Can You Buy Floss With a Health Savings Account?

A Health Savings Account (HSA) provides a financial tool, allowing individuals to save and pay for qualified medical expenses on a tax-advantaged basis. These accounts help manage healthcare costs while offering tax benefits, such as tax-deductible contributions, tax-free growth, and tax-free withdrawals for eligible expenses. An HSA also helps build savings for future healthcare needs.

Understanding HSA Eligible Expenses

The Internal Revenue Service (IRS) defines “qualified medical expense” for HSA purposes, generally aligning with expenses deductible as medical care. These expenses must primarily be for the prevention or alleviation of a physical or mental health condition. IRS Publication 502 provides comprehensive guidance on what is considered a qualified medical expense. This broad definition encompasses a wide range of services and products, including those related to medical, dental, and vision care.

However, the expense must serve a genuine medical purpose rather than being for general health maintenance or cosmetic improvement. For instance, while an HSA covers many medically necessary treatments, expenses for items that are merely beneficial to general health, like toothpaste, are typically not eligible. The underlying principle is that the expense must be directly related to the diagnosis, cure, mitigation, treatment, or prevention of disease.

Dental Hygiene Products and HSA Eligibility

When considering dental hygiene products, routine items primarily for general health are not HSA eligible. This typically includes products such as regular dental floss, manual toothbrushes, and standard toothpaste. These items are considered general toiletry products rather than medically necessary treatments for a specific condition. Even if a dentist recommends daily flossing for overall oral health, it does not automatically make the floss an HSA-eligible expense.

However, certain dental expenses are covered by an HSA. These generally include medically necessary dental treatments like X-rays, fillings, extractions, crowns, and implants if they address a dental disease. Medically necessary fluoride treatments and orthodontic expenses, such as braces, can also be eligible, especially when prescribed for health reasons. Cosmetic procedures, like teeth whitening, are usually not eligible because they do not treat or prevent a medical condition.

Purchasing and Documentation for HSA Reimbursement

Using an HSA for eligible expenses involves specific procedures and strict documentation requirements. Many individuals use an HSA-linked debit card to pay directly for qualified expenses at the time of service or purchase. Alternatively, individuals can pay for eligible expenses out-of-pocket and then reimburse themselves from their HSA. This self-reimbursement method allows flexibility, as there is no deadline for when the reimbursement must occur, provided the expense was incurred after the HSA was established.

Maintaining thorough records is important for all HSA transactions, regardless of the payment method. This documentation should include receipts, invoices, and any Explanation of Benefits (EOB) from an insurance provider. If an expense requires a medical necessity, such as a doctor’s or dentist’s prescription or a Letter of Medical Necessity, these documents must also be retained. These records are important for substantiating that withdrawals were for qualified medical expenses, especially in the event of an IRS audit.