Key takeaways: 

• Telehealth services are HSA eligible if they’re used to diagnose, treat, mitigate, or prevent a disease. 
• Conditions that can be treated through telehealth using HSA funds include common respiratory illnesses (cold, flu, COVID-19), skin conditions, and medication management. 
• You can pay for telehealth services with your HSA card or pay out of pocket and reimburse yourself from your HSA later. 

Seeing a healthcare provider in person can be helpful—especially if it’s someone you have a relationship with.  

But sometimes, getting to a doctor’s office can be a pain. You might have to drive a long way to get there, or you may not feel well enough to drive. Your provider might also be booked up, or you may worry about catching something from the waiting room (or getting other people sick). 

You can avoid all these issues with telehealth. Here’s how an online doctor visit works, which services are HSA eligible, and how to use your HSA for telehealth. 

What Is Telehealth? 

Telehealth, sometimes referred to as telemedicine, refers to seeing a healthcare provider virtually, instead of in person. Telehealth appointments can take place through a computer, tablet, or smartphone.  

You can talk to your telehealth provider through video, send them messages, and share information with them through an online portal, such as blood sugar readings.  

Telehealth has many benefits, including: 

• Allowing you to see a provider from anywhere 
• Avoiding long drives to a doctor’s office 
• Getting an appointment faster (though not always) 
• Giving you more provider options 
• Preventing potential illness from sitting in waiting rooms 

What’s more, virtual doctor visits may be cheaper than in-person visits. A 2026 study found that for common conditions such as COVID-19, respiratory symptoms, and anxiety, telehealth visits were billed on average $400 less than in-person visits, and resulted in fewer follow-up visits.  

Things to Keep in Mind 

Telehealth visits may be more effective with a provider you already know. That’s because they’re likely to be familiar with your medical history, which can help them rule out possible diagnoses and save you time and money. 

You should also double check that the telehealth provider takes your insurance. Not all platforms accept insurance and may charge you out of pocket for the full amount. 

Can I Use My HSA for Telehealth? 

Yes, telehealth is HSA eligible if the virtual visit is for the diagnosis, treatment, mitigation, or prevention of a disease.  

In addition, the One Big Beautiful Bill now allows people with high-deductible health plans to stay eligible for HSAs if they have telehealth coverage before they meet their deductible. The bill’s provision is retroactive to plan years beginning after December 31, 2024. It covers the gap that would have been created when the previous safe harbor provision expired at the end of 2024. 

What Kinds of Telehealth Services Are Covered? 

Conditions typically covered by an HSA include: 

• Visits for acute illnesses such as colds, the flu, or COVID-19 
• Mental health and substance abuse counseling (if the therapy is medically necessary) 
• Treatment of skin conditions 
• Follow-ups on lab tests and X-rays 
• Management of chronic conditions through at-home devices, such as blood pressure monitors and continuous glucose monitors 
• Medication management 
• Physical or occupational therapy 
• Weight loss medications 

Conditions and services that may require a letter of medical necessity to be treated through telehealth with your HSA include nutrition counseling and speech therapy. Telehealth platform fees aren’t eligible for HSA coverage. 

When Should I See a Provider In Person? 

Telehealth isn’t appropriate for every condition. Sometimes, you’ll need to come into an office or hospital—especially if you need to be examined. 

Conditions that may require in-person visits include: 

• Physicals exams, such as for gynecology 
• Biopsies 
• Joint pain 
• Abdominal pain 
• Eye or ear disorders 
• Steroid injections 

How Do I Use My HSA for Telehealth? 

Using your HSA for telehealth is similar to using it for other healthcare services. 

You can pay the provider directly with your HSA card or pay with another method and reimburse yourself from your account later. Just make sure you keep a record of the expense because you may need to submit it for reimbursement. The receipt or invoice should include the date of service, what the service was for, and how much it cost.  

To qualify for reimbursement, the telehealth visit must have taken place after you opened your HSA account. 

In Summary 

Using your HSA for an online doctor visit is a way to save time, see a provider from any location, and potentially save money.  

Many telehealth treatments and medical services qualify for HSA reimbursement. But you may need to see a provider in person for issues requiring exams or injections. 

Ready to get started? Explore HSA eligible telehealth services right here at HSA Store®. 

FAQs 

Can I use my HSA for a weight loss telehealth program? 

You can use your HSA for these programs if a doctor confirms that they will treat, mitigate, or prevent a medical condition. You will need an LMN to qualify for coverage.  

But receiving weight loss medications such as GLP-1s through telehealth platforms is an HSA eligible expense because they are prescriptions. 

Can I use my HSA for mental health therapy online? 

Yes, you can use your HSA to cover mental health therapy online. However, the therapy must be deemed medically necessary. In some circumstances, you may need an LMN for the service to qualify for reimbursement.  

Examples of medically necessary reasons for online mental health therapy include bipolar disorder, depression, and anxiety disorders.  

Couples therapy and marriage counseling are not HSA eligible. 

Do I need a letter of medical necessity for telehealth? 

It depends. If you’re seeing a provider for weight loss treatment, nutrition counseling, or treatment of chronic pain with saunas, cold plunges, gym equipment, or massages, you’ll likely need to get a letter of medical necessity (LMN). You must use the product or service to diagnose, treat, mitigate, or prevent a disease. 

These are just a few common examples of when you’d need a letter of medical necessity. Always check with your plan before you see a provider. 

References 

Andrews, M. (2023). Virtual or In Person: Which Kind of Doctor’s Visit Is Better, and When It Matters. KFF Health News. 

Fidelity. (2025). HSA reimbursement guide. 

Gordon, M. (2025). Is telehealth a good idea, or should I see my regular doctor? NPR. 

Telehealth.HHS.gov. (2025). Why use telehealth? 

Zhang, B., et al. (2026). Episode Charges and Subsequent Visits After Telemedicine vs In-Person Care. JAMA Network Open.