Why
Publication 502 allows birth control pills prescribed by a doctor, condoms, a legal sterilization, and a vasectomy.
HSA rules go further than the tax deduction on one point: since 2020, over-the-counter drugs don't need a prescription. That covers over-the-counter birth control pills and emergency contraception.
An IUD or implant isn't named in the publication, but it's prescription birth control provided by a clinician.
What to keep
- A pharmacy receipt or clinic bill.
- The explanation of benefits, if insurance paid part.
Watch out for
- Many health plans cover prescription contraception at no cost. You can only reimburse what you actually paid.
If you plan to reimburse yourself later
IRS Notice 2004-50, Q&A 39, sets no deadline, as long as the expense came after your HSA was established and your records show it wasn't paid by another source or deducted on a tax return. See what records the IRS expects and how long to keep them.