[USA] traction device with pre-tax money from HSA?

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pey ron

USA folks: if I wanted to finally get a traction device, could I pay with pre-tax money from the HSA? It might look weird especially if I buy it from abroad...

would it help if I ask my doctor for a written prescription to keep for my records in case I get audited?

thanks!
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JohnWright

pey ron:

Good on you for having an HSA!! Sweet! I LOVE my HSA.

I'll post this answer here to help other guys with the same question. The IRS is the only source of truth on Health Savings Accounts (HSA). The IRS makes the rules, and nobody else gets an opinion. Copy and pasted source quotes are in italics below.

a) IRS Pub 969 states:
Qualified medical expenses. Qualified medical expenses are those expenses that generally would qualify for the medical and dental expenses deduction. These are explained in Pub. 502, Medical and Dental Expenses.  (source:  See the section on "Distributions from an HSA" at https://www.irs.gov/publications/p969/ar02.html#en_US_2016_publink1000204081)

b) IRS Pub 502 then goes on to state:
What Are Medical Expenses?
Medical expenses are the costs of diagnosis, cure, mitigation, treatment, or prevention of disease, and the costs for treatments affecting any part or function of the body. These expenses include payments for legal medical services rendered by physicians, surgeons, dentists, and other medical practitioners. They include the costs of equipment, supplies, and diagnostic devices needed for these purposes.
 (source: https://www.irs.gov/pub/irs-pdf/p502.pdf)

Those excerpts are fairly easy to understand. Pub 502 goes on to list many specific expenses by name. But the list isn't exhaustive which is why one must read the two paragraphs above -- thoughtfully.

Pub 502 is updated for each tax year so HSA users will want to consult the guide for each new tax year.

Also, a reasonable tax payer would appreciate the wisdom in working with a doctor, specialist, or other licensed practitioner and probably seek prescriptions for devices, where possible, to further substantiate the validity of the expense -- in case of IRS audit. In the case of medicines and supplements, a written prescription is an absolute requirement in order for the expense to be HSA eligible (crack open the first link above to find this requirement).

For example, I am using the services of a licensed naturopathic MD to test and make adjustments to my testosterone level as part of my medical care. The adjustments include some supplements, herbs, etc. I had to educate him on the IRS's rules on HSAs. Now, he knows that I need written orders for everything that involves expense, knowing that I'm going to get reimbursed from my HSA.

Finally, the IRS doesn't care where you buy supplies from AS LONG AS the item in question is: 1) legal in the country where it originates, 2) legally obtained, and 3) is legal in the U.S.

Hope that helps.

John