Can I Buy Mouthwash With My HSA Funds?

A Health Savings Account (HSA) is a tax-advantaged savings account established alongside a high-deductible health plan, designed to help individuals save for qualified medical expenses. These accounts offer a triple tax advantage: contributions are tax-deductible, earnings grow tax-free, and withdrawals for eligible expenses are also tax-free. Many people wonder if common household items, such as mouthwash, can be purchased using these funds. This article clarifies HSA eligibility and addresses whether mouthwash qualifies.

HSA Eligible Expenses

The Internal Revenue Service (IRS) defines what constitutes a qualified medical expense for HSA purposes. Generally, these are costs incurred for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for treatments affecting any part or function of the body. Historically, over-the-counter (OTC) medications and products required a doctor’s prescription to be HSA-eligible.

The Coronavirus Aid, Relief, and Economic Security (CARES) Act in March 2020 permanently removed the prescription requirement for most OTC drugs and medicines, making them generally eligible for HSA reimbursement. This expansion aimed to provide greater flexibility for individuals to use their health savings for everyday health needs. However, the expense must still be primarily for a medical purpose, not merely for general health or cosmetic benefit.

Mouthwash Eligibility

General mouthwash, typically used for daily oral hygiene or fresh breath, is usually not an HSA-eligible expense. These products are viewed as personal care items rather than for the specific treatment or prevention of a medical condition. Like toothpaste or regular dental floss, their primary purpose is general health maintenance.

However, mouthwash can become HSA-eligible under specific circumstances if it is used to treat a diagnosed medical condition. For example, if a doctor or dentist prescribes a particular medicated mouthwash to address conditions like gingivitis, dry mouth (xerostomia), oral thrush, or other specific oral diseases, it may qualify. In such cases, a Letter of Medical Necessity (LMN) from a healthcare provider may be required. This letter should specify the diagnosis and explain why the mouthwash is medically necessary for treatment.

HSA Purchase and Reimbursement Process

Using HSA funds for eligible expenses can be done in a couple of ways. Many HSA providers issue a debit card, which can be used at the point of sale, similar to a regular credit or debit card. This allows for direct payment from your HSA at pharmacies or medical offices.

Alternatively, you can pay for qualified medical expenses out-of-pocket and then reimburse yourself from your HSA. This involves submitting a claim to your HSA administrator, along with supporting documentation like itemized receipts. Retain all receipts and any necessary documentation, such as a doctor’s note or Letter of Medical Necessity. This documentation is for tax purposes and to verify the eligibility of your withdrawals.