Nutritional Supplements: HSA Eligibility

What does IRS Publication 502 say about supplements? 

IRS Publication 502 states that you cannot claim nutritional supplements, vitamins, herbal supplements, or natural medicines as deductible medical expenses on your taxes unless a healthcare provider recommends them to diagnose, treat, or prevent a diagnosed medical condition.  

Essentially, that means these products aren’t HSA eligible without a medical professional’s recommendation.  

Which supplements are HSA eligible without a Letter of Medical Necessity? 

Nutritional supplements generally aren’t HSA eligible without a Letter of Medical Necessity (LMN). However, a few supplements qualify without an LMN. 

Prenatal vitamins 

Prenatal vitamins are used to prevent birth defects and are eligible without an LMN.  

Glucosamine 

Glucosamine is used to treat joint pain issues and is HSA eligible without an LMN. 

Fiber laxatives 

Fiber laxatives are used to treat constipation and are HSA eligible without an LMN.  

Fiber isn’t eligible when used for general health. 

When do you need a Letter of Medical Necessity for supplements? 

Nutritional supplements need a Letter of Medical Necessity (LMN) if you’re trying to use them to diagnose, treat, or prevent a medical condition with pre-tax funds from your health savings account.  

Supplements can be used for general health or to treat a medical condition (dual use). The LMN clarifies that you’re using them for medical purposes.  

How do I get a Letter of Medical Necessity for supplements? 

You can speak to a licensed healthcare provider about a Letter of Medical Necessity at an online or in-person appointment.  

An LMN for nutritional supplements should include:  

• Your name, date of birth, address, and contact information  

• The healthcare provider's name, credentials, and contact information 

• The date  

• Information on your medical condition, including the diagnosis, medical history, and duration of the condition 

• Why the supplement is medically necessary for your health 

• How long the treatment will last 

• The provider’s signature 

Does the supplement brand matter for HSA eligibility? 

No, brand doesn’t matter for HSA eligibility. The more important issue is having a Letter of Medical Necessity from a healthcare provider showing that you will use the supplement to treat a diagnosed medical condition. 

Are iron, magnesium, and probiotics HSA eligible? 

Iron, magnesium, and probiotics aren’t HSA eligible unless a healthcare provider determines that they’re medically necessary to treat a medical condition. You’ll need an LMN to pay for them with your HSA. 

Are protein powders and shakes HSA eligible? 

Protein products generally aren’t HSA eligible because they satisfy normal nutrition requirements. They don’t treat a medical condition. 

Can I use FSA or HRA funds for supplements? 

Yes, and the requirements are the same as with a health savings account. You can use FSA or HSA funds to pay for supplements if you get an LMN from a healthcare provider saying the supplements will be used to treat a diagnosed medical condition.  

FAQs 

Is melatonin HSA eligible?  

Yes, melatonin may be eligible with an LMN. It can be used to treat sleep disorders such as insomnia. 
 

Is fish oil HSA eligible? 

 
Yes, fish oil may be eligible with an LMN because it can be used to treat inflammatory conditions such as joint pain.  
 

Are electrolytes HSA eligible?  

Yes, electrolyte products are eligible without an LMN. They treat electrolyte imbalances in the body caused by dehydration, which can cause dizziness, cramping, joint pain, and heart palpitations.  

References 

Internal Revenue Service. (2024). Publication 502 (2024), Medical and Dental Expenses. 

Reviewed by the Health-E Commerce Compliance Team