Can you pay for blood glucose testing supplies with an HSA?

If you have a high-deductible health plan (HDHP) with a health savings account (HSA), you may be wondering whether you can use your pre-tax HSA funds to pay for blood glucose testing supplies.

HSA eligibility is not based on brand names or marketing claims. Instead, the IRS looks at whether an expense is primarily for medical care—meaning it is used to diagnose, treat, mitigate, or prevent a disease—and whether you can support that use with documentation if required.

Here's the clear answer:

You can typically pay directly with your HSA card or reimburse yourself after paying out of pocket. Be sure to keep an itemized receipt with your tax records in case your HSA administrator requests documentation.

How eligibility is determined

HSA eligibility is based on whether an expense is for qualified medical care under federal tax rules, not whether an item is "healthy," "recommended," or good for you."

The IRS does not determine eligibility based on how an item is marketed or whether it is commonly associated with health or fitness. What matters is the primary purpose of the expense and whether it qualifies as medical care under federal tax rules.

A simple way to think about it:

• Clearly eligible: primarily medical in nature and not mainly for general health or appearance.
• Clearly not eligible: general wellness, convenience, cosmetic, or personal expenses without a medical purpose.
• Conditional: may qualify with a diagnosed condition and documentation (often an LMN) showing medical necessity.

What to save for your records

• Itemized receipt (date, vendor, amount, and what was purchased).
• Proof of payment (card record or invoice).
• Medical documentation when relevant (provider note, diagnosis/treatment plan).
• LMN when needed for conditional expenses.

Common reasons HSA claims get denied

• The expense is primarily for general wellness, convenience, or personal use.
• No medical diagnosis or treatment plan supports the expense.
• A Letter of Medical Necessity is missing or incomplete when required.
• The receipt does not clearly show what was purchased.
• The expense occurred before the HSA was established.

Learn more about HSA rules

• What makes an expense HSA eligible?
• What is a Letter of Medical Necessity (LMN)?
• What happens if you use your HSA incorrectly?
• Common expenses that are not HSA eligible

Explore HSA eligibility for other products and services

HSA fast facts

• Health savings accounts (HSAs) are only available to individuals who are eligible and covered by a qualifying high-deductible health plan (HDHP).
• HSA funds can be used at any time, but withdrawals are only tax-free when used for qualified medical expenses under IRS rules.
• Using HSA funds for non-qualified expenses generally triggers income tax, and if you are under age 65, an additional 20% penalty typically applies.
• Over-the-counter medications and menstrual care products are HSA-eligible without a prescription, following changes made by the CARES Act.
• You can pay for eligible expenses with your HSA card or reimburse yourself later, as long as the expense occurred after your HSA was established.
• You generally cannot contribute to an HSA once you are enrolled in Medicare, though you can continue to use existing HSA funds.

Sources

• IRS Publication 502
• IRS Publication 969
• H.R. 748 (CARES Act)

Disclaimer

This page is for educational purposes only and is not tax or legal advice. Check with your HSA administrator or a qualified tax or legal professional if you have questions about your specific situation.