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User GuideUpdated for 2025

How to Use This Tool

Learn how to search for items, understand eligibility results, interpret badges and flags, and keep proper documentation for your HSA, FSA, or HRA expenses.

Search Tips

Use Brand Names or Generic Terms
Search for "Tylenol" or "ibuprofen" or "pain reliever" - all work! Our tool recognizes common brand names, generic drug names, and general categories.

Examples:

Brand: "Advil", "Tampax", "Flonase"
Generic: "acetaminophen", "menstrual products", "allergy medication"
Keep It Simple
Short, clear searches work best. No need for complete sentences or questions.

Examples:

Good: "massage therapy"
Good: "vitamins"
Less ideal: "Can I buy vitamins with my HSA account?"
Try Different Variations
If your first search doesn't find what you're looking for, try synonyms or related terms.

Examples:

Try: "pain reliever" → "ibuprofen" → "Advil"
Try: "contacts" → "contact lens solution"
Try: "period products" → "menstrual care" → "tampons"
Review All Account Types
Results automatically show eligibility for HSA, FSA, and HRA accounts. Check all three to see which accounts can cover your expense.

Examples:

Results page shows a clear table with eligibility for each account type
Some items may be eligible for one account type but not others

Understanding Eligibility Badges

Each search result includes an eligibility badge that shows whether the item is eligible for your selected account type (HSA, FSA, or HRA).

Eligible

What it means:

This item is a qualified medical expense for the selected account type. You can use your HSA/FSA/HRA funds to purchase it.

Examples:

OTC pain relievers (Tylenol, Advil), prescription medications, wheelchairs

Conditional

What it means:

This item may be eligible, but requires additional documentation or conditions to be met. Check the details for specific requirements.

Examples:

Vitamins (with prescription), massage therapy (with LMN), gym membership (for specific diagnosed conditions)

Not Eligible

What it means:

This item is not a qualified medical expense according to IRS rules. You cannot use HSA/FSA/HRA funds for this purchase.

Examples:

Cosmetics, general vitamins (without prescription), gym memberships (general wellness)

Understanding Flags

Some items have special flags that indicate additional requirements or important information about eligibility.

LMN Required
Letter of Medical Necessity
You need a letter from your doctor stating that this item/service is medically necessary for treating a specific diagnosed condition.

What to do:

  • Ask your doctor for a Letter of Medical Necessity
  • The letter should specify your diagnosis and why this treatment is necessary
  • Keep the LMN with your receipts for substantiation
  • Submit the LMN with your reimbursement claim (if paying out-of-pocket)

Examples:

Massage therapy for chronic pain
Gym membership for obesity or heart disease
Special diet foods for celiac disease
Rx Required
Prescription Required
This item requires a prescription from your doctor to be eligible. Note: Since the CARES Act (2020), most OTC drugs no longer require a prescription.

What to do:

  • Get a prescription from your doctor
  • Keep a copy of the prescription with your receipts
  • Some items may have been eligible before CARES Act but rules changed

Examples:

Prescription medications (always required)
Certain supplements when prescribed for a specific condition
CARES Act Eligible
CARES Act (2020) Expansion
This item became eligible (or became eligible without a prescription) due to the CARES Act signed in March 2020. This is a permanent change.

What to do:

  • No prescription required for OTC drugs and menstrual products
  • Simply purchase and keep your receipt
  • These changes apply to expenses incurred on or after January 1, 2020

Examples:

OTC pain relievers (Tylenol, Advil)
Menstrual care products (pads, tampons, cups)
OTC allergy medication
OTC cold and flu remedies

Keeping Proper Documentation

1
Save Your Itemized Receipts
Keep itemized receipts showing the item name, date of purchase, amount paid, and merchant name. Credit card statements alone are not sufficient.

Important Points:

  • Must be itemized (not just a total)
  • Must show what was purchased
  • Digital receipts (email, app screenshots) are acceptable
2
Keep Supporting Documentation
For conditional expenses, keep your Letter of Medical Necessity or prescription with the receipt.

Important Points:

  • LMN should be dated before the purchase
  • Prescription should match the item purchased
  • Keep all documents together in one place
3
Store for the Required Period
The IRS recommends keeping records for 3 years after filing the tax return. Some plan administrators may require you to submit documentation upon request.

Important Points:

  • Digital storage is acceptable (scan or photograph)
  • Organize by year and category
  • Keep backups of important documents
4
Be Ready for Substantiation
Your HSA/FSA administrator may request proof that an expense was for a qualified medical expense. This is called "substantiation."

Important Points:

  • Respond promptly to substantiation requests
  • Provide clear, complete documentation
  • If you cannot substantiate, you may have to repay the amount
What Makes a Good Receipt?

Good Receipt Includes:

  • Merchant name and address
  • Date of purchase
  • Itemized list of products/services
  • Amount paid for each item
  • Payment method (if using HSA/FSA card)

Not Sufficient:

  • Credit card statement alone
  • Receipt showing only total amount
  • Handwritten notes
  • Faded or illegible receipts
  • Screenshots without merchant details

Common Questions

Q:What if my search returns multiple results?
A:

This usually means the item could fall into different categories with different eligibility rules. Review each result and select the one that best matches your specific use case. For example, "vitamins" might return both "General Vitamins (Not Eligible)" and "Prescription Vitamins (Eligible with Rx)."

Q:What does "plan rules may vary" mean?
A:

While IRS rules set the baseline for what's eligible, your employer's FSA or HRA plan may have additional restrictions. Always check with your plan administrator if you're unsure. HSAs follow standard IRS rules and don't vary by employer.

Q:Can I use this tool for past purchases?
A:

Yes! You can look up items you've already purchased. If they were eligible, you may be able to submit a claim for reimbursement (if you paid out-of-pocket) or verify that your HSA/FSA card purchase was valid. Check your plan's time limits for reimbursement claims.

Q:What if I disagree with the eligibility result?
A:

Our results are based on IRS publications and regulations. If you believe an item should be eligible, consult with your tax advisor or plan administrator. In some cases, conditional eligibility may apply if you have proper medical documentation.

Q:How often is the information updated?
A:

We update our database regularly to reflect the latest IRS guidance. Each item page shows a "Last Verified" date. IRS Publication 502 is typically updated annually. Major changes (like the CARES Act) are reflected as soon as possible.

Q:What if I can't find what I'm searching for?
A:

Try different search terms or browse related categories. If you still can't find it, the item may be uncommon or fall into a gray area. We recommend contacting your plan administrator or consulting IRS Publication 502 directly for unusual items.

Limitations and Disclaimers

Important to Know

This tool provides information only

This is not tax, legal, or financial advice. Always consult with your tax advisor or plan administrator for personalized guidance.

IRS rules can change

While we strive to keep our information current, tax laws and regulations can change. Check the "Last Verified" date on each item page.

Plan rules may vary

Your employer's FSA or HRA plan may have additional restrictions beyond IRS rules. Always verify with your plan administrator.

You are responsible

You are ultimately responsible for ensuring your expenses are eligible and properly documented. Keep all receipts and supporting documentation.

When in doubt, ask

If you're unsure about an expense, contact your plan administrator before making the purchase. It's better to ask first than to have a claim denied later.

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