What are interesting things I can spend an HSA on?

Editorial team Published on

You can use your Health Savings Account (HSA) for surprising items like SPF 15+ sunscreen, menstrual products, and medical-related travel.

💡 Surprising Everyday & Travel Expenses

  • Sunscreen: Must be SPF 15 or higher.
  • Menstrual Care: Includes tampons, pads, and period underwear.
  • Medical Travel: Covers up to $50/night/person for lodging.
  • Mileage: Reimbursable at $0.21/mile plus tolls and parking.

📌 Items Requiring a Letter of Medical Necessity (LMN)

  • Air Purifiers: Eligible if diagnosed with severe allergies or asthma.
  • Massage Therapy: Qualifies when prescribed to treat a specific condition.
  • Weight Loss Programs: Eligible for doctor-diagnosed obesity treatments.

📊 The Age 65 Rule

  • Non-Medical Withdrawals: Withdrawals for any purpose are penalty-free.
  • Tax Impact: Ordinary income tax applies to non-medical spending.

What is the HSA loophole?

The "HSA loophole" typically refers to the reimbursement (or shoebox) strategy, where you pay for medical expenses out of pocket today and wait years to withdraw the money tax-free, letting your Health Savings Account (HSA) compound like a supercharged retirement fund.

💡 The Reimbursement Strategy ("Shoebox Rule")

  • No expiration date: The IRS sets no deadline to reimburse yourself for qualified medical costs.
  • Invest and grow: Pay medical bills with regular cash or credit, then leave your HSA funds invested for decades.
  • Tax-free cash out: Withdraw the money tax-free years later by matching it to those saved old receipts.
  • Strict rule: The HSA must have been open at the time the original medical expense occurred.

👨‍👩‍👧 The Adult Child Loophole

  • Double family limits: Adult children up to age 26 can stay on a parent's High-Deductible Health Plan (HDHP).
  • Independent filing: If that young adult is no longer claimed as a tax dependent, they can open their own HSA.
  • Full contribution: The adult child can contribute up to the full family or individual limit independently from the parents.

🛑 Risks & Rules to Watch

  • Total loss of records: Lose your receipts, and you cannot legally do a tax-free delayed reimbursement.
  • Estate taxes: Unspent HSA funds left to non-spouse heirs become fully taxable income all at once.
  • Eligibility requirement: You must actively have an HDHP to contribute.

Can I buy toilet paper with my HSA?

No, you cannot buy standard toilet paper with your Health Savings Account (HSA). The IRS classifies toilet paper as a general toiletry used for personal hygiene and everyday living rather than the diagnosis, cure, mitigation, treatment, or prevention of a specific medical condition. Because it is a universal necessity, it is 100% ineligible for tax-free reimbursement.

Are There Any Exceptions?

While regular toilet paper is excluded, certain medical exceptions or similar bathroom products may qualify:

  • Doctor-Prescribed Treatment: If a medical professional specifically recommends or prescribes a specialized toiletry product to treat a documented medical condition (such as severe skin disorders or post-surgical care), it may become eligible. You would typically need a Letter of Medical Necessity (LMN) from your doctor to prove this to your HSA administrator.
  • Incontinence Supplies: While not toilet paper, items like adult diapers, disposable underwear, and protective pads designed for incontinence are fully HSA eligible.
  • Menstrual Products: Since the passage of the CARES Act, feminine hygiene items like tampons, pads, and liners are fully eligible medical expenses.

A Note on Retail Search Filters

You may sometimes see standard toilet paper pop up on major retail platforms when searching for "FSA/HSA eligible" products. This is usually due to keyword tagging errors or algorithm confusion on the merchant's site. Buying standard toilet paper with your HSA card can lead to a rejected transaction at checkout, or potential tax penalties if audited by the IRS.

For a complete and authoritative list of what you can purchase, you can review IRS Publication 502 (Medical and Dental Expenses).

What things can I buy with my HSA account?

You can use your Health Savings Account (HSA) to buy qualified medical, dental, and vision expenses defined by the IRS, including doctor visits, prescriptions, and over-the-counter health products.

Everyday Health & Over-the-Counter Items

  • OTC Medications: Pain relievers (ibuprofen, acetaminophen), allergy relief, cold and flu medicine, and sleep aids.
  • Personal Care & Sun Protection: Menstrual products (tampons, pads) and sunscreen with SPF 15 or higher.
  • First Aid & Monitoring: Bandages, first aid kits, blood pressure monitors, and thermometers.
  • Skin Treatments: Acne treatments and eczema creams formulated for medical conditions.

Medical Care & Services

  • Doctor & Virtual Care: Copays, deductibles, and telemedicine appointments.
  • Therapies & Alternative Care: Physical therapy, chiropractic care, and acupuncture.
  • Family Planning: Pregnancy tests, birth control, and vasectomy procedures.
  • Specialized Gear: Breast pumps and lactation supplies, hearing aids, and crutches or walkers.

Vision & Dental

  • Vision Care: Eye exams, prescription eyeglasses, contact lenses, contact solution, and prescription sunglasses.
  • Dental Care: Cleanings, fillings, root canals, and braces.

Items Requiring a Letter of Medical Necessity (LMN)

Some items are only eligible if a doctor writes a formal Letter of Medical Necessity stating they treat a specific medical condition:

  • Air purifiers and humidifiers
  • Dietary supplements or specific vitamins
  • Massages or specific fitness equipment
  • Home modifications like wheelchair ramps

Can I buy an Apple Watch with my HSA?

You can buy an Apple Watch with your Health Savings Account (HSA) only if you have a Letter of Medical Necessity (LMN) from a licensed healthcare provider.

How Eligibility Works

  • General Wellness Excluded: The IRS considers smartwatches and fitness trackers to be general lifestyle and wellness devices by default, meaning they are not automatically eligible.
  • Medical Necessity Required: To use pre-tax HSA funds legally, your doctor must prescribe the watch to diagnose, treat, or monitor a specific diagnosed medical condition (such as cardiac arrhythmias, hypertension, or diabetes).
  • Risk of Penalties: Buying an Apple Watch directly with your HSA card without an LMN risks an IRS audit, resulting in income taxes and a 20% penalty on the ineligible withdrawal.

Steps to Purchase

  1. Consult Your Doctor: Ask your physician to write a signed Letter of Medical Necessity (LMN) detailing your specific medical condition and explaining how the Apple Watch is necessary for treatment or monitoring. Some online wellness platforms or services like Truemed also facilitate this evaluation.
  2. Save Documentation: Keep the LMN and your itemized receipt stored securely with your tax records for substantiation in case of an audit.
  3. Pay or Reimburse: Purchase the watch using your personal funds or HSA debit card, then submit the receipt and LMN to your HSA administrator if you require formal reimbursement approval.

The Real TRUTH About An HSA - Health Savings Account Insane Benefits

9 related questions found

What does Dave Ramsey say about HSA?

Dave Ramsey and his team at Ramsey Solutions view a Health Savings Account (HSA) as a powerful, tax-advantaged tool, but they emphasize that it must be used at the right time and paired with the correct insurance plan.

Core Views on HSAs

  • Triple Tax Advantage: Ramsey highlights that HSAs offer three tax benefits: contributions go in tax-free, the money grows tax-free, and withdrawals are tax-free when used for qualified medical expenses.
  • The "Stealth IRA": His team refers to the HSA as a stealth retirement account because the funds roll over year-to-year and can be invested like a 401(k) or IRA. After age 65, you can withdraw money for any purpose (though non-medical withdrawals are taxed like a traditional 401(k)).
  • Requires an HDHP: You must be enrolled in a High-Deductible Health Plan (HDHP) to qualify and contribute to an HSA. Ramsey notes that lower monthly premiums on HDHPs benefit very healthy individuals or those with predictable costs.

Rules and Priorities in the Ramsey Plan

  • Don't Invest Too Early: Ramsey advises against using your HSA as part of your primary 15% retirement investing goal during the early Baby Steps. Standard retirement accounts like a 401(k) and Roth IRA should handle your main 15% investment allocation.
  • Prioritize Debt First: He warns people not to let the excitement of an HSA distract them from paying off pressing consumer debt (Baby Step 2), stressing that basic debt payoff always comes before funding optional savings components.
  • Use for Medical Costs First: Treat the HSA primarily as an emergency fund for health care costs rather than a speculative investment vehicle, unless you are already financially secure.

Can I use my HSA for a haircut?

❌ No, you cannot use your Health Savings Account (HSA) for a standard cosmetic haircut.

❌ Why It Is Ineligible

  • Personal care: The IRS classifies standard grooming and haircuts as personal care, not medical expenses.
  • No medical purpose: Funds are strictly reserved for diagnosing, curing, mitigating, treating, or preventing a disease or medical condition.
  • Tax penalties: Using HSA funds for non-qualified expenses triggers ordinary income tax plus a 20% IRS penalty.

⚠️ The Rare Exception

  • Medical necessity: A haircut might qualify only if a licensed physician writes a formal Letter of Medical Necessity (LMN) stating it treats a specific diagnosed medical condition (such as a severe scalp disorder requiring specialized medical trimming).
  • Wigs for hair loss: While the haircut itself remains personal, a wig due to medical hair loss (like chemotherapy) can sometimes be eligible.

What is the smartest way to use an HSA?

The smartest way to use a Health Savings Account (HSA) is to contribute the maximum amount, invest the funds for long-term growth, pay for today's medical care out of pocket, and save your receipts to reimburse yourself tax-free years later.

Read the T. Rowe Price Guide for more details on unlocking tax savings.

Understand the Triple-Tax Advantage

An HSA offers a rare triple-tax benefit for federal taxes:

  • Tax-deductible: Money you put in lowers your taxable income right now. If you use payroll deductions, you also skip FICA taxes.
  • Tax-free growth: Any money you invest grows without taxes on the gains.
  • Tax-free withdrawals: You pay zero taxes when you take money out for qualified medical costs.

Max Out Contributions and Invest

Treat your HSA like a retirement account instead of a regular bank account.

  • Contribute the max: For 2026, you can put in up to $4,400 for an individual and $8,750 for a family. People aged 55 and older can add an extra $1,000.
  • Invest the balance: Do not let the cash sit idle. Move your funds into low-cost index funds or mutual funds so your money compounds over time.

Pay Out of Pocket and Save Receipts

This is the ultimate HSA trick.

  • Pay for your doctor visits or prescriptions using your regular credit card or checking account.
  • Keep digital copies of all your medical receipts.
  • Leave your HSA invested to grow.
  • Withdraw the cash tax-free years or decades later when you need extra money. The IRS has no time limit on when you must reimburse yourself, as long as you had the HSA open when the medical expense happened.

Use it in Retirement

Your HSA turns into a flexible tool as you age.

  • After age 65, you can withdraw money from your HSA for any non-medical reason without a penalty, though you will pay ordinary income tax (just like a traditional IRA).
  • If you use the money for medical care, it stays 100% tax-free.
  • Unlike 401(k)s, HSAs do not force you to take required minimum distributions (RMDs).

Learn more about this strategy in the Fidelity HSA Insights.

Can I buy a bra with HSA?

You can buy certain specialized bras with a Health Savings Account (HSA), but standard everyday bras do not qualify.

✅ Eligible Bra Categories

  • 🤱 Pumping & Nursing Bras
    • Criteria: Must directly aid lactation or hold a breast pump hands-free.
    • Examples: Brands like Kindred Bravely or Bodily.
  • 🩺 Post-Surgical & Mastectomy Bras
    • Criteria: Designed for recovery from a mastectomy, reconstruction, or reduction.
    • Examples: Specialized medical recovery garments with drain tabs or prosthesis pockets.
  • ♿ Adaptive & Mobility Bras
    • Criteria: Built for individuals with limited upper-body mobility or arthritis.
    • Examples: Magnetic or front-closure adaptive options from Liberare or Springrose.

⚠️ Ineligible Purchases

  • Everyday Wear: Standard bras used for general support and daily use are rejected by the IRS.
  • Documentation: You may need a Letter of Medical Necessity (LMN) from your doctor for certain adaptive or specialized garments if your HSA administrator requests verification.

Can I buy laundry detergent with my HSA card?

No, you cannot buy standard laundry detergent with an HSA card because the IRS classifies general household cleaning and personal care products as ineligible personal expenses.

Why It Is Not Eligible

  • General Use: Laundry detergent is meant for general household maintenance rather than treating or preventing a specific medical condition.
  • IRS Rules: Qualified medical expenses under IRS Publication 502 must be primarily to alleviate or prevent a physical or mental defect or illness.