What Can You Buy With Your HSA? Complete 2026 Guide

Top 20 Most Common HSA Purchases (With Prices)

These are the items most Americans use their HSA for every year. If you have any of these on your shopping list, skip the credit card and use your HSA card instead.

HSA-Eligible Items by Category

Here is the complete breakdown by category. Everything below qualifies under IRS Section 213(d) as of 2026.

Medical Supplies & Equipment

Durable medical equipment and supplies qualify when they serve a medical purpose. Items like blood pressure monitors, glucose meters, and CPAP machines are unambiguously eligible. The test: is this item primarily for diagnosing or treating a medical condition?

Since the CARES Act of 2020, first aid supplies (bandages, gauze, antiseptic) became fully eligible OTC purchases without a prescription. Stock up your home first aid kit with your HSA card.

Medical Equipment Worth Paying With Your HSA

• CPAP machines: Full cost covered — machines, masks, humidifiers, tubing, and replacement parts.
• Hearing aids: One of the biggest HSA uses. A quality pair runs $1,000–$5,000 and insurance often covers little.
• CGM sensors (continuous glucose monitors): Dexcom G7, FreeStyle Libre, and similar devices qualify — even for pre-diabetics with a doctor's note.
• Compression socks: Require a medical prescription to qualify. Without one, they don't count.
• Back braces and orthopedic supports: Qualify when used to treat an injury or diagnosed condition.

Prescription Medications & Over-the-Counter Drugs

All prescription medications are HSA-eligible without question. The bigger shift came with the CARES Act of 2020 — it expanded OTC coverage to include virtually all OTC medications without a prescription, reversing a 2010 restriction that had confused consumers for years.

Insulin is a special case: it qualifies for HSA reimbursement without a prescription, even under the pre-CARES rules. This was always covered.

Dental & Vision

Dental and vision care are among the most common HSA uses — and among the most impactful, because these are often large out-of-pocket expenses that insurance covers poorly.

LASIK surgery is a standout HSA use case. A procedure that costs $2,000–$4,000 per eye is effectively discounted by your marginal tax rate when paid from pre-tax HSA dollars. Someone in the 22% bracket who pays $3,500 for LASIK from their HSA saves ~$770 compared to paying after-tax.

Orthodontics is another major opportunity. Braces and Invisalign for adults and children are fully HSA-eligible. A $5,000 treatment saves $1,100+ in taxes at the 22% bracket.

One Thing to Watch: Cosmetic Dental

Teeth whitening and cosmetic veneers are NOT HSA-eligible — they're considered cosmetic procedures, not medical treatment. If a dentist recommends veneers to protect damaged teeth after trauma, get documentation of the medical necessity. The line between cosmetic and medically necessary is where most dental HSA disputes occur.

Mental Health & Therapy

All licensed mental health care qualifies — psychiatrists, psychologists, licensed therapists, and counselors. Telehealth mental health platforms (like Brightside, Talkspace, Alma) are also eligible when you're receiving treatment for a diagnosed condition.

Prescription psychiatric medications qualify the same as any other Rx. Antidepressants, anti-anxiety medications, ADHD treatments, and mood stabilizers are all covered.

Substance abuse treatment — inpatient or outpatient — is fully eligible. This includes residential treatment programs, IOP (intensive outpatient programs), and related medications like Suboxone or naltrexone.

The Surprising HSA-Eligible Purchases Most People Miss

These are legitimate qualified expenses that most HSA holders don't know about — and where the biggest "found money" opportunities exist.

• Sunscreen (SPF 15+): Qualifies as preventive care. If you're buying sunscreen for a family of four, you're spending $100+ per year on an HSA-eligible item that most people pay after-tax.
• Menstrual care products: Added by the CARES Act. Tampons, pads, period underwear, menstrual cups — all eligible. Roughly $100–$200/year per person, fully HSA-eligible.
• Breast pumps and lactation supplies: The IRS explicitly covers breast pumps, milk storage bags, nursing pads, and lactation consultant fees.
• Service animal care: If you have a service animal, the cost to buy, train, and maintain the animal (including food and vet bills) qualifies — because the animal exists to treat a medical condition.
• Home modifications for a disability: Wheelchair ramps, stairlifts, grab bars, door widening, and other modifications to accommodate a disability are HSA-eligible. Keep the contractor invoice and your diagnosis documentation.
• Transportation to medical appointments: Mileage to and from medical appointments ($0.21/mile in 2026), parking fees, tolls, and airfare for out-of-town medical care all qualify. Most people don't track this.
• Fertility treatments: IVF, egg freezing, sperm banking, artificial insemination, fertility medications, and embryo storage fees are all HSA-eligible. This is often the largest single HSA expenditure a family makes.
• Acupuncture: Fully eligible when treating a diagnosed condition. Chronic pain, migraines, fertility, and post-surgical recovery are common qualifying uses.
• Wearable health devices: Blood pressure monitors, pulse oximeters, and continuous glucose monitors qualify. Smartwatches like Apple Watch, Fitbit, Oura Ring, and Garmin also qualify when prescribed by a doctor for a specific medical condition (Letter of Medical Necessity required). See the full Wearables HSA Eligibility Guide for device-by-device details.
• Smoking cessation: Nicotine patches, gum, lozenges, and prescription cessation medications (Chantix, Wellbutrin for smoking) are all covered. Structured quitting programs qualify when prescribed.

What You CANNOT Buy With Your HSA

These are the most common mistakes. Using your HSA card on a non-qualified expense means you'll owe income tax + a 20% penalty on that withdrawal.

Frequently Asked Questions

Can I use my HSA at any store?

Your HSA debit card works at most pharmacies and major retailers that have IIAS (Inventory Information Approval System) — the system that identifies HSA-eligible items at checkout. CVS, Walgreens, Rite Aid, Target, Walmart, Costco, and Amazon all support this. If a retailer doesn't have IIAS, you can still pay out of pocket and reimburse yourself with documentation.

Does Amazon have HSA-eligible products?

Yes. Amazon has a dedicated HSA & FSA Store (amazon.com/hsa-fsa-store) that filters for eligible products automatically. Your HSA debit card works there, and eligible items are clearly marked. This is one of the easiest ways to shop for HSA-eligible OTC items.

Can I use my HSA for my spouse or kids?

Yes. HSA funds can pay for qualified expenses for you, your spouse, and any dependents you claim on your federal tax return — even if they're not on your health insurance plan.

Do I need a receipt to use my HSA?

Yes. You should keep receipts for all HSA purchases. The IRS can audit HSA distributions, and you must be able to prove the expense was a qualified medical expense. For recurring items like therapy, keep the Explanation of Benefits (EOB) or itemized receipts. A photo on your phone in a dedicated folder is sufficient.

Can I use my HSA for expenses from previous years?

Yes — with an important caveat. You can reimburse yourself from your HSA for a qualified expense incurred in any prior year, as long as the expense occurred after your HSA was opened and before you took the distribution. There is no time limit. This is the "HSA as a reimbursement bank" strategy: pay out of pocket now, let the HSA grow, reimburse years later.

What happens if I use my HSA card for something ineligible by mistake?

If you catch it before filing your taxes, you can repay the HSA for the incorrect distribution and avoid the tax + penalty. Most HSA administrators allow this correction. If you don't catch it, you'll owe income tax + the 20% additional tax when you file.