Can You Use HSA for a Concierge Doctor?

A Health Savings Account (HSA) functions as a tax-advantaged savings account specifically designed for healthcare expenses. It allows individuals to contribute pre-tax money, which can then grow tax-free and be withdrawn tax-free for qualified medical costs. Concierge medical services, on the other hand, represent a direct patient-physician relationship often characterized by an annual membership fee. This model aims to provide enhanced access and personalized care outside the traditional insurance-driven framework.

HSA-Eligible Medical Expenses

The Internal Revenue Service (IRS) outlines what qualifies as a “medical expense” for HSA purposes in Publication 502. These are costs incurred for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for affecting any structure or function of the body, covering a wide range of services and products aimed at alleviating or preventing a physical or mental defect or illness.

Common examples of HSA-eligible expenses include doctor visits, prescription medications, hospital services, dental care, vision care, acupuncture, chiropractic care, and certain over-the-counter medicines and menstrual care products. Expenses must primarily be for medical care, not for general health improvement or cosmetic purposes. For instance, a weight-loss program might be eligible if prescribed by a doctor to treat a specific disease, but general health club dues are not.

Concierge Medical Service Components

Concierge medical services involve an annual or monthly membership fee for enhanced patient access to their physician. This fee often covers administrative costs, extended appointment times, and direct communication channels. The primary goal is to foster a more personalized and accessible healthcare experience.

Annual fees, ranging from $1,500 to over $10,000, allow concierge practices to maintain smaller patient panels. This reduced patient load, typically 400-600 patients compared to thousands in traditional practices, enables longer appointments and more focused attention. While the membership fee provides access and convenience, it may also include a limited set of basic services like routine check-ups and preventative screenings. Many concierge models still bill separately for specific medical services, such as lab tests, specialist referrals, or hospital visits, which may be covered by traditional health insurance.

Determining HSA Eligibility for Concierge Fees

The core question of using HSA funds for concierge fees hinges on whether the expense constitutes “medical care” under IRS guidelines. An annual retainer or membership fee paid solely for access to a concierge physician is not considered an HSA-eligible expense. This is because it is a payment for the right to receive services rather than for specific medical services already rendered.

However, portions of a concierge fee may be HSA-eligible if they are directly attributable to and itemized for specific medical services received. If the fee explicitly covers preventative care services, such as annual physical exams or specific screenings, those itemized components could be eligible. The payment must be for actual medical services, not merely for enhanced access, priority scheduling, or administrative convenience. For example, if a concierge membership includes a comprehensive annual physical that is a qualified medical expense and clearly itemized on a statement, that specific portion might be reimbursed. Patients should request itemized statements from their concierge provider that clearly differentiate eligible medical services from ineligible access or administrative charges.

Documentation for HSA Reimbursement

Maintaining thorough records is important when seeking HSA reimbursement, particularly for concierge medical fees. The IRS requires documentation to substantiate that HSA distributions were used exclusively for qualified medical expenses, which is important in case of an audit.

Key documents to retain include itemized statements from the concierge provider. These statements should clearly detail the specific medical services received and their corresponding charges, distinct from any non-eligible access fees. Proof of payment, such as credit card receipts or bank statements, should also be kept. Any agreements or communications with the concierge provider that clarify the breakdown of fees and services are valuable. It is advisable to keep these records for at least three years from the date your tax return was filed, or as long as your HSA remains open, whichever period is longer.