HSA/FSA Education and References

IRS Publication 969 (2022) covers detail on Health Savings Accounts and Other Tax-Favored Health Plans here.

Publication 969 (above) refers to covered “Medical and Dental Expenses” which are detailed in IRS Publication 502 (2022) here. This publication identifies what may or may not be considered to be applied with HSA and FSA programs. Publication 969 describes how those programs work to receive benefit for Medical and Dental Expenses considered covered.

Generally speaking, weather or not an expense will be covered or not is based on:

  • (are includible) if it is “medically necessary” as a treatment for a specific disease diagnosed by a physician (such as obesity, hypertension, or heart disease) with a prescription or Letter of Medical Necessity (LMN). This includes fees you pay for membership in a weight reduction group as well as fees for attendance at periodic meetings as examples.

  • (are not includible) if it is for improvement of appearance, general health, or sense of well-being, such as food and beverages that substitute for what is normally consumed to satisfy nutritional needs or membership dues in a gym, health club, or spa when the expense isn't for a specific disease diagnosed by a physician. In this case for example, you can't include either the fees you pay for membership in a weight-reduction group or fees for attendance at periodic meetings.

The following provide excerpts from the two publications mentioned above including links on each area:

  • Weight Loss Programs (included)

    Weight Loss Programs (not included)

  • Meals (can include):

    You can include the cost of special food in medical expenses only if:

    • The food doesn't satisfy normal nutritional needs,

    • The food alleviates or treats an illness, and

    • The need for the food is substantiated by a physician.

    The amount you can include in medical expenses is limited to the amount by which the cost of the special food exceeds the cost of a normal diet.

    Meals (cant include):

    You can't include the cost of diet food or beverages in medical expenses because the diet food and beverages substitute for what is normally consumed to satisfy nutritional needs.

  • Physical Training:

    You can include separate fees charged specifically for weight loss activities for example when it is a treatment for a specific disease diagnosed by a physician (such as obesity, hypertension, or heart disease)

  • Nutritional Supplements:

    Nutritional Supplements must be recommended by a medical practitioner as treatment for a specific medical condition diagnosed by a physician. They will not be covered when they are taken to maintain your ordinary good health and aren't for medical care.

  • Laboratory:

    You can include in medical expenses the amounts you pay for laboratory fees that are part of medical care.