Unlocking Hidden Savings: Lesser-Known Qualified Expenses for HSA and FSA Accounts

Understanding Tax-Advantaged Health Savings

For those managing healthcare costs, HSA and FSA accounts represent powerful yet underutilized financial tools. Both accounts function as tax-advantaged savings vehicles, allowing you to set aside pre-tax dollars for medical expenses while lowering your overall taxable income. The key distinction lies in their structure and flexibility.

To qualify for an HSA, enrollment in a high-deductible health plan (HDHP) is mandatory—specifically one with a minimum deductible of $1,650 for individual coverage or $3,300 for family plans. The account holder can contribute up to $4,300 annually for individual plans or $8,550 for families in 2025. Those aged 55 and older enjoy an additional $1,000 catch-up contribution option.

An FSA operates differently, tethered to employer-sponsored benefits with a $3,300 annual contribution limit for 2025. Unlike HSAs, FSA funds must be fully deployed within the plan year—any unspent balance is forfeited, though some employers allow rolling $660 into the following year or extending a 2.5-month grace period.

The Overlooked Spectrum of Eligible Purchases

What many account holders don’t realize is the breadth of qualified medical expenses extending far beyond routine doctor visits and prescription medications. Tax-free withdrawals from both HSA and FSA accounts cover an extensive range of healthcare-related items, many of which surprise consumers when they discover eligibility.

Personal Care and Wellness Expenses

Acne treatments, hair-growth medications, and stop-smoking programs (including nicotine patches and gum) all qualify as approved expenses. Fertility treatments and vasectomy procedures represent another category of reproductive healthcare eligible for HSA/FSA funding. Broad-spectrum sunscreen with SPF 15 or higher, along with after-sun remedies, fall within the qualified list.

Medical Equipment and Diagnostic Tools

At-home diagnostic kits provide convenient health monitoring at HSA/FSA-eligible expense. Hearing-aid batteries, repairs, and maintenance services ensure ongoing device functionality. Wheelchairs, walkers, and crutches qualify as durable medical equipment. Vision-correction surgery such as LASIK represents a substantial expense many don’t realize can be covered through these accounts.

Specialized Healthcare Services

Chiropractic care opens another avenue for expense coverage. Contact lens solutions and enzyme cleaners maintain optical health. Service animals registered for medical purposes receive approval as qualified expenses. Pregnancy tests and ovulation monitors support family planning efforts. Transportation costs associated with medical care—including bus fare, taxi rides, mileage reimbursement, parking fees, and tolls—represent an often-forgotten eligible category.

Preventative and Protective Items

First-aid kits stock essential medical supplies. Personal protective equipment designed to prevent COVID-19 transmission qualifies as approved expense. Thermometers enable home health monitoring. Breast pumps and lactation supplies support nursing mothers.

Additional Covered Services

Braille books and magazines for individuals with vision impairments satisfy qualified expense criteria. The list extends substantially beyond these 20 categories, with hundreds of additional items and services qualifying under IRS guidelines.

Maximizing Your Tax Advantages

The primary benefit of HSA and FSA utilization lies in the dual tax advantage: contributions reduce taxable income in the current year, and withdrawals for qualified expenses avoid taxation entirely. This structure creates immediate annual savings through lower tax liability.

Before assuming an item qualifies, consult your specific plan’s approved expense list or contact your plan administrator. IRS regulations govern eligible categories, and interpretations can vary by plan. Taking time to verify eligibility ensures you maximize these valuable tax-advantaged accounts while maintaining compliance with account rules and regulations.