Can You Use Your HSA to Pay Past Medical Bills? Understanding HSA Rules

One common question that arises for HSA account holders is whether they can use their HSA to pay past medical bills. Let's delve into this to get a better understanding of how HSAs work.

Health Savings Accounts (HSAs) are designed to help individuals save money for qualified medical expenses on a tax-free basis. But when it comes to paying past medical bills with an HSA, there are specific rules to keep in mind:

  • You can only use your HSA funds to pay for medical expenses incurred after you opened your HSA account.
  • If the medical expense occurred before you opened your HSA, you cannot use your HSA funds to pay for it.
  • However, if the expense was incurred after you opened your HSA account, even if the bill is from a previous year, you can use your HSA to pay for it.

It's important to keep this distinction in mind to ensure you are using your HSA funds appropriately and in compliance with IRS regulations. If you try to use your HSA to pay for a past medical bill that does not meet the criteria, you may face penalties and tax implications.

While you cannot use your HSA to directly pay off old medical debt, you can use it to reimburse yourself for qualified medical expenses you paid out of pocket as long as they were incurred after you established your HSA.


Many HSA account holders wonder about the flexibility of their accounts, particularly when it comes to settling past medical bills. It's crucial to understand the specific guidelines that govern Health Savings Accounts (HSAs) to avoid any inadvertent financial missteps.

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