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Which medical expenses can be paid for with tax-deductible HSA funds?
The following is a partial list of eligible/potentially eligible/ineligible medical expenses. If you have any questions about anitem’s eligibility, please contact SelectAccountSM customer service at (651) 662-5065 or toll free at 1-800-859-2144.
Eligible medical expenses
Eyeglasses – prescription sunglasses/safety glasses Physical exams (routine, medical, well-child) Fertility treatments (e.g., artificial insemination, Prescription drugs (special rules apply, e.g., prescription drugs obtained from out of country are not covered) Fluoridation treatment at a dental office Preventive care screenings (e.g., mammogram, Chiropractic treatments (e.g., adjustments) Shipping and handling fees for eligible expenses Coinsurance amounts (health, dental or vision) Individual counseling (counseling must be performedto alleviate or prevent a physical or mental defect or Contraceptives (e.g., birth control pills, condoms, Surgical stockings (e.g., Jobst stockings) Convalescent home (for medical treatment only) Telephone/television equipment for hearing-impaired Occlusal guards to prevent teeth grinding Transportation expenses relative to health care (corresponding medical documentation requested) Dental procedures, non-cosmetic (e.g., X-rays, Organ transplant (including donor’s expenses) Diabetic supplies (e.g., insulin, syringe, monitor, Patient responsibilities under the medical, dental or vision plan solely because of the plan’s deductible,copay (coinsurance), reasonable and customary Potentially eligible medical expenses (requires Letter of Medical Necessity from health care provider)
Abdominal supports
Mentally handicapped residential or group home Mineral supplements (if prescribed by a physician Guide dog/service animal (purchase, care for, Automobile modifications (capital expense) Holistic or natural healers, dietary substitutes, Prescription drugs that also have a cosmetic purpose Home improvements (e.g., exit ramps, widening (e.g., Retin-A, Rogaine, Botox, Propecia) Special education costs for dependents with disabilities Household products/improvements to treat allergies Special foods/beverages (if prescribed by a physician to treat a specific condition) (excess cost) Breast reduction surgery that is medically necessary Childbirth/lamaze classes (related to pre-birth) Cosmetic surgery (for repair or reconstruction after accident or surgery or for correction of birth defect) Lodging (away from home for outpatient care – Vitamins (if prescribed by a physician for a specific medical condition, e.g., prenatal vitamins) Weight loss program and medications (if prescribed by a physician for a specific medical condition – Medical conference admission and transportation Ineligible medical expenses
Late fees (e.g., for late payment of bills for Prescription drugs and medicines obtained from Cosmetics, hygiene products and similar items Lodging while attending a medical conference Marijuana or other controlled substances in Feminine hygiene products (e.g., tampons) Transportation costs of disabled individual Non-prescription eyeglasses, sunglasses, safety Eligible medical expense
Excess cost
Medical expenses that can be reimbursed through your HSA Some expenses are only partially reimbursable. This means only include services and supplies incurred by you or your eligible the portion of the cost that exceeds the price of a regular item (excess dependents for the diagnosis, treatment or prevention of cost) is eligible. Example: If your health care provider recommends disease or for the amounts you pay for transportation to get orthopedic shoes and the cost is $15 more than regular shoes, only the $15 excess cost is eligible for reimbursement. You must submit a price comparison for a similar item along with your claim form. If In general, deductions allowed for medical expenses on the item is potentially eligible, you must also submit a Letter of your federal income tax according to Internal Revenue Code Section 213(d) may be reimbursed through your HSA. You cannot deduct medical expenses on your federal income tax Capital expense
that have been reimbursed through your HSA. It is possible A capital expense is an improvement and/or special equipment added that changes in the IRS rules can affect the eligible, to a home or other capital expenditure that may be eligible if the potentially eligible, and/or ineligible expense categories.
primary purpose is medical care. A Letter of Medical Necessity is HSA eligible medical expenses do not include medical premiums required from your health care provider. To submit your capital except COBRA, health insurance (other than Medicare Supplement expense, you must have an appraisal of your home within one year policies) after the individual has reached age 65, qualified long-term prior to the installation and an appraisal after the installation to care insurance, and health coverage while the account holder is determine the value added to the home. The amount eligible is the receiving unemployment compensation. Premiums for employer- difference between the cost of the expense and the increase in the sponsored retiree medical plans can also be paid from the HSA.
additional value of your home. If the improvement/special equipment is used by individuals other than the person needing it for Potentially eligible medical expenses
medical care, the eligible amount should be divided by the number In order to determine eligibility for potentially eligible items, of people using the item. Example: A ramp is purchased for $3,000 SelectAccount requires a Letter of Medical Necessity from and prior to installation your house is appraised at $100,000. After your health care provider. You can obtain a Letter of Medical installation of the ramp your house is appraised for $101,000.
Necessity to have your health care provider complete at The amount that is eligible under your HSA is $2,000.
www.selectaccount.com.
For assistance in calculating capital expense, the Capital Expense Worksheet is available at www.selectaccount.com. If you have
questions about a capital expense, please contact customer service These lists are intended to serve as a quick reference and are provided with the understanding that SelectAccount is not engaged in rendering tax advice. For more detailed information, please refer to IRS Publication 502, “Medical and DentalExpenses,” Catalog Number 15002Q. Publications can be ordered from the IRS by calling 1-800-TAX-FORM (1-800-829-3676).
If tax advice is required, seek the services of a competent professional.

Source: http://villageofpinckney.org/wordpress/wp-content/uploads/2012/02/HSA-eligible-expenses.pdf

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