You’ve got the high-deductible health plan. You’ve got the little plastic debit card in your wallet. But let’s be honest: most people just use their HSA for the occasional dentist visit or a box of overpriced Band-Aids. It’s kinda tragic because a Health Savings Account is basically a "get out of taxes free" card if you know where to look.
Most people think the list of what can HSA money be spent on is restricted to things that happen in a sterile doctor's office. Not true.
In 2026, the rules are more flexible than ever. Thanks to some major legislative shifts over the last few years—looking at you, CARES Act and the subsequent 2025-2026 IRS updates—the range of eligible items has exploded. We’re talking about everything from high-tech sleep trackers to the sunscreen you buy for your beach trip.
The "Pharmacy Aisle" Revolution
There was a time when you needed a literal doctor’s note just to buy a bottle of Advil with your HSA funds. That’s dead.
The current rules allow you to walk into any CVS or Walgreens and grab over-the-counter (OTC) meds without a prescription. This includes the basics like Tylenol and allergy meds, but it also covers things people often forget.
- Menstrual products: Tampons, pads, liners, and even those fancy period underwear brands. All fair game.
- Acne treatments: If it’s got active medicinal ingredients (like salicylic acid or benzoyl peroxide), your HSA covers it.
- Family planning: Condoms, pregnancy tests, and even morning-after pills are eligible.
It’s about more than just pills, though. Ever look at the price of high-quality sunscreen? If it’s SPF 15 or higher, you can use your tax-free dollars. Same goes for lip balm with SPF. Basically, if it prevents a medical condition—like, say, skin cancer—the IRS is usually cool with it.
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What Can HSA Money Be Spent On for Your Home?
This is where it gets interesting. Most folks don't realize their HSA can help furnish a healthier home environment.
Do you have chronic allergies? A doctor might suggest an air purifier. While you might need a Letter of Medical Necessity (LMN) for some big-ticket items, things like Neti pots or saline sprays are straightforward.
Modern Health Tech
In 2026, the line between "gadget" and "medical device" is blurring. You can now find HSA-eligible smart scales, blood pressure monitors that sync to your phone, and even certain wearables if they are primarily used to monitor a specific medical condition.
The Weird and Wonderful: Surprising Eligibility
I recently talked to a friend who was shocked to find out they could use their HSA for a doula. If you’re expecting, the costs of labor and delivery are obviously covered, but the support staff—including lactation consultants and even prenatal classes—often qualify too.
Then there’s the "travel" factor.
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If you have to drive a significant distance for a specialist, you can reimburse yourself for the gas (at the IRS medical mileage rate) or the bus/train fare. If you’re staying overnight for treatment, up to $50 per night for lodging can be covered. It’s not a five-star hotel budget, but it’s something.
Specialized Therapy
It’s not just "The Doctor." You can spend this money on:
- Acupuncture: Great for chronic pain.
- Chiropractic care: Your back will thank you.
- Psychotherapy: Mental health is health, period.
- Service animals: This includes the cost of buying, training, and even vet bills for a guide dog or other service animal.
The "After 65" Loophole
Here is the secret sauce that makes the HSA a "stealth IRA."
Once you hit 65, the 20% penalty for using HSA money on non-medical stuff just... vanishes. If you want to buy a boat with your HSA money at age 67, you can. You’ll just pay regular income tax on it, exactly like you would with a 401(k) or a Traditional IRA.
But if you use it for medical stuff? Still 100% tax-free. In 2026, you can even use it to pay for Medicare premiums (Parts B, D, and Medicare Advantage), though Medigap remains a no-go.
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The "Oops" List: What to Avoid
Don't get cocky. The IRS still has a "No" list that is surprisingly firm.
Toothpaste? No. Deodorant? No. Hair regrowth treatments like Rogaine? Usually no, unless it's for a specific disease. Most cosmetic surgery is a hard pass too. You can’t use your HSA for a facelift just because looking at your wrinkles makes you feel "unwell."
Also, keep your receipts. Seriously. The IRS doesn't actually see what you buy at the point of sale. You’re on the honor system until you get audited. Use an app to scan those receipts immediately so they don't fade into blank slips of paper in a shoebox.
2026 Limits and Logistics
For the 2026 tax year, the contribution limits have ticked up again to account for inflation. You can now squirrel away $4,400 for self-only coverage and $8,750 for a family. If you’re 55 or older, you get that extra $1,000 "catch-up" contribution.
If you have the cash flow, the best strategy is actually to not spend your HSA money. Pay for your Tylenol out of pocket, save the receipt, and let the HSA money stay invested in the S&P 500. Ten years later, you can "reimburse" yourself for that Tylenol and take the money out tax-free after it has doubled in value.
Actionable Next Steps
- Check your "Amazon HSA/FSA Shop": Most major retailers now have a dedicated section that only shows eligible items. It’s the easiest way to see what you can buy without guessing.
- Review your 2025 receipts: If you paid for a qualified expense out of pocket last year and didn't reimburse yourself, you can do it now. There is no deadline for reimbursement as long as the expense happened after you opened the account.
- Update your contributions: If you aren't hitting the 2026 max of $4,400 (individual) or $8,750 (family), log into your payroll portal and bump it up. It’s the only way to get a triple tax advantage in the US tax code.