As of March 2018, over 21% of Americans were enrolled in high-deductible health insurance plans with HSAs. HSAs, or health savings accounts, are tax-deductible bank accounts that you can use to pay for health care costs. As long as you use the money in your HSA account on qualified purchases, you never have to pay taxes on it. The IRS gives a detailed account of what you can and can’t spend your HSA money on. Much of it is predictable, but there are a few surprises. Can you guess which of these two items you can pay for with your HSA card, and which you can’t?

Pregnancy Tests or Baby Diapers?

Any expenses associated with the process of birth control can be paid for using HSA funds. This includes those prescribed by a doctor (birth control pills, IUD, diaphragm, etc.) as well as over-the-counter products and devices (e.g., condoms, spermicide, and pregnancy test kits). Diapers, on the other hand, do not qualify as a medical expense unless they are for a handicapped individual beyond the age of infancy. Money spent on a diaper service for an adult can also qualify if it’s been prescribed by a physician for a specific medical condition.

CPR Classes or Smoking Cessation Programs?

Some things related to smoking cessation, including prescription drugs and the cost of classes or programs to help you quit, are qualified medical expenses. Things that don’t need a prescription, like nicotine gum or patches, do not qualify. CPR classes are not considered “medically necessary,” so you shouldn’t charge this to your HSA.

Medical Marijuana or Experimental Drugs?

Experimental drugs, if they are obtained legally, can be purchased using funds from your HSA. Marijuana, on the other hand, is illegal under federal law. Even if it is legal in your state and you are using it to treat a specific medical condition under the supervision of a doctor, it does not qualify as a medical expense for the purposes of your health savings account.

Acupuncture or a Gym Membership?

You might be surprised to learn that several different kinds of therapy, including acupuncture, chiropractors, and fees paid to a Christian Science practitioner are all qualified expenses, as long as these professionals are providing medical care. A gym membership, whether it is to promote your general health or to help with weight loss, does not count as a qualified expense.

Contact lens solution (saline) or aspirin?

There are a number of surprising items that you can buy with your HSA card. If you use contact lenses for a medical reason (not just because it’s Halloween, or you want to change your eye color), you can buy related supplies like saline solution with your HSA card. Bandages are considered a qualified medical expense for your HSA, but over-the-counter medications that don’t require a prescription, including aspirin, OTC allergy medications, and vitamins do not qualify. These drugs and supplements may be beneficial to your overall health, but they are not deemed medically necessary.

For a more detailed list of what you can and can’t use your HSA for, look over Publication 502 and Publication 969, created every year by the Internal Revenue Service. Remember, even if you can’t pay for something with your HSA account, different insurance plans cover different types of treatments, so go over your options carefully with a HealthMarkets insurance agent to find the plan that’s best for your situation. If you’re interested in switching to an affordable health insurance plan that will give you access to a health savings account, HealthMarkets can help! We’ll discuss your situation and search thousands of plans nationwide to find the right one for you, all at no cost to you.


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