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I am about to go on safaris in South Africa and Zambia and need to be vaccinated against a few diseases.

The IRS publication 502 doesn't mention vaccinations explicitly, but does state that

Medical care expenses must be primarily to alleviate or prevent a physical or mental defect or illness.

So I'm assuming that is a "yes", however I'd like to know if anyone knows for sure or has already used an HSA for that purpose. Thanks.

  • 1
    You can technically 'use' it for shopping at Walmart, nobody cares. I assume you mean will the IRS accept it at the end as 'qualified expense'. – Aganju Jul 15 '16 at 23:40
  • Yes, of course. – Hill Jul 16 '16 at 5:05
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Yes, copays and costs associated with vaccinations are qualified medical expenses under HSA guidelines. Receiving a vaccine is a service, not a prescription drug. You don't take the vaccine home with you.

You can include in medical expenses amounts you pay for prescribed medicines and drugs. A prescribed drug is one that requires a prescription by a doctor for its use by an individual.

IRS Publication 502

Additionally, the ACA mandated that certain preventive care services be made available at zero cost. Here's a list of the ACA Mandated preventive care benefits related to immunization:

  • Immunization vaccines
    • Diphtheria
    • Hepatitis A
    • Hepatitis B
    • Herpes Zoster
    • Human Papillomavirus (HPV)
    • Influenza (flu shot)
    • Measles
    • Meningococcal
    • Mumps
    • Pertussis
    • Pneumococcal
    • Rubella
    • Tetanus
    • Varicella (Chickenpox)

Carriers are free to add to this list, but these are the minimums required. The rest of the list can be seen here.

When you make your appointment, be clear that you're making a preventive care appointment for XYZ.

  • Are you sure about that? I've seen conflicting information on this subject, such as here. – Ben Miller - Reinstate Monica Jul 16 '16 at 0:53
  • @BenMiller Yes, I'm sure. Before the ACA changed the rules you could buy things like Tylenol with HSA funds, now you need a prescription for Tylenol in order to use HSA funds. A flu shot is different in that you don't administer your own flu shot, you pay a fee to have a flu shot administered. The fee you pay is a medical expense that's eligible under HSA guidelines. When in doubt, talk to your HSA bank. – quid Jul 16 '16 at 1:10
  • You might be right, but I've seen articles that say both things, and the IRS is vague about it. And banks are not necessarily the authority on what is allowed. In practice, of course, IRS audits are relatively rare. – Ben Miller - Reinstate Monica Jul 16 '16 at 1:16
  • In most cases immunizations administered at your doctor's office are covered under your ACA mandated preventive care benefit anyway; so if costs are a concern you should schedule it that way. – quid Jul 16 '16 at 1:18
  • @BenMiller The Intuit site you linked to says they're not deductible, not that you can't use your HSA account. Multiple insurance company do say that you can use your HSA account to pay for a vaccination. – mkennedy Jul 16 '16 at 14:38
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I've seen some conflicting information on this, but here is my understanding.

Vaccinations are considered medicines by the IRS. Here is what IRS Pub 501 has to say about medicines:

Medicines

You can include in medical expenses amounts you pay for prescribed medicines and drugs. A prescribed drug is one that requires a prescription by a doctor for its use by an individual. You can also include amounts you pay for insulin. Except for insulin, you can't include in medical expenses amounts you pay for a drug that isn't prescribed.

In order for medicines to be deductible (and eligible for HSA medical expenses), it needs to be prescribed by a doctor. If you are getting the vaccination from your doctor's office, it should be eligible for the HSA. If you are walking into the pharmacy without a prescription and getting a vaccination (as is commonly done for a flu shot, for example), it is not eligible for the HSA.

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