Can You Include Medical Expenses Paid with HSA on Schedule A?

Many individuals wonder whether they can include medical expenses paid with their HSA (Health Savings Account) on Schedule A. The answer to this question can be a bit complex but understanding the rules and regulations can help you navigate this issue effectively.

Firstly, it's essential to note that you cannot double-dip when it comes to tax benefits. This means that if you have already used HSA funds to pay for medical expenses, you cannot also claim those same expenses as deductions on your tax return.

However, there are certain circumstances where you can include HSA expenses on Schedule A:

  • If you have medical expenses that exceed the IRS deduction threshold (usually 7.5% of your adjusted gross income), you can include those expenses on Schedule A.
  • You can include expenses paid with HSA funds that were used for qualified medical expenses that weren't covered by your high-deductible health plan.

It's crucial to keep detailed records of your medical expenses, including which expenses were paid with HSA funds and which were paid out of pocket. This documentation will be essential if the IRS ever questions your deduction claims.


Many individuals often ask if they can list the medical expenses paid using their Health Savings Account (HSA) on Schedule A for tax purposes. While the answer is not a straightforward 'yes' or 'no', grasping the underlying rules can make things clearer.

A key point to remember is that the IRS does not allow you to take advantage of tax benefits twice, commonly known as 'double-dipping'. If you've already utilized your HSA funds to cover certain medical expenses, you cannot also list those same expenses when filing your taxes.

Nonetheless, there are specific situations in which you can still include HSA expenses on Schedule A:

  • If your total medical expenses surpass the IRS threshold for deductions, which is typically 7.5% of your adjusted gross income, you may include those expenses.
  • You can add in expenses that were paid using HSA funds for qualified medical services that were not reimbursed by your high-deductible health plan.

Maintaining thorough records of all medical expenditures is vital, especially distinguishing between what was paid through HSA and out-of-pocket payments. This will be crucial if the IRS ever examines your tax return.

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