Key takeaways:
Health savings accounts (HSAs) allow you to use pretax dollars to pay for qualified medical expenses. You can use these funds for emergency, dental, vision, and family medical costs that meet IRS requirements.
The CARES Act expanded the list of HSA-eligible items to include menstrual products and over-the-counter purchases such as allergy, cough, and cold medications. These changes apply to expenses paid after December 31, 2019.
Starting January 1, 2026, you may be eligible to use your HSA to pay for a direct primary care (DPC) membership.
A health savings account (HSA) is a tax-exempt fund that helps you save to pay for qualified healthcare expenses. To open and contribute to an HSA, you must be actively enrolled in a qualifying high-deductible health plan (HDHP) through an employer. Or, you need to open your own if you’re self-employed and covered by a HDHP. Every dollar that you contribute to an HSA can pay for eligible medical expenses. When you withdraw money from the account, you won’t have to pay taxes on the funds as long as they’re used for HSA-eligible expenses.
An HSA is a triple tax-advantaged account. When you enroll through your employer, your contributions are typically made with pretax dollars. If you contribute to your HSA with after-tax dollars — which is usually the case if you’re self-employed — you’ll receive a deduction when you file your tax return. As long as the money is used for eligible medical expenses, you won’t have to worry about paying taxes later.
To get the most out of your HSA, make sure you log in regularly to review your account balance and track expenses. Many HSA providers also offer a benefits card, which works like a debit card for eligible purchases. Before spending, check with your HSA administrator to ensure your expense qualifies.
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You can use your HSA to purchase a wide range of qualified medical expenses that aren’t covered by your health insurance or reimbursed by another plan.
Below, we’ll explain how to use your HSA funds for more than 90 HSA-eligible expenses.
1. Common healthcare supplies
Some of the most common healthcare supplies that are HSA eligible include:
Annual exams
Baby ointment
Bandages
Blood pressure monitor
Breast milk storage bags and bottles
Breast pumps
Breathing strips
Certain types of lip balm
Certain types of sunscreen
Copays for prescriptions and office visits
Crutches
Dental care (see below)
Diaper-rash cream
Medical alert bracelet
Nursing pads
Pedialyte (electrolyte drinks)
Prescription medications
Thermometers
Vision care (see below)
Wheelchairs
2. COVID PPE supplies
The IRS in 2021 announced that personal protective equipment (PPE) items are qualified expenses. PPE is used to prevent the spread of COVID-19 and other viruses. The IRS made the following items HSA-eligible expenses and they remain so:
Hand sanitizer
Masks
Sanitizing wipes
3. Menstrual products and OTC medications
The Coronavirus Aid, Relief, and Economic Security (CARES) Act also added some medical expenses to the list. Menstrual products and over-the-counter (OTC) medications are now HSA qualified. These changes apply to expenses paid after December 31, 2019.
The following items are examples of now-qualified medical expenses:
Acetaminophen (Tylenol)
Ibuprofen (Advil, Motrin)
Laxatives
Liners
Menstrual cups
Nasal sprays
Pads
Period panties
Sleep aids
Tampons
Tums (calcium carbonate)
4. Family-planning products
Your HSA can also pay for family-planning healthcare expenses, such as:
Birth control, including pills
Ovulation monitors
Tubal ligations
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5. Emergency medical expenses
These eight emergency medical expenses may also be covered by your HSA:
Medical record fees
Urgent care services
6. Mental health expenses
Studies show that nearly 1 in 4 U.S. adults experienced a mental illness in 2022. If you need to pay for mental health expenses out of pocket, your HSA may cover the following:
Transportation to mental health appointments
7. Dental care
HSA accounts can be used to pay for care provided by an orthodontist, a dental hygienist, or a dentist. This includes, but is not limited to, the following 10 dental care items and services:
Dental implants for a restorative procedure
Dental X-rays
Orthodontist visits
Teeth whitening is not covered. This service is considered a cosmetic dental procedure, and not health related.
8. Vision care
Before scheduling a vision appointment, it’s important to understand which expenses can be covered by your HSA funds. You can typically use your HSA to cover out-of-pocket payments for the following eight vision expenses:
Contact lens cases
Contact lens cleaning solution
Eye exams
Eyeglass cases
If you’re visually impaired or blind and have a guide dog, here are some additional HSA-eligible expenses:
Buying a guide dog to assist with daily activities
Training a guide dog
Visiting the vet for the guide dog
9. Eligible insurance premiums
Generally, you can’t use your HSA to pay standard monthly premiums for commercial insurance or employer-based coverage. But there are some exceptions. You can use your HSA to pay premiums for other types of insurance plans, such as:
COBRA continuation coverage
Medicare, which includes Part A hospital insurance, Part B outpatient insurance, Medicare Advantage, and Part D prescription plans (but you can’t use HSA funds to pay Medigap supplement insurance premiums)
Are dependent care expenses HSA eligible?
No, dependent care expenses are not HSA eligible. But if you have a dependent care flexible spending account (FSA), you can use the funds in that account to pay for qualified child and dependent care expenses tax-free. The IRS has specific criteria that you must meet for eligible dependent care expenses, including that the spending must be necessary to allow you to actively look for work or allow you to work.
Eligible expenses may include the following if they meet certain criteria:
Babysitting
Before- and after-school care
Day camp
Although you can contribute to an HSA and a dependent care FSA at the same time, you cannot use the funds in an HSA for dependent care expenses.
What are the HSA contribution limits for 2026 and 2027?
Each year, the IRS raises the HSA contribution limit to keep up with inflation. The 2026 contribution caps increased by $100 for individuals and $200 for families, compared to 2025, and the figures are even higher for 2027.
The table below shows the HSA contribution limits based on your age and coverage type. If you’re 55 or older, you can contribute an extra $1,000 to your HSA. This is called a catch-up contribution. So people who meet the age requirement can contribute up to $5,400 as an individual or $9,750 for a family plan in 2026.
HSA contribution limits for 2026 and 2027
Year | Individual | Family | Catch-up contribution (55 and over) |
2026 | $4,400 | $8,750 | $1,000 |
2027 | $4,500 | $9,000 | $1,000 |
Source: IRS
Starting January 1, 2026, you may be able to use your HSA to pay for qualified direct primary care (DPC) membership fees. Under the One Big Beautiful Bill (H.R. 1), these arrangements are recognized as eligible expenses when they meet certain requirements. DPC memberships typically involve paying a monthly fee directly to a healthcare professional for preventive and routine primary care services. The law sets monthly limits of up to $150 for self-only coverage and $300 for family coverage. Check with your HSA administrator to confirm eligibility before using HSA funds for DPC payments.
To take advantage of the more than 90 HSA-eligible expenses mentioned above, you must have funds in your HSA. The more money you contribute every year, the more money you’ll be able to invest in assets that can boost your account balance. The growth in your account can provide you with more money to help offset the rising cost of healthcare. It is important to capitalize on contributing to your HSA to prepare for healthcare costs.
Quiz: Think you’re an HSA pro? Let’s find out
Which healthcare expenses are not HSA eligible?
There are a few healthcare expenses for which you can’t use HSA funds. One example, as mentioned above, are premiums for Medicare supplemental insurance known as Medigap.
When preventive care is not prescribed by a healthcare professional, it might not be HSA eligible. Some examples of common healthcare expenses that fall into this category are:
Personal hygiene items, such as toothpaste and deodorant
Vitamins, as well as nutritional and herbal supplements for general health
Weight-loss programs for general health or well-being
But there can be exceptions. If you have a doctor’s note — also called a letter of medical necessity (LOMN) — you may be able to buy items with your HSA funds that typically wouldn’t be eligible.
Services that may be eligible with a letter of medical necessity
A LOMN should briefly outline your condition and why you need a specific product or service. Before you purchase an item, check with your HSA administrator to determine if your expense is HSA eligible with an LOMN. If so, the following are among the items that you may be able to use your HSA funds to purchase:
Gym membership
Weight-loss programs
Frequently asked questions
No, you generally cannot use an HSA to pay for a gym membership if it’s for general fitness or wellness. But if a healthcare professional prescribes a gym membership to treat a specific medical condition or to improve a function of the body, it may qualify as an HSA-eligible expense. For example, a membership prescribed as part of physical therapy for an injury could qualify. In that case, you’ll most likely need an LOMN from a healthcare professional and all related documentation to show it’s a qualified medical expense.
Yes, you can withdraw money from your HSA for nonmedical expenses. But the amount you take out will be taxed as income. If you’re younger than age 65, you’ll also pay a 20% penalty. Starting at age 65, you can withdraw funds for any reason without the penalty, but nonmedical withdrawals are still subject to income tax.
Yes, you can use your HSA to pay for qualified medical expenses for your spouse and for dependents.
No, you generally cannot use an HSA to pay for a gym membership if it’s for general fitness or wellness. But if a healthcare professional prescribes a gym membership to treat a specific medical condition or to improve a function of the body, it may qualify as an HSA-eligible expense. For example, a membership prescribed as part of physical therapy for an injury could qualify. In that case, you’ll most likely need an LOMN from a healthcare professional and all related documentation to show it’s a qualified medical expense.
Yes, you can withdraw money from your HSA for nonmedical expenses. But the amount you take out will be taxed as income. If you’re younger than age 65, you’ll also pay a 20% penalty. Starting at age 65, you can withdraw funds for any reason without the penalty, but nonmedical withdrawals are still subject to income tax.
Yes, you can use your HSA to pay for qualified medical expenses for your spouse and for dependents.
The bottom line
You can use your health savings account (HSA) to pay for healthcare costs such as emergency, dental, and vision expenses. The CARES Act expanded the list of HSA-eligible items to include over-the-counter purchases, which makes these items tax deductible. Confirm eligible expenses with your HSA administrator. You’ll also need to determine if you will need a letter of medical necessity from a healthcare professional to use your HSA funds to make a purchase.
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References
Choi, Y., et al. (2026). Health savings accounts (HSAs). Library of Congress.
Fidelity Viewpoints. (2026). HSAs and Medicare: Diagnose the possible pitfalls. Fidelity.
Internal Revenue Service. (2020). IRS outlines changes to health care spending available under CARES Act.
Internal Revenue Service. (2021). Face masks and other personal protective equipment to prevent the spread of COVID-19 are tax deductible.
Internal Revenue Service. (2024). Publication 502 (2024), medical and dental expenses.
Internal Revenue Service. (2025). Frequently asked questions about medical expenses related to nutrition, wellness and general health.
Internal Revenue Service. (2025). 26 CFR 601.602: Tax forms and instructions.
Internal Revenue Service. (2026). Instructions for Form 2441 (2025).
National Institute of Mental Health. (2024). Mental illness. National Institutes of Health.
Schiller, M. (2026). Health savings accounts: 2027 cost-of-living adjustments. Wolters Kluwer.
U.S. 119th Congress. (2025). H.R.1 - One Big Beautiful Bill Act.
