Sunscreen, Therapy, Gym: What's Actually HSA Eligible in 2026

Expenses most people don't know are eligible

Sunscreen ✅

Any sunscreen with SPF 15 or higher is permanently eligible since the CARES Act. You don't need a prescription. Buy it at the drugstore, pay with your HSA card or reimburse yourself.

Mental health therapy ✅

Any session with a licensed therapist, psychologist, psychiatrist, or counselor is eligible. This includes teletherapy platforms like BetterHelp and Talkspace — as long as you're seeing a licensed provider for a mental health condition.

Acupuncture ✅

Eligible as long as it's for treatment of a medical condition, not general wellness. Most acupuncture visits qualify — your practitioner's documentation will support the claim if needed.

Fertility treatments ✅

IVF, egg freezing, sperm analysis, fertility medications, and embryo storage fees are all eligible. This is one of the most significant but least-known eligible categories — fertility treatments are extremely expensive and HSA reimbursement can save thousands.

Prescription weight-loss medications ✅

Wegovy, Ozempic, and similar GLP-1 medications prescribed for obesity are eligible as prescription medications. The cost can be thousands per month — HSA reimbursement is significant.

Service animals ✅

The cost of buying, training, and maintaining a service animal (for a medical condition) is eligible. This includes food, veterinary care, and grooming costs for the animal.

CPAP machines and supplies ✅

CPAP machines, masks, filters, humidifier chambers, and cleaning supplies are all eligible for diagnosed sleep apnea treatment.

Expenses that are eligible only with a Letter of Medical Necessity (LMN)

Some expenses are only eligible when a doctor certifies they're medically necessary:

• Gym membership: Only with an LMN stating exercise is necessary for a specific medical condition (obesity, heart disease, hypertension)
• Standing desk: With LMN for back condition
• Air purifier: With LMN for allergies or asthma
• Massage: With LMN for a specific medical condition
• Special diet food: Only the additional cost above regular food, with LMN

Expenses that are NOT eligible (despite sounding medical)

• Teeth whitening or bleaching (cosmetic)
• Cosmetic surgery (unless correcting a deformity or injury)
• Vitamins and supplements (unless prescribed for a specific deficiency)
• Gym membership without LMN
• Hair loss treatments (Rogaine is yes, transplants are no)
• Funeral or burial expenses
• Maternity clothes
• Toothpaste, mouthwash (general hygiene)