HRA eligible expense tool

A complete list of expenses eligible for reimbursement with an HRA. Use our interactive table to quickly filter through HRA eligible expenses from IRS Publication 502 and the CARES Act.

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Expenses eligible for reimbursement with an HRA

A health reimbursement arrangement (HRA) allows employers to reimburse employees for various medical expenses listed in IRS Publication 502, which includes more than 200 eligible expenses. The type of HRA you have determines the eligibility of expenses.

For example, if you have a qualified small employer HRA (QSEHRA) or an individual coverage HRA (ICHRA), your organization can reimburse you for your individual health insurance premiums. But if you have an integrated HRA, also known as a group coverage HRA (GCHRA), your health plan premiums aren’t eligible for reimbursement. However, you may submit your copayments, coinsurance, and deductible amounts for reimbursement.

While the IRS initially prohibited employers from reimbursing employees tax-free for some medical items, the CARES Act expanded eligible items to include over-the-counter medicines without a prescription and menstrual care products in 2020.

With an HRA, you can purchase the expenses that make sense for you and your family’s health. Check out our interactive list below to see what medical services and items are eligible for reimbursement to get the most out of your health benefit.

PeopleKeep makes launching and managing an HRA more accessible and intuitive for employers by automating the most time-consuming tasks and providing award-winning customer support to employees.

HRA expense eligibility guide

The items on this list are subject to change based on changes in federal regulations. Employers can further limit which expenses they can reimburse employees for.

: Items that are eligible for reimbursement
RX : Items that are eligible with a prescription from your doctor
NOTE : Items that are eligible with a note from your doctor
X : Items that aren't eligible for reimbursement

Expense

Eligible

HSA Compatible

Tags
Acid controllers X  
Acne medicines and treatments X Over-the-counter, medications, over the counter, OTC
Acupuncture X Alternative
Adoption (associated medical expenses) X  
Adoption fees X X  
Alcoholism treatment X therapy, rehabilitation, alcoholics
Allergy and sinus medicine and products X Over-the-counter, medications, over the counter, OTC, pills
Alternative dietary supplements NOTE X  
Alternative healers NOTE NOTE  
Ambulance and emergency health services X transportation
Anesthesia for dental treatments surgery, operation
Anesthesia for medical treatments X surgery, operation
Anesthesia for vision treatments surgery, operation
Antacid X Over-the-counter, medications, over the counter, OTC, Pharmacy, Prescription
Antibiotic ointment X Over-the-counter, medications, over the counter, OTC, Pharmacy, Prescription
Artificial limb X Prosthetics
Anti-diarrheal medicine X Over-the-counter
Anti-itch products X Itch, over-the-counter
Aspirin or other pain reliever X Over-the-counter, medications, over the counter, OTC, pills
Asthma medicines or treatments (over-the-counter) X contraceptive, contraception
Baby bottles X X  
Baby oil X X  
Baby rash ointment X  
Bandages and related items X  
Birth control (over-the-counter) X contraceptive, contraception,
Blood pressure monitor X  
Body scans X hospital, doctor, x-ray
Braille books and magazines (additional amount only) vision
Breast enhancement X X  
Breastfeeding classes X Maternity, lactation, breastfeeding, nursing
Breast pumps & accessories X Maternity, lactation, breastfeeding, nursing
Breast reconstruction surgery (following mastectomy) NOTE X operation
Cancer insurance premiums (Premiums are only reimbursable with a QSEHRA or ICHRA, not a GCHRA) X X accident, sickness, illness, lump-sum, lump sum, indemnity
Canker and cold sore treatments (over-the-counter) X Over-the-counter, medications, over the counter, OTC, medicine
Car modifications NOTE X Transport, Transportation, wheelchair, handicap, disability
Childbirth classes (charges for mother only) X Maternity, lamaze
Child or newborn care instruction X X Maternity
Chiropractic care X Chiropractor
Cholesterol test kits and supplies X  
Christian Science practitioners X  
COBRA premiums (COBRA premiums are only reimbursable with a QSEHRA, not an ICHRA or a GCHRA) Insurance, policy, MEC
Cold and flu medicine X Over-the-counter, medications, over the counter, OTC, medicine
Compression or anti-embolism socks, stockings, or hose NOTE X  
Concierge medical fees for future services X X  
Concierge medical fees for services received X  
Contact lenses and solutions Vision, eye, glasses
Contraceptives X Over-the-counter, medications, over the counter, OTC, prescription
Cord blood storage NOTE X  
Cord blood storage (for unidentified future use) X X  
Corn and callus remover X Over-the-counter, medications, over the counter, OTC, prescription
Corneal keratotomy Vision, eye, myopia, nearsightedness
Cosmetic procedures for birth defects or injury NOTE X reconstructive, operation, surgery
Cosmetic procedures or surgery X X  
Cost of meals while attending medical conferences X X  
Cotton swabs X X  
Cough drops and sore throat lozenges X Over-the-counter, medications, over the counter, OTC,
Cough syrup X Over-the-counter, medications, over the counter, OTC, prescription
Counseling (marriage) X X therapy
CPR classes X X education
Dancing lessons X X  
Dental and oral pain products (over-the-counter) tooth
Dental care (non-cosmetic) Dentist, teeth, tooth, copay, co-pay, dentist, xrays, x-rays
Dental insurance premiums (Premiums are only reimbursable with a QSEHRA or ICHRA, not a GCHRA) policy
Dental products for general health X X teeth, tooth
Dental surgery surgery, teeth, dentist, implants
Dental veneers NOTE NOTE Dentist, teeth, tooth
Dentures, bridges, etc. Dentist, Dental, teeth, tooth
Dependent care expenses (medical) X  
Dermatologist X skin
Dermatology products NOTE X skin care
Diabetic monitors and supplies X diabetes
Diaper rash creams (over-the-counter) X newborn, pediatric, ointment
Diapers and diaper services X X newborn, pediatric
Dietary supplements NOTE X  
Dietitian/nutrition services NOTE X  
Doctor-supervised weight loss program, such as for hypertension or heart disease NOTE X Obesity
Doctor visits (medical) X health, doctor, co-pay, copay
Doula or birthing coach NOTE X Maternity
Drug addiction treatment X therapy, rehab, rehabilitation
Drugs imported and FDA-approved X prescriptions, RX
Drugs imported and not FDA-approved X X prescriptions, RX
Drugs purchased and consumed in another country that are legal in that country and the U.S. X prescriptions, RX
Drugs and medicines (over-the-counter drugs) X prescriptions, rx, Over-the-counter, medications, over the counter, OTC, pills
Dyslexia treatment NOTE X therapy, rehab, rehabilitation, mental health
Ear drops and wax removal (over-the-counter) X Over-the-counter, medications, over the counter, OTC
Electrolysis X X cosmetic
Exercise equipment NOTE X weight loss, weight-loss, obesity
Eye drops and treatments Over-the-counter, medications, over the counter, OTC, vision
Eye examinations Vision, office visit
Eyeglasses (prescription) Vision, glasses, contacts
Eye-related equipment/materials Vision
Eye surgery or treatment Vision, operation
Facelifts X X Cosmetic
Face masks for COVID-19 protection For COVID-19 
Feminine hygiene products (see menstrual care products below)  
Fertility monitor X pregnancy
Fertility treatment X  
Fiber supplements X  
First aid kits X bandages, bandaids
Fitness programs NOTE X wellness, obesity, weight loss, weight-loss, exercise
Fluoride treatments Dental, Teeth, Dentist
Flu shots Preventive, vaccine, immunization
Foam rollers (for pain relief) X  
Funeral expenses X X  
Guide dog (dog, training, care) Vision
Hair regrowth products X X Cosmetic
Hair removal X X Cosmetic
Hair transplant X X Cosmetic
Hair treatments X X Cosmetic
Hand lotion X X Over-the-counter, medications, over the counter, OTC
Hand sanitizer and sanitizing wipes for COVID-19 protection For COVID-19 protection
Health club dues NOTE X wellness, obesity, weight loss, weight-loss, gym
Health insurance premiums (Premiums are only reimbursable with a QSEHRA or ICHRA, not a GCHRA) policy, medical insurance, MEC
Health savings account (HSA) contributions X X  
Hearing aids and batteries X  
Herbal or homeopathic medicines NOTE X over-the-counter
Home modifications NOTE X wheelchair ramp, lift, inclinator
Hospital insurance premiums (Premiums are only reimbursable with a QSEHRA or ICHRA, not a GCHRA) X X indemnity, lump-sum, lump sum
Hospital services and fees X ER, emergency room
Household help X X  
Humidifier, air filter and supplies NOTE X allergy, allergies, cold, asthma
Immunizations Vaccines, preventive, wellness
Incontinence supplies X diapers, adult diapers
Infertility treatment X fertility
Insulin, testing materials and supplies X Diabetes
In vitro fertilization X fertility
Laboratory fees X Lab, tests
Lactation items and devices (for convenience) X X bra, bras, tank top, maternity, breastfeeding, nursing
Lactose intolerance medication X Over-the-counter, medications, over the counter, OTC, pills
Lamaze classes (charges for mother only) X Maternity, childbirth, pregnancy
Laser / LASIK eye surgery Vision
Late payment fees X X  
Laxatives/stool softeners X Over-the-counter, medications, over the counter, OTC, pills
Learning disability treatments X therapy
LED light therapy treatments X therapy
Lice treatment (over-the-counter) X Over-the-counter, medications, over the counter, OTC
Listening therapy X hearing
Lodging for dental or vision care hotel, motel, room
Lodging for medical care X hotel, motel, room
Long-term care premiums (Premiums are only reimbursable with a QSEHRA or ICHRA, not a GCHRA) policy, insurance
Long-term care services X X  
Magnetic therapy NOTE X Alternative, Over-the-counter, medications, over the counter, OTC
Massage therapy NOTE X Alternative
Mastectomy-related special bras X breast, reconstructive
Maternity clothes X X  
Meals at a hospital or similar institution (if the principal reason for being there is to receive medical care) X  
Medicaid/CHIP insurance premiums (Premiums are only reimbursable with a QSEHRA or ICHRA, not a GCHRA) policy, MEC
Medical abortion X  
Medical diagnostic services X  
Medical equipment and repairs X  
Medical literature, books, pamphlets, or audio X X Education
Medical monitoring and testing devices X  
Medical operations X surgery
Medical records charges X  
Medical X-ray fees X Hospital, Doctor, x-rays, xrays
Medicare Part A, Part B insurance premiums (Premiums are only reimbursable with a QSEHRA or ICHRA, not a GCHRA) policy, MEC
Medicare supplement insurance premiums (Premiums are only reimbursable with a QSEHRA or ICHRA, not a GCHRA) policy, MEC
Menstrual care products (tampons, pads, liners, cups, sponges, and other similar products) Tampons, pads, liners, cups, sponges, and other  products    
Mental health counseling X therapy
Midwife X Maternity, childbirth
Modified equipment (extra cost only) NOTE X capital expense, improvement
Monitors and test kits X Over the counter, Over-the-counter, OTC
Motion sickness medication X Over the counter, Over-the-counter, OTC
Multiplan insurance premiums (Premiums are only reimbursable with a QSEHRA or ICHRA, not a GCHRA) policy, health, vision, prescription, dental, medical, MEC
Nasal sprays X RX, Over the counter, Over-the-counter, OTC, medication, nose, prescription
Nasal strips X RX, Over the counter, Over-the-counter, OTC, medication, nose, prescription
Norplant insertion or removal X birth control, contraceptive
Nursing services (wages and taxes) X Nurse
Nutritional supplements NOTE X Over the counter, Over-the-counter, OTC, medication, vitamins
OB/GYN fees X Doctor, Hospital, Childbirth, Maternity, wellness
Occlusal guards to prevent teeth grinding Dental, Dentist
Occupational therapy (for medical / disability) X rehabilitation, rehab
Optometrist or ophthalmologist fees Vision, eye, office visit
Organ transplants (recipient and donor) X Hospital
Orthodontia (braces and retainers) Dental, Dentist, teeth
Ortho keratotomy Vision
Orthopedic and surgical supports X equipment, braces
Orthopedic shoes and inserts NOTE X  
Orthotics X  
Ovulation monitor X Fertility, Maternity, Pregnancy
Oxygen X CO2
Physical exams Wellness, Preventive
Physical therapy X rehabilitation
Physical therapy supplies X  
Physician retainer fee X X  
Pregnancy tests X Maternity, pregnancy, fertility, childbirth
Premium tax credits (the portion of insurance premiums that tax credits cover) X X  
Prescription drugs X Rx, medicine, pharmacy, script, copay, co-pay
Prescribed drugs for cosmetic purposes X X  
Prescription insurance premiums (Premiums are only reimbursable with a QSEHRA or ICHRA, not a GCHRA) policy
Psychiatric / therapy X counseling, mental health
Radial keratotomy vision, cornea, surgery, operation, RK
Reading glasses Vision, eye
Short-term medical insurance premiums (Premiums are only reimbursable with a QSEHRA or ICHRA, not a GCHRA) Insurance
Sleep aids and sedatives (over-the-counter) X RX, Over the counter, Over-the-counter, OTC, medication, pills
Smoking cessation (programs/counseling) X therapy, rehab
Smoking cessation drugs, nicotine gum, or patches X RX, Over the counter, Over-the-counter, OTC, medication, prescriptions
Special equipment NOTE X  
Special foods NOTE X diet, dietary
Special school (for mental and physical disabilities) NOTE X Education
Speech therapy X  
Spermicidals X Contraceptive, contraception, birth control
Splints, supports, and braces X  
Sterilization X Contraceptive, contraception, birth control
Stomach remedies/aids for indigestion X Over-the-counter, OTC, medication
Sunglasses (prescription) Vision
Sunscreen / sunblock and creams with SPF 15+ X Over the counter, Over-the-counter, OTC, medication
Sunscreen / sunblock with SPF <15 or suntan lotion X X Cosmetic, OTC, Over the counter, Over-the-counter
Surgery (non-cosmetic) X  
Swimming lessons (for therapy) NOTE X therapy, rehabilitation
Swimming lessons (for general health) X X  
Take-home urinary tract infection test X OTC, Pharmacy
Teeth bleaching or whitening X X Cosmetic, Dental
Toothpaste, medicated (difference in cost only) RX RX Dental
Toothpaste, toothbrush, floss, etc. X X Personal Use
Transgender treatments/surgery NOTE X  
Transportation and parking (to dental or vision care) miles, mileage, travel
Transportation and parking (to eligible medical care) X miles, mileage, travel
TRICARE insurance premiums (Premiums are only reimbursable with a QSEHRA or ICHRA, not a GCHRA) policy, MEC
Tubal ligation X  
Tuition or educational classes NOTE X  
Urological products X catheters
UV protection clothing X X Personal Use Item
Vaccinations Preventive, Wellness, flu, shots
Varicose vein removal surgery (for medical care) X Surgery, Operation
Vasectomy X Infertility, surgery, operation, hospital, birth control
Vision care Eye, optomologist, co-pay, copay
Vision insurance premiums (Premiums are only reimbursable with a QSEHRA or ICHRA, not a GCHRA) policy, eye, plan
Vision operations eye, surgery
Vision products Eye
Vitamins RX X Rx, prescription
Vitamins (for general health) X X  
Walking aids (canes, walkers, crutches) X Durable Medical equipment
Wart removal treatments X Over the counter, Over-the-counter, OTC, medication
Weight loss drugs RX X Obesity, Rx, prescription
Weight loss foods X X  
Weight loss program (for general health) X X  
Wheelchair and repairs X  
Wound care X Over the counter, Over-the-counter, OTC, medication, bandaids, bandages, wraps

Both employers and employees need to become familiar with the IRS list of eligible expenses for HRAs. This understanding allows employees to make informed choices about their medical expenses while employers can ensure they comply with IRS regulations.

HRAs provide a valuable benefit to employees by reimbursing them for certain medical costs. By following the IRS guidelines and staying up-to-date with any changes in regulations, both employers and employees can maximize the benefits of these arrangements.

What is IRS Publication 502?

IRS Publication 502 is a document that lists which medical and dependent care items employees can claim as a deduction on Schedule A of Form 1040, also known as the Federal Income Tax Return. This document is especially important for organizations that offer personalized health benefits as it lists eligible expenses for HRAs, health savings accounts (HSAs), and flexible spending accounts (FSAs).

How PeopleKeep can help

When your organization offers an HRA through PeopleKeep, our team of experts reviews employee reimbursement requests for compliance. If it’s a qualified expense, we notify employers so they can reimburse their employees. If not, we’ll notify employees of any issues, such as a missing doctor’s note.

You can administer three types of HRAs with our software:

LEARN MORE

Guide to health reimbursement arrangements (HRAs)

GUIDE

Get our HRA compliance toolkit

This toolkit offers quick reference material to help you with HRA compliance.