Why
Publication 502 says you can include the amount you pay for eye surgery to treat defective vision, such as laser eye surgery or radial keratotomy.
It isn't treated as cosmetic, even though glasses would also correct your vision. In Revenue Ruling 2003-57 the IRS said eye surgery to correct defective vision, including laser procedures such as LASIK, corrects a dysfunction of the body, so the cost is medical care.
The eye exams before and after surgery count too. Publication 502 allows eye examinations.
What to keep
- The surgery center's itemized bill and proof of what you paid.
- Any vision plan or insurance statement showing a discount or benefit that was applied.
Watch out for
- Many vision plans give a discount on LASIK without paying for it. You can reimburse only what you paid.
- LASIK is a large one-time bill, so it's a common receipt to save and reimburse years later. That only works if the surgery happened after your HSA was established.
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. Paying now and reimbursing years later is the HSA shoebox strategy.