Open My Shoebox

Is It HSA Eligible?

Look up an expense to see the IRS rule behind the answer and what to keep as proof. We only list what we've checked against IRS sources, so if the IRS hasn't settled something, we say so.

35 expenses checked against IRS sources

  • AcupunctureEligible

    Named in Publication 502.

  • Bandages and first aid suppliesEligible

    Publication 502 allows medical supplies such as bandages.

  • Birth controlEligible

    Yes. The IRS names prescribed birth control pills and sterilization, and since 2020 over-the-counter birth control pills count too.

  • Blood sugar test kitsEligible

    Count when used to diagnose or treat an illness such as diabetes, and so does insulin. A glucose sensor worn for general wellness doesn't.

  • Botox and fillersIt depends

    Not for wrinkles. Botox can qualify when it's medical treatment for a diagnosed condition, such as chronic migraine.

  • Braces and clear alignersEligible

    Yes. The IRS lists braces as dental treatment, and clear aligners fit the same rule when they correct a dental problem.

  • Breast pumpsEligible

    Pumps and supplies that assist lactation count.

  • ChiropractorEligible

    Fees paid for medical care count.

  • Contact lenses and solutionEligible

    Lenses needed for medical reasons, plus saline solution and similar supplies.

  • Dance and swimming lessonsNot eligible

    Not for general health, even if a doctor recommends them.

  • Dental workEligible

    Cleanings, fillings, extractions and dentures count.

  • DiapersNot eligible

    Only if needed to relieve the effects of a particular disease.

  • Direct primary care feesIt depends

    Yes since January 2026, if the arrangement meets the IRS definition and you paid the fee yourself. The $150 monthly limit affects contributions, not reimbursement.

  • Glasses and prescription sunglassesEligible

    Yes. Prescription glasses, prescription sunglasses and the eye exam all count. Non-prescription fashion sunglasses don't.

  • Gym membershipsIt depends

    Only if bought solely to treat a diagnosed disease or as part of prescribed physical therapy.

  • Health insurance premiumsIt depends

    Generally no before 65. The exceptions are COBRA, long-term care insurance and coverage while on unemployment. At 65, most coverage counts except Medigap.

  • Hearing aidsEligible

    Plus the batteries, repairs and maintenance needed to operate them.

  • IVF and fertility treatmentEligible

    Yes, when it's done to overcome an inability to have children. The costs of a gestational surrogate don't count.

  • LASIK and eye surgeryEligible

    Eye surgery to treat defective vision counts.

  • Massage therapyIt depends

    Only when it's treatment for a specific medical condition. A massage for relaxation or general wellness doesn't count.

  • Medicare premiumsIt depends

    Yes if you, the HSA owner, are 65 or older, except for Medigap. If you're under 65, your spouse's Medicare premiums generally don't count.

  • Mileage to medical appointmentsEligible

    Yes. For 2026 the IRS rate is 20.5 cents a mile through June 30 and 23.5 cents from July 1. Parking and tolls count too.

  • Nursing homes and long-term careIt depends

    The medical care counts. Meals and lodging count too, but only if a principal reason for being there is to get medical care.

  • Over-the-counter medicineEligible

    Yes. Since 2020 you don't need a prescription to pay for over-the-counter drugs from an HSA.

  • Ozempic, Wegovy and other GLP-1 drugsIt depends

    Yes with a prescription to treat a diagnosed condition such as diabetes or obesity. Not if the goal is to improve your appearance or general health.

  • Pet careNot eligible

    Veterinary fees generally don't count, with an exception for service animals.

  • Pregnancy testsEligible

    Named in Publication 502.

  • Smartwatches and fitness trackersIt depends

    Usually not. The IRS said in September 2026 that a wearable with everyday uses qualifies only if it's bought and used primarily for a specific disease.

  • Stop-smoking programs and nicotine gumEligible

    Yes. Stop-smoking programs count, and over-the-counter nicotine gum and patches can be paid for from an HSA.

  • SunscreenIt depends

    Possibly, if it's labeled Broad Spectrum SPF 15 or higher. The IRS hasn't addressed sunscreen directly, so this is an argument from FDA rules.

  • Tampons, pads and period productsEligible

    Yes. Federal law has treated tampons, pads, liners, cups and similar products as medical care since 2020.

  • Teeth whiteningNot eligible

    Named in Publication 502 as not includible.

  • Therapy and counselingIt depends

    Yes when it treats a diagnosed mental health condition. Marriage counseling and general self-improvement don't count.

  • Toothpaste and toothbrushesNot eligible

    No. The IRS uses a toothbrush and toothpaste as its example of a personal expense that doesn't count.

  • Vitamins and supplementsIt depends

    Only if a medical practitioner recommends them as treatment for a specific diagnosed condition. Vitamins taken for general health don't count.

How to read these answers

  • Eligible: the IRS names it, or its rule plainly covers it.
  • It depends: the purpose, your paperwork or your age decides it, or the IRS hasn't addressed it directly.
  • Not eligible: the IRS rules it out, apart from any narrow exception we note.

The test behind every answer

An HSA can pay tax-free for medical care as the tax code defines it. Publication 502 says medical care expenses must be primarily to alleviate or prevent a physical or mental disability or illness, and that things merely beneficial to general health don't count. A store's "HSA eligible" tag isn't an IRS ruling.

Publication 969 adds that the expense has to be for you, your spouse or a dependent, and can't be paid or reimbursed by insurance or another source. It also can't come from before your HSA was established. A withdrawal that fails those tests counts as income, with an additional 20% tax unless you're 65 or older, disabled, or the withdrawal is made after death.

Eligible today, reimbursed later

If you pay out of pocket, you don't have to reimburse yourself right away. That's the idea behind the HSA shoebox strategy, and the calculator shows what waiting could be worth. It only works if you can still prove the expense years from now, so see what records the IRS expects.

Keep the proof where you can find it

Shoebox reads a receipt you forward by email or upload as a photo, and stores the file with the details. It's free for 30 days with no card, then $60/year if you keep it. You can still view and download your receipts if you stop paying.

Checked against IRS sources on Nov 8, 2026. This is general information, not tax advice. Shoebox sells HSA receipt software, so factor that in.