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We have driven an elderly relative to her medical visits, because she cannot drive herself, and needs help communicating with medical staff. She is not our dependent, however.

We have a Health Savings Account. Are the mileage costs ($0.16 per mile in 2021 per IRS) for these trips reimburseable from the HSA?

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Transportation costs (mileage) is something that is a qualified medical expense for the HSA. However, your HSA can only be used to pay for the medical expenses of certain people. According to IRS Publication 969,

Qualified medical expenses are those incurred by the following persons.

  1. You and your spouse.

  2. All dependents you claim on your tax return.

  3. Any person you could have claimed as a dependent on your return except that:

     a. The person filed a joint return;

     b. The person had gross income of $4,300 or more; or

     c. You, or your spouse if filing jointly, could be claimed as a dependent on someone else’s 2020 return.

You mentioned that your elderly relative is not your dependent, so the answer to your question is probably no, you cannot take an HSA distribution for these miles, unless your elderly relative meets the criteria in point #3 above.

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  • can you help me understand #3? this relative could qualify as a dependent (family member in the "qualifying relative" category), except that we do not provide any of her financial support, and she did have gross income of more than $4300.... she filed a single return (no on "a"), had gross income of more than $4,300 (yes on "b"), and no on "c". Does the not providing financial support mean we can't use HSA to reimburse our mileage for her visits? – Jason S Apr 14 at 5:17
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    @JasonS Yes, unfortunately, the fact that you do not provide any of her financial support means that you cannot use HSA money to reimburse yourself for this mileage. In order to claim someone as a dependent, there are several requirements that all must be met. #3 above means that if you fail the dependent test due to only these three requirements, you can still use the HSA to pay for that person’s expenses. However, the support test, which says that you have to provide for at least half of the dependent’s total financial support, is not one of the requirements that is waived here. – Ben Miller - Remember Monica Apr 14 at 6:20
  • @JasonS The alternative, I suppose, is that your relative could pay you the 16 cents per mile. That would then be a medical expense for her, which she could possibly deduct from her taxes or take as a distribution from her HSA (if she has one). – Ben Miller - Remember Monica Apr 14 at 18:52
  • yeah, that occurred to me, but she doesn't have HSA + takes the standard deductible anyway; medical expenses need to be a pretty big percentage (7%?) to itemize at all. And it just seems petty to ask her to pay 16c/mile. – Jason S Apr 14 at 21:04

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