Can You Use Your HSA for Fillers?

A Health Savings Account (HSA) is a tax-advantaged savings account. This account allows for pre-tax contributions, tax-free growth, and tax-free withdrawals when used for eligible medical expenses. HSAs provide a flexible way to save and pay for out-of-pocket medical expenditures. A common question arises regarding the use of HSA funds for cosmetic procedures, specifically fillers.

Defining Qualified Medical Expenses

The Internal Revenue Service (IRS) provides specific guidelines for what constitutes a “qualified medical expense.” These are generally costs incurred for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for the purpose of affecting any structure or function of the body. The expense must primarily aim to alleviate or prevent a physical or mental defect or illness, rather than being merely beneficial for general health.

Common examples include doctor visits, prescription medications, dental care, vision services, hospital services, mental health care, and medical equipment. These rules establish eligible expenses for tax-advantaged accounts like HSAs.

HSA Eligibility for Cosmetic Procedures

Cosmetic procedures, including fillers, are generally not considered qualified medical expenses if they are performed solely to improve appearance. The IRS specifies that cosmetic surgery or similar procedures are ineligible if they do not ameliorate a deformity arising from a congenital abnormality, personal injury, or disfiguring disease.

However, an important exception exists for cosmetic procedures, including fillers, when they are medically necessary. If a filler procedure is required to correct a deformity caused by a severe burn, an injury, or a congenital condition, it can be considered a qualified medical expense. For instance, using fillers to reconstruct facial features after an accident or to correct a congenital facial asymmetry would likely qualify. The distinction rests on whether the procedure addresses a medical condition or merely seeks to improve appearance.

Proving Medical Necessity and Compliance

If a filler procedure falls under the medically necessary exception, the taxpayer bears the responsibility of substantiating its eligibility. This requires comprehensive documentation, including a clear diagnosis and recommendation from a licensed physician. The physician’s notes should detail the specific medical condition being treated and explain why the filler procedure is necessary to alleviate or prevent a physical defect or illness.

Taxpayers should retain all relevant medical records, diagnostic codes, and receipts related to the procedure. In some cases, a “Letter of Medical Necessity” from the healthcare provider, explicitly outlining the medical justification for the expense, is advisable. Using HSA funds for non-qualified expenses can lead to significant financial repercussions. The amount withdrawn for an ineligible expense will be included in the account holder’s gross income for tax purposes and may be subject to a 20% penalty, unless the account holder is age 65 or older.