What is not eligible for HSA?

Asked by: Colby Kovacek  |  Last update: January 21, 2026
Score: 4.8/5 (7 votes)

If you or your spouse participates in a Healthcare Flexible Spending Account (Healthcare FSA) or a Health Reimbursement Arrangement (HRA) that allows for reimbursement of your medical expenses, you are not eligible to establish a new HSA or make contributions to a current HSA.

What disqualifies you for an HSA?

You must participate in a High Deductible Health Plan, have no other insurance coverage other than those specifically allowed, and not be claimed as a dependent on someone else's tax return in order to be eligible for an HSA.

What makes you ineligible for HSA contributions?

An employee covered by an HDHP and a health FSA or an HRA that pays or reimburses qualified medical expenses can't generally make contributions to an HSA.

What would disqualify your client from an HSA deduction?

You also cannot contribute to an HSA if you have disqualifying additional medical coverage, such as a general-purpose health flexible spending account (FSA), at the same time.

Can I use my HSA for gym membership?

Generally, the IRS doesn't allow pretax dollars in HSAs or FSAs for gym memberships. This is because they see them as expenses for general well-being rather than medical necessity. However, with a Letter of Medical Necessity (LMN), your HSA or FSA could be used to fund those expenses.

Not Eligible for an HSA or a Roth IRA – What's the Next Step?

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Can I use HSA for dental?

Your HSA also covers expenses for standard dental cleanings and dental check-ups. One thing to keep in mind is that some of these procedures may have a co-payment, so it's important that you check with your dental insurance provider to find out exactly what you'll have to pay out of pocket.

Can you use your HSA for massages?

Your HSA can pay for massage therapy, though you'll likely need a letter of medical necessity (LMN) from your doctor. An LMN states what condition the treatment is for, how many sessions you need, and any other relevant details. An HSA may also be used on alternative or holistic treatments, such as: Massage therapy.

What Cannot be used for HSA?

Generally, you can't use your HSA to pay for expenses that don't meaningfully promote the proper function of the body or prevent or treat illness or disease. Nutritional supplements and weight loss programs not prescribed by a physician are examples of expenses that would not be covered by your HSA.

What triggers an HSA audit?

Does HSA spending trigger an audit? The IRS doesn't monitor how you spend your HSA funds throughout the year, but that doesn't mean they won't ask for proof that your expenses were eligible. And if your tax return contains unrelated IRS audit red flags, your risk for an HSA audit could increase.

What is the downside of an HSA?

Drawbacks of HSAs include tax penalties for nonmedical expenses before age 65, and contributions made to the HSA within six months of applying for Social Security benefits may be subject to penalties. HSAs have fewer limitations and more tax advantages than flexible spending accounts (FSAs).

Are vitamins HSA-eligible?

In general, vitamins are not considered an HSA eligible expense unless they are prescribed by a doctor for a specific medical condition. For example, if your doctor prescribes prenatal vitamins during pregnancy or recommends vitamin D supplements to treat a deficiency, those could be eligible expenses under your HSA.

Why do I not qualify for HSA?

If you or your spouse participates in a Healthcare Flexible Spending Account (Healthcare FSA) or a Health Reimbursement Arrangement (HRA) that allows for reimbursement of your medical expenses, you are not eligible to establish a new HSA or make contributions to a current HSA.

What is the 12 month rule for HSA?

It means you must remain eligible for the HSA until December 31 of the following year. The only exceptions are death or disability. If you violate the testing period requirement, your ineligible contributions become taxable income.

What makes you ineligible to contribute to your HSA?

An employee covered by an HDHP and a health FSA or an HRA that pays or reimburses qualified medical expenses generally cannot make contributions to an HSA.

How to know if something is HSA-eligible?

Lip balm is typically HSA-eligible if it meets certain requirements, but here's what you should know.
  1. Common or routine medical expenses. Annual exams. ...
  2. COVID PPE supplies. ...
  3. Menstrual products and OTC medications. ...
  4. Family planning products. ...
  5. Emergency medical expenses. ...
  6. Mental health expenses. ...
  7. Dental care. ...
  8. Vision care.

Who should not do an HSA?

HSAs might not make sense if you have some type of chronic medical condition. In that case, you're probably better served by traditional health plans. HSAs might also not be a good idea if you know you will be needing expensive medical care in the near future.

What would disqualify you from an HSA deduction?

Based on the above eligibility qualifications, enrolling in Medicare, Medicaid or HIP 2.0 will disqualify you from having contributions into a Health Savings Account (HSA). Once enrolled in any of these plans, you may not receive or make any contributions into an HSA.

Can I use my HSA to pay for yoga?

Fitness fees do not immediately qualify as eligible HSA/FSA expenses, but they do qualify if a provider recommends exercise to prevent or treat a medical condition. To qualify those expenses for reimbursement with an HSA/FSA administrator, you need a Letter of Medical Necessity from a provider.

What is HSA receipt loophole?

The Adult Child HSA Family Contribution Loophole

That's why you can do things like save receipts for decades and then pull the money out of the account. That's why you can use it as a stealth IRA by investing in it for decades and then pulling it out after age 65 penalty-free and buying a sailboat with it.

Can I use my HSA to pay for gym membership?

Gym memberships. While some companies and private insurers may offer discounts on gym memberships, you generally can't use your FSA or HSA account to pay for gym or health club memberships. An exception to that rule would be if your doctor deems fitness medically necessary for your recovery or treatment.

Can I use HSA for groceries?

No, you can't use your Flexible Spending Account (FSA) or Health Savings Account (HSA) for straight food purchases like meat, produce and dairy. But you can use them for some nutrition-related products and services. To review, tax-advantaged accounts have regulatory restrictions on eligible products and services.

What happens if I accidentally use my HSA card for non-medical expenses?

You can repay the incorrect distribution before filing your federal taxes for that tax year. However, if you do not correct the mistake, the unqualified amount will be subject to income tax, and you may also face an additional 20% tax penalty.

Can I use HSA for vitamins?

You want to be careful when trying to buy vitamins with your FSA or HSA. They are not always deemed a qualified expense. If your vitamins are not prescribed by a healthcare professional or used to treat a specific condition, your purchase most likely won't be FSA or HSA eligible.

Can I use HSA for glasses?

Yes! You can definitely use funds from your flexible spending account (FSA) or health savings account (HSA) to purchase prescription glasses. (FSAs and HSAs can be used for many other vision- and eye health-related expenses, too, but we'll discuss that more in a bit.)

Is a chiropractor covered by HSA?

It also will help lower your overall health care costs because you are using pre-tax dollars, thus reducing your taxable income by the amount of money you put into your HSA. You can use the funds in an HSA at any time to pay for qualified medical expenses, including chiropractic care.