Mar 24, 2026

Beware of This Tax Mistake That Can Cost You Big Time

Written by John Csiszar
|
Edited by Gary Dudak
Discover Woman looking at taxes with a surprised look on her face as she sits in her kitchen

Every tax season, the IRS comes out with various warnings and reminders to taxpayers about how to avoid problems with their filings. Usually, this is in response to common mistakes that taxpayers actually make or scams/misinformation being propagated by unscrupulous or erroneous promoters.



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One of these warnings focuses on the reimbursement of general expenses for health and welfare. If you have a health savings account, a flexible spending account or other type of health reimbursement account, this could affect your tax filing. Here's what you need to know.

Accounts like HSAs and FSAs are a great way for Americans to get tax-advantaged reimbursement of qualifying medical expenses. HSAs, for example, provide a tax deduction on contributions, tax-free growth and tax-free distributions when used for appropriate expenses. The same is true for FSAs, although the tax benefit on contributions comes from direct salary deductions.

What the IRS is emphasizing, however, is that not all so-called "medical expenses" qualify for reimbursement. According to IRS commissioner Danny Werfel, "Legitimate medical expenses have an important place in the tax law that allows for reimbursements. But taxpayers should be careful to follow the rules amid some aggressive marketing that suggests personal expenditures on things like food for weight loss qualify for reimbursement when they don't qualify as medical expenses."

Essentially, the IRS is cracking down on personal expenses being reimbursed as qualifying medical expenses. Specifically, the IRS is responding to companies that are erroneously promoting various wellness, exercise and food for weight loss as being "medically necessary and reimbursable expenses," rather than the personal expenses that they really are.



According to a statement from the IRS, merely getting a doctor's note based on self-reported health information is not enough to convert non-medical expenses into qualified medical expenses.

If you take a distribution from an HSA and use it for a nonqualifying medical expense, you'll generally be responsible for ordinary income tax on that distribution, plus a 20% penalty. If you're 65 or older, you can avoid the penalty, but you'll still have to pay income tax. For an FSA, you're not supposed to be allowed to make such a purchase. However, if you do, you'll be responsible for paying that money back to the account.

There are literally hundreds of qualifying medical expenses for HSA and FSA reimbursement. Here's a quick overview, broken down by type of expense, along with a list of items specifically not eligible. If there is an asterisk next to the expense, that means that in certain circumstances it may not qualify for reimbursement.

  • Acupuncture

  • Ambulance

  • Artificial limbs

  • Artificial teeth*

  • Birth control treatment

  • Blood sugar test kits for diabetics

  • Breast pumps and lactation supplies

  • Chiropractor

  • Contact lenses and solutions*

  • Crutches

  • Dental treatments (including x-rays, cleanings, fillings, sealants, braces and tooth removals*)

  • Doctor's office visits and co-pays

  • Drug prescriptions

  • Eyeglasses (Rx and reading)*

  • Fluoride treatments*

  • Feminine hygiene products

  • Fertility enhancement (including in-vitro fertilization)

  • Flu shots

  • Guide dogs

  • Hearing aids and batteries

  • Infertility treatment

  • Inpatient treatment at a therapeutic center for alcoholism or drug addiction

  • Insulin

  • Laboratory fees

  • Laser eye surgery*

  • Medical alert bracelet

  • Medical records charges

  • Midwife

  • Occlusal guards to prevent teeth grinding

  • Orthodontics*

  • Orthotic Inserts (custom or off the shelf)

  • Over-the-counter medicines and drugs (see more information below)

  • Personal protective equipment (PPE) like masks and hand sanitizer

  • Physical therapy

  • Psychiatric care

  • Psychoanalysis

  • Psychologist

  • Special education expenses that include tutoring for a child with learning disabilities caused by mental impairments (recommended by doctor)

  • Speech therapy

  • Stop-smoking programs (including nicotine gum or patches, if prescribed)

  • Surgery, excluding cosmetic surgery

  • Vaccines

  • Vasectomy

  • Vision exam*

  • Walker, cane

  • Wheelchair



  • Acid controllers

  • Acne medicine

  • Aids for indigestion

  • Allergy and sinus medicine

  • Anti-diarrheal medicine

  • Baby rash ointment

  • Cold and flu medicine

  • Eye drops*

  • Feminine antifungal or anti-itch products

  • Hemorrhoid treatment

  • Laxatives or stool softeners

  • Lice treatments

  • Motion sickness medicines

  • Nasal sprays or drops

  • Ointments for cuts, burns or rashes

  • Pain relievers, such as aspirin or ibuprofen

  • Sleep aids

  • Stomach remedies

  • Weight-loss program only if it is a treatment for a specific disease diagnosed by a physician (e.g., obesity, hypertension, heart disease)

  • Compression hosiery/socks, anti embolism socks or hose

  • Massage treatment for specific ailment or diagnosis

  • CPR classes for adult or child

  • Improvements or special equipment added to a home or other capital expenditures for a physically handicapped person

  • Au pair services

  • Babysitting services

  • Before- and after-school programs

  • Custodial or eldercare expenses, in-home or daycare center (not medical care)

  • Nursery school

  • Pre-kindergarten

  • Summer day camp (not educational in nature)

Note: Clothing, food/meals, overnight camp and kindergarten and higher education/tuition expenses for dependents are not eligible.

  • Aromatherapy

  • Baby bottles and cups

  • Baby oil

  • Baby wipes

  • Breast enhancement

  • Cosmetics and skin care

  • Cotton swabs

  • Dental floss

  • Deodorants

  • Hair re-growth supplies and/or services

  • Health club membership dues

  • Humidifier

  • Lotion

  • Low-calorie foods

  • Mouthwash

  • Petroleum jelly

  • Shampoo and conditioner

  • Spa salts

As always, it is recommended to consult with a tax professional if you have any questions.

This article was provided by MoneyLion.com for informational purposes only and should not be construed as financial, legal or tax advice.

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Written by
John Csiszar
Gary Dudak
Edited by
Gary Dudak