Ever wondered what the heck you can actually spend your health account money on?

I used to think these accounts were just for doctor visits and medicine.

But it turns out there’s a whole world of health expenses you can pay for tax-free using your Health Equity account (or HSA, FSA, or HRA).

Let me break it all down for you – from the obvious stuff to the “wait, I can buy THAT?” items you probably didn’t know about.

Health Equity Eligible Expenses: The Complete Guide

First things first – all these health accounts (HSA, FSA, HRA) follow IRS rules about what counts as a “qualified medical expense.” But your specific employer might have extra restrictions, so always double-check your plan.

The basic rule: If it’s primarily for medical care to maintain or improve health, it’s probably eligible.

Who Can You Spend This Money On?

You can use your Health Equity funds for:

• Yourself (obviously)
• Your spouse
• Your tax dependents (usually your kids)

But sorry – your roommate’s medical bills don’t count, even if they’re like family.

The Big Categories of Eligible Expenses

1. Medical Care (The Obvious Stuff)

• Doctor visits and hospital fees
• Urgent care
• Mental health care (therapy, psychiatric services)
• Lab tests and X-rays
• Prescription medications
• Over-the-counter drugs (and since 2020, you don’t need a prescription!)
• Menstrual products (yes, tampons and pads count now!)
• Medical devices like crutches and blood pressure monitors

Remember when the CARES Act passed in 2020? That’s when they finally made over-the-counter meds and period products eligible without jumping through hoops. About time!

2. Dental Care (Smile!)

• Cleanings, fillings, and X-rays
• Braces and orthodontics
• Dental implants
• Dentures

Just remember – teeth whitening isn’t covered. The IRS doesn’t care if your smile is Instagram-worthy.

3. Vision Care (See Clearly)

• Eye exams
• Prescription glasses and contacts
• Contact solution (yes, really!)
• LASIK surgery
• Even guide dogs for visual impairment

The American Academy of Ophthalmology has a great guide on maximizing vision benefits through health accounts.

4. Surprising Eligible Expenses You Might Not Know About

• Transportation to medical appointments (gas, parking, bus fare)
• Smoking cessation programs
• Fertility treatments
• Hearing aids and batteries
• COVID tests and masks
• Some home healthcare

Did you know acupuncture is eligible? According to the Mayo Clinic, it can help with various pain conditions – and your health account can pay for it!

Important Stuff to Remember

Keep. Your. Receipts.

I can’t stress this enough. If you get audited, you’ll need to prove these were legitimate medical expenses.

Some expenses need a Letter of Medical Necessity from your doctor – especially things that might seem like “general wellness” rather than medical treatment.

For FSAs specifically – remember the use-it-or-lose-it rule. Unlike HSAs, FSA money typically doesn’t roll over to the next year.

What’s Definitely NOT Covered

Don’t try to use your health account for:

• Cosmetic procedures (botox, etc.)
• Regular soap and shampoo
• Most vitamins and supplements
• Gym memberships
• That fancy exercise bike you’ve been eyeing

The IRS Publication 502 is the bible of what counts as a qualified medical expense – when in doubt, check there.

How to Get the Most Out of Your Health Account

Plan ahead! Estimate your yearly medical expenses so you’re not leaving money on the table or putting in too much.

Use the Health Equity portal to check what’s eligible before you buy.

For big expenses, time them strategically. Need new glasses? Consider whether it makes sense to get them this plan year or next.

Bottom Line

Your health account is more flexible than you probably thought. From doctor visits to contact solution to period products, there’s a lot you can cover tax-free.

Just remember: keep your receipts, check your specific plan rules, and when in doubt, ask before you spend.

Health accounts like these can save you serious money on taxes while helping you manage healthcare costs. Don’t let those benefits go to waste!