My HSA will pay for what?!

My HSA will pay for what?!

Health Savings Accounts (HSAs) are skyrocketing in popularity as premium increases have become the new normal in this uncertain market. In fact, recent reports project 30 million accounts, with assets exceeding $60 billion, by the end of 2019. To put those numbers into perspective, there were around 6 million accounts in 2008.

HSAs also remain popular because consumers are looking for more choices and more ways to save. For example, HSAs offer triple tax savings. This means any HSA contributions can be made either pre-tax or are tax deductible at year-end. Any interest income or earnings on investments tied to an HSA remains tax free.

Additional HSA benefits include

  • 100% of unused funds roll over year-after-year
  • Funds go with you even if you switch employers
  • Can pay for the eligible expenses of your legal spouse and tax dependents regardless of their insurance
  • Can be used for Medicare premiums as well as qualified long-term care premiums 

Further, there are literally hundreds of ways to spend HSA funds. In fact, the IRS has laid out an extensive list of allowable expenditures in IRS Publication 502. Many probably take it for granted that HSA funds will cover a doctor’s visit; however, most are probably unaware that the IRS considers these services as allowable expenses:

  • Travel expenses and lodging
    • It’s an eligible expense if the costs associated with transportation and lodging essential to and primarily for medical care.
    • Note: Lodging expenses are limited to $50 per person up to a maximum of $100 per night. Additional requirements for lodging include:
      • Medical care must be provide by a doctor in a licensed healthcare facility
      • Lodging is not lavish or extravagant
      • There is no significant element of personal leisure in the travel
  • Eye surgery
    • The cost associated with laser or LASIK eye surgery is an eligible expense.
  • Artificial eye, limb and teeth
    • Amount paid for the design and purchase of an artificial limb, eye or teeth is an eligible medical expense.
  • Birth control pills
    • The cost of prescription birth control (such as IUD, diaphragm, pill, Norplant, etc.) is an eligible medical expense. In addition, amounts paid for OTC products and devices (such as condoms, etc.) are eligible medical expenses.
  • Chiropractic and acupuncture treatments
    • Massage therapy may qualify for HSA compensation in certain situations, as well!
  • Drug and alcohol addiction treatment
    • The cost of treatment at a center for alcohol or drug addiction is an eligible medical expense. This includes meals and lodging provided by an inpatient center during treatment
  • Artificial Reproductive Technologies
    • A health care professional must provide evidence of medical necessity for the cost of Artificial Reproductive procedures to be an eligible medical expense. Evidence of medical necessity must be included by providing a Letter of Medical Necessity (LMN) that specifically identifies the recommendation and expense is for treatment of a medical condition with the request for reimbursement.
    • To qualify as potentially eligible, procedures must be intended to overcome an inability to have children due to medical reasons and are performed on you, your spouse or your dependent.
  • Home improvements such as ramps or doorways to accommodate a wheelchair
    • A health care professional must provide evidence of medical necessity for the cost of installing equipment in the home to be an eligible medical expense. Evidence of medical necessity must be included by providing a Letter of Medical Necessity (LMN) that specifically identifies the recommendation and expense is for treatment of a medical condition with the request for reimbursement. 
  • Smoking cessation programs
    • The cost of participating in a smoking cessation program is an eligible expense.
  • Tutoring or tuition costs for children with medical-related learning disabilities
    • A health care professional must provide evidence of medical necessity for the cost of tuition/tutoring fees covering services rendered specifically for your child's severe learning disabilities caused by mental or physical impairments to be an eligible medical expense. Evidence of medical necessity must be included by providing a Letter of Medical Necessity (LMN) that specifically identifies the recommendation and that the expense is for treatment of a medical condition with the request for reimbursement.