Why
Publication 502 allows prescribed medicines and drugs. For weight loss, it says the cost counts when it's treatment for a specific disease diagnosed by a physician, such as obesity, hypertension or heart disease, and doesn't count when the purpose is to improve appearance or general health.
The IRS hasn't addressed GLP-1 drugs by name, so this is those general rules applied to them.
What to keep
- The pharmacy receipt showing the drug, the date and what you paid.
- The prescription or a note from your doctor naming the diagnosis, especially if the drug is for weight loss.
Watch out for
- Prescription drugs imported from another country generally don't count.
- Telehealth membership fees bundled with the drug are harder to support than the drug itself, so ask for an itemized bill.
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.