Why
Publication 502 allows transportation primarily for and essential to medical care, including bus, taxi, train or plane fares and ambulance service.
For your own car, the standard medical rate was 21 cents a mile for 2025, 20.5 cents for January through June 2026, and 23.5 cents for July through December 2026. The date of the drive sets the rate.
You can use your actual gas and oil costs instead of the standard rate. Either way, parking fees and tolls count on top.
What to keep
- A log with the date, where you went, why, and the round-trip miles.
- Parking and toll receipts.
Watch out for
- Depreciation, insurance, general repairs and maintenance don't count.
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.