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The Who and What of a Health Savings Account

You have opened your Health Savings Account and you are starting to see your account balance grow.  At this point, you may be thinking “I have not really been sick, what else can I use this money for?” or “I wonder if can I use these funds for someone other than myself?”  We are here to help you answer those questions and some of the answers might be surprising.

 

Who can I cover with my HSA?

The IRS states that you can withdraw tax-free money from your HSA to pay for qualified medical expenses for:

  • Yourself
  • Your Spouse (regardless of whether you file taxes jointly or separately)
  • Any dependents you claim on your tax return (your children, a qualifying relative dependent, and/or any children who are claimed on your ex-spouse’s tax return)
  • Anyone you could have claimed as a dependent, but were not able to because he or she
    • filed a joint tax return (for example, your married teenage child who files a return with his or her spouse)
    • earned more than $4,150, or you (or your spouse, if you file jointly) could be claimed as a dependent on someone else’s tax return.

As long as the person is in one of the above categories, you can reimburse yourself for the cost of their qualified medical expenses with tax-free money from your HSA.  It does not matter whether the person was covered under your high deductible health plan or if they had health coverage at all.

 

What can I pay for using my HSA?   

While, there are numerous ways for you to spend the funds in your HSA account, here are ten that you might find surprising.  For a complete list of HSA-qualified medical expenses please go to https://www.irs.gov/pub/irs-pdf/p502.pdf

  1. Prescription Sunglasses:   Most people assume that an eye exam would be an allowable expense, but not too many people think about sunglasses!  Of course, regular prescription eyeglasses and contact lenses are qualified expenses, too.
  2. Eye Surgery:   Any costs you might have to pay out-of-pocket for surgery to correct your vision, such as LASIK or the removal of cataracts, can be paid for using HSA funds.  Also, if your vision or hearing is impaired, you can purchase and care for a guide dog or other service animal with your HSA.
  1. Dental Care:   You can use your HSA to pay for services such as routine cleanings, fluoride treatments, X-rays, fillings, extractions, dentures, and braces.  Just remember that teeth whitening and any cost or treatment that are purely cosmetic are not qualified expenses.
  1. Chiropractic:   All chiropractic care is HSA-qualified, even if it isn’t covered by your insurance plan.
  1. Acupuncture:   People often seek acupuncture as an alternative treatment for allergies, pain, and infertility.  So, if you’ve wanted to try it, but it isn’t covered by your health insurance, you could pay for it tax-free using your HSA.
  1. Fertility Enhancement:   You can use an HSA to pay for any treatment to overcome an inability to have children, such as in vitro fertilization. Once you’re a parent, you can also spend it on breast pumps and supplies that assist lactation.
  1. Drug and Alcohol Addiction Treatment:   Any amount you pay for yourself or a family member to have inpatient treatment at a drug rehabilitation center, including meals and lodging, is HSA-qualified. You can also pay for transportation to and from Alcoholics Anonymous meetings in your community.
  1. Care from a Psychologist or Psychiatrist:   The cost to support yourself or a family member through the treatment of a mental condition or illness is HSA-qualified. You can use HSA funds to pay for a patient’s treatment at a health institute if treatment is prescribed by a physician to alleviate a physical or mental disability or illness.
  1. Home Improvement:   Any special equipment or improvements installed in a home to care for you or your family members can be paid for with HSA funds, if their purpose is medical care. These might include constructing entrance ramps, widening doorways, installing lifts, or lowering cabinets and sinks.
  1. Transportation and Travel:   Costs to get to and from any type of medical care, whether it is on a bus, taxi, train, plane, or ambulance, can be paid for with HSA money. This includes making regular visits to see an ill family member, if visits are recommended as part of treatment. You can include lodging, but not meals, when you travel to another city for medical purposes.