Can You Use HSA for Food? What Expenses Qualify?

A Health Savings Account (HSA) is a tax-advantaged savings account designed to help individuals cover 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. A common question arises regarding whether everyday food purchases can be considered an HSA-eligible expense, a topic that requires understanding specific Internal Revenue Service (IRS) guidelines.

Understanding Eligible Medical Expenses

A “qualified medical expense” is defined as costs for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for the purpose of affecting any structure or function of the body. These expenses must be primarily for medical care and cannot be merely beneficial to general health. Common examples of eligible expenses include payments for doctor visits, prescription medications, dental care, and vision services. The IRS outlines these specifics in publications such as Publication 502.

Conditions for Food to Be an Eligible Expense

Food is generally not considered an eligible HSA expense, as regular groceries are viewed as ordinary living expenses. However, exceptions exist when food is prescribed by a medical professional, such as a doctor, dietitian, or nutritionist, for the treatment of a specific medical condition or disease. For example, special dietary foods required for conditions like celiac disease, severe food allergies, or diabetes may qualify. Nutritional supplements can also be eligible if they are specifically recommended by a medical practitioner as part of a treatment plan for a diagnosed medical condition.

These medically necessary food items must be distinguished from general groceries, dietary supplements taken for overall wellness, or weight loss programs pursued for cosmetic reasons. The expense must directly address a diagnosed medical issue, not simply improve general health. Only the cost difference between the special food and a comparable non-specialty food item that would otherwise be consumed is typically considered an eligible expense. This ensures that the HSA funds cover the medical necessity rather than the ordinary cost of sustenance.

Essential Documentation and Record Keeping

When claiming food as an HSA expense, maintaining thorough documentation is crucial. Documentation includes a written prescription or a detailed letter of medical necessity from a qualified medical professional. This document must explicitly state the medical condition and clearly link the specific dietary recommendation or food items to the treatment of that condition. The medical professional should explain the connection between the diagnosed condition and how the expense addresses it, beyond general wellness.

Alongside the medical prescription, detailed receipts for the purchased food items are necessary. These receipts should clearly show the date of purchase, the vendor, and an itemized list of the eligible foods. It is advisable to keep these records for at least three years from the date you file your tax return.