Can You Use Your HSA for Mouthwash?

A Health Savings Account (HSA) is a tax-advantaged savings account designed to help individuals save and pay for qualified medical expenses. Contributions made to an HSA are tax-deductible, funds grow tax-free, and withdrawals for eligible medical expenses are also tax-free. This triple tax advantage makes HSAs a valuable tool for managing healthcare costs and saving for future medical needs.

General HSA Eligibility Rules

To be considered a qualified medical expense for HSA purposes, an item or service must primarily be for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for affecting any structure or function of the body. This definition, outlined by the Internal Revenue Service (IRS) in Publication 502, ensures that expenses are genuinely medical in nature, not merely for general health or cosmetic improvement. The CARES Act removed the prescription requirement for most over-the-counter (OTC) medications and products to be HSA eligible. This means common OTC items, such as pain relievers or cold and flu medications, can now be purchased with HSA funds without a doctor’s note.

Specifics for Mouthwash Eligibility

Mouthwash purchased for routine oral hygiene, breath freshening, or cosmetic purposes is not an eligible HSA expense. Such products are personal care items and do not meet the IRS definition of medical care for a specific diagnosed condition. They are not primarily used to treat, alleviate, or prevent a disease.

However, mouthwash can be an eligible expense if prescribed by a medical professional to treat a specific medical condition. For instance, a prescription for therapeutic mouthwash to address severe gingivitis, an oral infection, or dry mouth caused by a medical condition or medication side effect qualifies. Fluoride rinses prescribed for a specific dental or medical condition are also covered, provided a medical diagnosis is required. The distinction is whether the mouthwash is for general well-being or for targeted treatment of a diagnosed illness.

Documentation and Reimbursement

Maintaining thorough records is important when using your HSA, especially for expenses that may not be clearly medical. For any eligible expense, particularly a prescribed item like therapeutic mouthwash, retain the original receipt. A copy of the prescription or a Letter of Medical Necessity (LMN) from your healthcare provider is needed to substantiate that the expense was for a specific medical condition. This documentation is necessary in case of an IRS audit, which can occur up to seven years after filing your tax return.

You can use HSA funds in two ways: by using a dedicated HSA debit card at the point of sale, or by paying out-of-pocket and then reimbursing yourself from your HSA. To reimburse yourself, submit a claim online to your HSA administrator. While HSA administrators do not verify every expense, the IRS receives reports of total withdrawals from your HSA, and you are responsible for proving the eligibility of all expenses if audited.