Who Determines What is Covered Under an HSA?

When it comes to determining what is covered under a Health Savings Account (HSA), it is essential to understand the rules and regulations set forth by the Internal Revenue Service (IRS).

The IRS has specific guidelines regarding eligible expenses that can be paid for using funds from an HSA. These guidelines help ensure that HSAs are used for qualified medical expenses only.

Key points to consider regarding what is covered under an HSA:

  • IRS Publication 502 provides a comprehensive list of medical expenses that qualify for HSA coverage.
  • Generally, expenses like doctor visits, prescribed medications, and certain medical procedures are considered eligible for HSA reimbursement.
  • Non-qualified expenses, such as cosmetic procedures or over-the-counter medications without a prescription, are not covered under an HSA.

Ultimately, the account holder is responsible for determining if an expense qualifies for HSA coverage. It is crucial to keep accurate records and receipts to substantiate HSA withdrawals.


Understanding the coverage of a Health Savings Account (HSA) is fundamental for maximizing your benefits. The Internal Revenue Service (IRS) lays down the law on what qualifies as an eligible expense.

It is important to familiarize yourself with IRS guidelines, as they are designed to help you utilize your HSA funds for qualified medical expenses only, maintaining the intended purpose of your savings.

Key insights to keep in mind include:

  • IRS Publication 502 serves as your go-to resource for a detailed list of medical expenses eligible for HSA funding.
  • Commonly accepted expenses include routine doctor visits, necessary prescriptions, and a variety of medical treatments that are deemed essential.
  • However, keep a watchful eye on non-qualified expenses; cosmetic surgeries and over-the-counter drugs without a prescription typically do not qualify for coverage.

Ultimately, you, as the account holder, must ensure that each withdrawal aligns with HSA qualifications. Keeping well-organized records and receipts can save you from unnecessary tax headaches later.

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