Can You Get Toothpaste With an HSA?

Health Savings Accounts (HSAs) offer a tax-advantaged way to save and pay for qualified medical expenses, allowing individuals to use pre-tax funds to reduce out-of-pocket costs. Understanding the specific eligibility rules set by the Internal Revenue Service (IRS) helps account holders make informed decisions about their healthcare spending.

General HSA Eligibility Rules

The IRS defines qualified medical expenses as costs primarily for the diagnosis, cure, mitigation, treatment, or prevention of a disease, or for treatments affecting any structure or function of the body. This definition distinguishes eligible expenses from those incurred for general health or cosmetic purposes. For many over-the-counter (OTC) items to be eligible, they often require a prescription from a licensed healthcare provider or a Letter of Medical Necessity (LMN) to demonstrate their medical purpose.

Toothpaste Eligibility with HSA Funds

Regular toothpaste, used for general oral hygiene and cosmetic purposes, is generally not considered an HSA-eligible expense. The IRS views such items as “general health” products, which do not meet the criteria for medical care. This applies to most standard toothpastes found in pharmacies and supermarkets, regardless of their fluoride content or whitening claims.

However, certain specialized or medicated toothpastes might qualify under specific circumstances. If a dentist or doctor prescribes a particular medicated toothpaste, such as prescription-strength fluoride toothpaste or specific therapeutic pastes, to treat a diagnosed medical condition like severe gum disease, rampant cavities, or extreme sensitivity, it could become eligible. In such cases, a prescription or a Letter of Medical Necessity (LMN) from the healthcare provider would be required. Even with a prescription, eligibility is not guaranteed and remains subject to IRS interpretation and your HSA plan administrator’s rules.

Using Your HSA for Eligible Purchases

Once an expense is determined to be HSA-eligible, there are several ways to use your funds. You can pay directly at the point of sale using your HSA debit card. Alternatively, you may pay out-of-pocket and then reimburse yourself from your HSA account later. Many HSA providers offer options to transfer funds to your personal bank account or send checks.

It is important to maintain meticulous records for all HSA transactions. This includes keeping original receipts for every purchase, along with any necessary prescriptions or Letters of Medical Necessity. These documents are crucial for substantiating the eligibility of your expenses in case of an IRS audit, which can occur years after the purchase. Proper documentation helps ensure that your tax-free distributions remain compliant with IRS regulations.