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/depts/uwhealth/benefits/open-enrollment/uwhc-open-enrollment/health-savings-account-hsa/resources/HSA-Eligible-Expenses.pdf

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HSA Eligible Expenses

HSA Eligible Expenses - Departments & Programs, UW Health, Benefits, UW Health Open Enrollment, UWHC Open Enrollment, Health Savings Account (HSA), Resources





Once you have contributed money into your Health Savings Account (HSA), you can use it to pay for
eligible medical expenses tax free.

Below is a partial list of eligible expenses that are reimbursable through an HSA. Eligible expenses can
be incurred by you, your spouse, or qualified dependents. For more information, see your HSA
Participant Guide. For the complete list of eligible and ineligible expenses, visit www.IRS.gov and see IRS
Publications 502.

Medical Expenses
ξ Acupuncture
ξ Ambulance services
ξ Annual physical examination
ξ Artificial limbs or prosthesis
ξ Artificial teeth
ξ Birth control/contraceptive devices
ξ Birth classes/Lamaze1
ξ Blood pressure monitor
ξ Blood sugar test kits/test strips
ξ Breast reconstruction surgery1
ξ Childbirth/delivery
ξ Chiropractic therapy/exams/adjustments
ξ Co-payments
ξ COBRA healthcare premiums
ξ Cosmetic surgery1
ξ Crutches1
ξ Dermatology services
ξ Diagnostic services
ξ Electronic body scans
ξ Flu shots
ξ Guide dog or other service animal
ξ Gynecological care
ξ Hearing aids and batteries1
ξ Incontinence supplies
ξ Infertility treatments
ξ Insulin and diabetic supplies
ξ In vitro fertilization
ξ Laboratory fees
ξ Lactation expenses
ξ Legal sterilization
ξ Medical supplies to treat an illness or injury
ξ Nasal strips
ξ Neurological care
ξ Nursing home
ξ Nursing services
ξ Obstetric care
ξ Operations/surgery1
ξ Optometrist/ophthalmologist services

1: Restrictions may apply. See IRS Publication 502 for more details.
ξ Orthopedic shoes
ξ Oxygen and oxygen equipment
ξ Physical exams
ξ Physical therapy1
ξ Pregnancy test kits
ξ Podiatry services
ξ Prenatal/postnatal treatment
ξ Prescription medications
ξ Psychological care
ξ Psychiatric care
ξ Sleep apnea services/products1
ξ Smoking cessation programs
ξ Special education tutoring
ξ Speech therapy
ξ Surgery
ξ Telephone or TV equipment for the hearing or vision
impaired
ξ Therapy or counseling
ξ Transplants
ξ Treatment for alcohol or drug dependency
ξ Vaccinations
ξ Vasectomies
ξ Weight loss programs1
ξ Wheelchairs
ξ Wigs1
ξ Wrist supports/elastic straps
ξ X-ray fees









HEALTH SAVINGS ACCOUNT
ELIGIBLE EXPENSES

What is an eligible expense?
An eligible medical expense is a health
care service, treatment, or item that the
IRS states can be paid for without taxes.


How should I keep track of my eligible
expenses?
You should keep all of your receipts and
pertinent documentation in order to prove
your HSA was used for eligible medical
expenses.


Dental Expenses Vision Expenses
ξ Cleanings and exams
ξ Crowns and bridges
ξ Dental surgery
ξ Dental x-rays
ξ Dentures
ξ Extractions
ξ Diagnostic services
ξ Fillings
ξ Orthodontia
ξ Root canals
ξ Contact lenses and lens
solutions
ξ Eye exams
ξ Eye surgery
ξ Diagnostic services
ξ Laser eye
surgery/LASIK
ξ Prescription eyeglasses
ξ Seeing eye dog (buying,
training, and maintaining)
OTC Medicines and Drugs
Over-the-counter (OTC) medicines and drugs, except for insulin, require a prescription from your physician to be
reimbursable with your TASC HSA. The prescription must be included with each request for reimbursement.

ξ Calamine lotion
ξ Canker/cold sore relievers
ξ Diaper rash ointments
ξ First Aid supplies
ξ Hemorrhoid creams and treatments
ξ Hydrogen Peroxide or rubbing alcohol
ξ Indigestion and anti-acid relievers
ξ Nicotine patches
ξ Pain relievers (Tylenol, Advil, etc.)
ξ Pain relieving creams or gels (Bengay, etc.)
ξ Sinus medications
ξ Teething gels

Individuals Over Age 65
Individuals over the age of 65 may use HSA funds to pay for the following expenses:
ξ Medicare Parts A or B
ξ Medicare HMO premiums (Medicap insurance premiums do NOT qualify)
ξ Health insurance premiums while receiving unemployment compensation
ξ Employee share of premiums for employer-sponsored health insurance, including retiree health insurance (if not
already taken before taxes)

Ineligible Health Savings Account Expenses
Note: If you pay for anything other than qualified expenses with your HSA, the amount will be taxable, and you
will pay an additional 20 percent tax penalty. If you are age 65 or older, the tax penalty does not apply, but the
amount must be reported as taxable income.



Below is a partial list of ineligible expenses. For more information, see your HSA Participant Guide. For the complete list
of eligible and ineligible expenses, visit www.IRS.gov and see IRS Publications 502.

ξ Advance payment for future medical expenses
ξ Athletic mouth guards
ξ Childcare
ξ Contributions to state disability funds
ξ Cosmetic supplies (makeup, cleansers,
moisturizers, etc.)
ξ Cosmetic surgery (unless due to trauma or disease)
ξ Deodorant
ξ Dental floss
ξ Diaper services
ξ Dietary and fiber supplements
ξ Electrolysis or hair removal
ξ Eye drops for general comfort
ξ Eyeglass cases
ξ Funeral, cremation & burial expenses
ξ Gasoline
ξ Hand sanitizer
ξ Health club or athletic club membership dues
ξ Household help
ξ Hygiene products
ξ Insurance premiums (all types)
ξ Lotions or skin moisturizers
ξ Marriage counseling
ξ Maternity clothes
ξ Mattresses
ξ Meals
ξ Medicare premiums
ξ Nutritional supplements and vitamins
ξ Over-the-counter medications not prescribed by your
doctor
ξ Sunglasses and sun clips (non-prescription)
ξ Safety classes (non-prescription)
ξ Swimming lessons
ξ Teeth whitening
ξ Toiletries
ξ Weight-loss programs (unless prescribed to treat a
specific disease)







TASC Customer Care | Phone 844-786-3947 or 608-316-2408 | Email 1customercare@tasconline.com