Why
The IRS says nutritional supplements, vitamins and herbal supplements aren't medical expenses unless a medical practitioner recommends them as treatment for a specific condition diagnosed by a physician.
A daily multivitamin taken to stay healthy fails that test. An iron supplement your doctor tells you to take for diagnosed anemia should pass it.
The 2020 change for over-the-counter drugs didn't remove this rule. The IRS still answers the two questions separately.
What to keep
- The practitioner's written recommendation, naming the diagnosed condition and the supplement.
- An itemized receipt for each purchase.
Watch out for
- The same test applies to prenatal vitamins, fish oil and probiotics, whatever a store's HSA tag says.
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.