Can You Use Your HSA for a Toothbrush?
Understand the nuances of HSA-eligible expenses. This guide clarifies IRS rules for everyday health items, helping you wisely manage your tax-advantaged funds.
A Health Savings Account (HSA) is a tax-advantaged savings account designed for individuals enrolled in a high-deductible health plan (HDHP). It allows funds to be saved and used for qualified medical expenses on a tax-free basis. This article clarifies which expenses are eligible for HSA funds, particularly addressing common questions about items such as toothbrushes, by referencing IRS guidelines.
Understanding HSA Eligible Expenses
IRS Publication 502 defines medical care as expenses paid 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 are generally eligible for HSA use. Examples of commonly eligible expenses include fees for doctor visits, prescription medications, and various medical equipment like crutches or wheelchairs.
Certain items and services are generally not eligible for HSA funds. These typically include cosmetic procedures or general health items that do not address a specific medical condition. For instance, elective cosmetic surgery is usually not covered unless it is necessary to improve a deformity resulting from a congenital abnormality, personal injury, or disfiguring disease.
The Internal Revenue Service provides guidance on what constitutes a qualified medical expense under Internal Revenue Code Section 213. While Publication 502 relates to the medical and dental expenses itemized deduction, it largely indicates which items and services are considered qualifying medical expenses for HSA purposes. Some HSA-specific rules exist, such as the general exclusion of health insurance premiums from qualifying medical expenses.
Oral Health Items and HSA Eligibility
Common oral hygiene items, such as toothbrushes, toothpaste, and dental floss, are generally not considered eligible medical expenses for HSA reimbursement. These items are typically viewed as general health products for routine care, rather than expenses for the diagnosis, cure, mitigation, treatment, or prevention of a specific disease. An exception arises if a medical professional, such as a dentist or doctor, prescribes a specific oral hygiene item for a diagnosed medical condition. For example, a specialized toothbrush might qualify if prescribed for a severe gum disease or after oral surgery.
In contrast, most dental services provided by a licensed professional are typically eligible medical expenses. This includes routine cleanings, fillings for cavities, extractions, and more complex procedures like root canals or orthodontia. Dentures and their adhesives are also generally considered eligible expenses.
The distinction lies in whether the item or service addresses a specific medical need or prescribed treatment, rather than simply maintaining general hygiene. While over-the-counter medicines and menstrual care products became qualified medical expenses under the CARES Act, everyday hygiene products like standard toothbrushes did not receive similar designation.
How to Use Your HSA for Qualified Purchases
Once an expense is determined to be HSA-eligible, there are several common methods to use the funds. Many HSA providers issue a debit card specifically linked to the account, which can be used directly at the point of purchase, similar to a regular debit card. This offers immediate payment for qualified expenses.
Alternatively, individuals can pay for eligible expenses out-of-pocket using their personal funds and then reimburse themselves from their HSA. This method requires keeping detailed receipts and records of all purchases to substantiate the expense for tax purposes. Reimbursement can typically be initiated through the HSA provider’s online portal or by submitting a claim form.
Some HSA providers also allow for direct payment to a healthcare provider from the HSA. Regardless of the payment method, maintaining thorough documentation, including receipts and explanations of benefits, is important. These records may be requested by the IRS in the event of an audit to verify that funds were used for qualified medical expenses.