) are HSA-eligible. Here are some common examples:

13. Antibiotics

14. Asthma inhalers

15. Birth control

16. Antidepressants

17. Hormone therapy

18. Insulin and diabetic medications

Over-the-Counter (OTC) Health Items

19. Pain relievers (like ibuprofen and acetaminophen)

20. Allergy medicines (like Claritin and Zyrtec)

21. Heartburn and digestive aids

22. Cold and flu remedies

23. Menstrual care products (like pads, tampons, and cups)

24. First aid supplies (like bandages and antiseptics)

25. Bug bite relief products

Dental Care

26. Cleanings and exams

27. Fillings and root canals

28. Orthodontics (like braces or Invisalign)

29. Wisdom teeth removal

30. Dentures

31. Prescription toothpaste (Prevident)

Vision Expenses

32. Eye exams

33. Prescription glasses and lenses

34. Lens cloths and cleaners

35. Contact lenses and solution

36. LASIK and PRK surgery

Mental Health Services

37. Therapy and counseling

38. Psychiatry appointments

39. Inpatient mental health treatment

40. Prescribed mental health medications (like antidepressants or antipsychotics)

Alternative and Complementary Treatments

41. Acupuncture

42. Chiropractic care

43. Naturopathic treatments (like herbal medicines)

44. Nutrition counseling

45. Massage therapy

46. Occupational therapy

47. Speech therapy

48. Pulmonary therapy

49. Hypnotherapy

Medical Equipment and Supplies

50. Blood pressure monitors

51. Glucose meters and testing strips

52. CPAP machines and accessories

53. Crutches, walkers, wheelchairs

54. Compression socks

55. Hearing aids

56. Heat and cold wraps

57. Nebulizers

58. Masks

59. Hand sanitizer

Pregnancy and Fertility Care

60. Prenatal vitamins

61. Childbirth classes

62. Childbirth expenses

63. Breast pumps and lactation supplies

64. Fertility treatments

65. Egg and sperm storage

66. Doula services (typically require an LMN)

Preventive and Health Expenses

67. Vaccines and immunizations

68. Health screenings (like mammograms or cholesterol tests)

69. Medically supervised smoking cessation programs

70. Medically supervised weight-loss programs

71. Skin care products (like acne spot patches, acne drying lotion, and sunscreen)

72. Colonoscopies

73. Gut microbiome tests (with LMN)

74. DNA health tests (with LMN)

75. Food sensitivity testing (with LMN)

76. Allergy testing

77. Water filtration device

Fitness Memberships

78. Gym memberships

79. Personal training

80. Fitness studio memberships (like yoga, Pilates, and spin studios)

Fitness Equipment

81. Home gym accessories (like weights and resistance bands)

82. Fitness equipment (like treadmills, bikes, and rowing machines)

83. Fitness shoes (like running and cross-training shoes)

84. Fitness clothing (like leggings and athletic socks)

85. Recovery tools (like foam rollers and percussion massagers)

86. Vibration plates

Health Tech

87. Wearables and fitness trackers (like a Whoop band or Oura Ring)

88. Air purifiers

89. Blue-light blocking glasses

90. Smart scales

91. Blood oxygen monitors

92. Thermometers

93. Red-light therapy panels or masks for inflammation recovery

94. Red-light devices for skin rejuvenation

95. Health app subscriptions (like Calm or InsideTracker)

96. Bidets

97. Saunas

98. Cold plunges

99. Massage devices (like a foot massager)

Sleep

100. Sleep masks

101. Specialty mattresses or pillows

102. White noise machines

103. Weighted blankets

104. Light therapy lamps

105. Mouth tape

Supplements

106. Probiotics

107. Vitamin supplements

108. Mineral supplements (like magnesium, calcium, iron, and zinc)

109. Omega-3s

110. Digestive enzymes

111. Immunity support

112. Protein powder

113. Greens powders

114. Electrolytes and hydration mixes

Common Misunderstandings: What’s Unlikely to Be Eligible

It’s also just as important to know what doesn’t typically count as an FSA or HSA item, as misusing your funds can lead to financial penalties and taxes, says Miller. While a provider could in theory determine that one or more of the below items is medically necessary for a certain individual, and could then write a LMN for it, it’s much less likely than for the above list. Here are some common items that are not usually HSA-eligible (and why):

• Cosmetic procedures (like liposuction, facelifts, and teeth whitening): These are considered elective or purely aesthetic, not medically necessary treatments. Because HSAs cover expenses that diagnose, treat, or prevent illness, these cosmetic procedures don’t qualify, even if you feel they improve your appearance or confidence.
• Over-the-counter beauty products (unless treating a diagnosed medical condition): Everyday items like skin foundation, regular moisturizers, or shampoos are seen as personal care, not medical expenses. However, if you have a prescription or doctor’s note confirming a medical condition—such as eczema or psoriasis—then medicated creams and treatments may be eligible for reimbursement.
• Household items (like toilet paper and cleaning products): While important for hygiene, these are considered general household necessities rather than medical expenses. Even during cold or flu season, they don’t meet IRS criteria for HSA eligibility because they don’t treat or prevent specific medical conditions directly.
• Groceries and everyday food: Normal grocery purchases, including fruits, vegetables, and specialty diets, generally don’t qualify. The exception is rare cases where a doctor prescribes specific foods that don’t satisfy everyday nutritional needs and are part of a medical treatment plan. Though even then, it often requires documentation and is tightly regulated.
• Childcare: While some medical supplies for children (like diabetic testing kits or prescription eyewear) can be covered, general childcare expenses like daycare, babysitting, preschool tuition, and other non-medical care are not eligible. HSAs are designed to cover health-related costs, so routine child supervision or education expenses don’t qualify. However, a Dependent Care FSA is a separate benefit that can be used to pay for certain childcare expenses like daycare and after-school programs.
• Other types of insurance: Your health insurance premium is typically HSA-eligible. However, life insurance, medical coverage related to your car insurance, and policies for loss of life, limb, and sight are all coverages that can’t be paid for with HSA dollars.

The takeaway: HSA rules are all about intent and proper documentation. If the expense isn’t tied to a specific diagnosis or treatment—and backed up by your doctor—it probably won’t qualify.

How to Confirm Expense Eligibility

Before you swipe your HSA card or submit for reimbursement, it’s important to confirm that your purchase qualifies as an HSA-eligible expense for you, right now. The last thing you want is to assume something’s covered, only to get denied—or worse, face tax penalties or a surprise bill.

You can always check the IRS’s official list of qualified medical expenses in Publication 502 and Publication 969. These resources spell out what usually counts (and what doesn’t), and are a good baseline for understanding the rules.

But let’s be real: IRS documents aren’t exactly beach reading. And using your HSA should feel empowering, not confusing.

That’s where Truemed comes in, with tools and guides that break it all down, plus a curated marketplace that features products that have been HSA- and FSA-eligible for many individuals. You can shop confidently knowing these products will likely check the box. And if an LMN is required, Truemed can walk you through how to get one.

If you’re still unsure about a specific item, contact your HSA or FSA provider, use our HSA eligibility guide, or message Truemed directly to cover your bases. Just don’t forget to hang on to your receipts and any supporting documentation (like an LMN) in case you need to justify your purchase during the reimbursement process or tax season.