What Costs Can Be Reimbursed by FSAs, HSAs, Archer MSAs, or HRAs?

The IRS posts FAQs to explain when costs can and cannot be reimbursed through health plans (https://www.irs.gov/individuals/frequently-asked-questions-about-medical-expenses-related-to-nutrition-wellness-and-general-health). For 2023, participants may contribute up to an annual maximum of $3,050, up from $2,850 for 2022. In addition, the maximum carryover limit from 2022 to 2023 is $570.

The following cost of the following can be reimbursed under a health savings account (HSA), health flexible spending account (FSA), Archer medical savings account (Archer MSA), or health reimbursement arrangement (HRA), subject to any stipulation noted:

• Dental exams, eye exams, and physical exams
• Programs to treat drug-related substance abuse disorder, alcohol use disorder, and for smoking cessation
• Nutritional counseling, weight loss program, and gym membership, but only if done to treat a specific disease diagnosed by a physician (e.g., obesity; diabetes; hypertension; heart disease)
• Food or beverages purchased for weight loss or other health reasons, but only if (1) the food or beverage doesn’t satisfy normal nutritional needs, (2) the food or beverage alleviates or treats an illness, and (3) the need for the food or beverage is substantiated by a physician. Note: The IRS recently ruled that infant formula for an infant with no known illness, purchased on a doctor’s recommendation without a prescription, is nondeductible food and not a deductible medical expense (Letter Ruling 202311001).
• Over-the-counter drugs and medicine
• Nutritional supplements, but only if recommended by a medical practitioner as treatment for a specific medical condition diagnosed by a physician