‍Our Experts

• Fran Scott, Director of Compliance, HealthEquity
• Jane Gachucha, CFE, Certified Fraud Examiner

So you’ve got an HSA (Health Savings Account) and you’ve been dutifully stashing pre-tax dollars in there. Maybe you’ve even bought some health and wellness products out of pocket, figuring you’d deal with it later. It's true that your HSA may be able to pay you back for those purchases, and the upside is that there's no deadline to do it.

"It is actually simpler than most people think, but the documentation part is where people get confused," says Jane Gachucha, CFE. The reimbursement process itself only takes a few minutes once you know the steps, and getting it right means you'll never stress about an audit or a rejected claim.

Here's exactly how to reimburse yourself from your HSA, what documentation you need, and a strategy that can help your money grow while you're at it.

Two Ways to Use Your HSA Funds

There are generally two ways to tap into your HSA for a qualified medical expense, according to Fran Scott, Director of Compliance at HealthEquity. You can either pay directly with your HSA debit card at checkout, or you can pay out of pocket and reimburse yourself later.

Using the debit card is more straightforward, because all you need to do is swipe and you're done. The reimbursement route takes a couple more steps, but it comes with a pretty decent perk we’ll get to in a minute.

How to Reimburse Yourself: Step by Step

Here’s how it works:

1. Pay for the expense out of pocket. This can be a doctor visit, a prescription, a recovery tool, or any other qualified medical expense. For a full list of what qualifies, check IRS Publication 502. And if you’re eyeing something that doesn’t automatically qualify, like certain fitness equipment or supplements, you may be able to make it work with a Letter of Medical Necessity (LMN) from your doctor.
   
   
2. Keep your receipt and documentation. This is the step that trips people up. A credit card statement alone is not enough. You need an itemized receipt showing the date, the provider or merchant, the product or service, and the amount you paid.
   
   
3. Log into your HSA account and submit a reimbursement request. Most HSA providers make this pretty painless. You can just enter the expense details, upload your receipt, and select how you want the funds deposited.
   
   
4. Receive your funds. "Link your personal bank account directly to your HSA account," says Gachucha. "I use HealthEquity and once I uploaded my receipt, I received my reimbursement within a few days. It is that fast when your documentation is ready."

A Strategy for Making Your HSA Work For You

Garucha shared a nifty little strategy you may want to consider to make the most of your HSA funds. The IRS doesn’t set a deadline for HSA reimbursements, which means you can pay out of pocket today, let your HSA balance keep growing tax-free, and reimburse yourself months or even years later.

"That is one of the most powerful strategies, because your HSA balance keeps compounding while your money works for you," says Gachucha. She paid for a $1,000 dental procedure out of pocket and reimbursed herself a full year later, while her HSA funds stayed invested and growing in the meantime.

Scott agrees, adding that this approach works especially well for people who are "intentionally using their HSA as a long-term savings vehicle."

And speaking of investing, only about 10% of HSA accounts actually hold investments, according to the Devenir 2025 Midyear HSA Research Report. Most people leave their HSA money sitting in cash, and if you’re one of them, you may be missing out on some significant tax-free growth. Depending on your provider, you can invest in mutual funds, ETFs, or individual stocks through your HSA.

Keep Your Receipts (Seriously)

Both of our experts were very clear that documentation is everything, so keep those receipts. "If you ever get audited, the IRS is not going to take your word for it. They want the paper trail," says Gachucha. "One thing I always tell people from my audit experience: save everything digitally. A ‘shoebox’ of receipts is not a documentation system."

Scott recommends keeping records that show the date, provider or merchant, product or service, and the amount paid. "Most HSA providers let you upload and store them directly in your account," she says.

If you’re purchasing something that requires a Letter of Medical Necessity (like a fitness device or supplement tied to a diagnosed condition), get the LMN before you buy. Scott is clear that an LMN can’t work retroactively, and LMNs are typically valid for up to 12 months, so you’ll need to renew annually for ongoing purchases. For more on how LMNs work, check out our full guide.

A Quick Note If You Have an FSA

FSA reimbursement works similarly, but there’s one big difference. FSAs are employer owned accounts that typically follow a use it or lose it rule, so you can't reimburse yourself years later. Some employers offer a small rollover (up to $680) or a short grace period, but there's far less flexibility that there is with an HSA. If you want to know more about the differences between HSAs and FSAs, we’ve got you covered.

"I have even received reminders from my own FSA administrator to use the funds by a certain date or lose them," says Gachucha. If you’re working with an FSA, plan to submit reimbursements within the plan year.

Put Your HSA to Work

Reimbursing yourself for your health purchases is the same process as it is for a doctor's visit. Pay, save your receipt, and submit when you’re ready. For some supplements and fitness equipment, you'll need a Letter of Medical Necessity, but otherwise, it's fairly straightforward. Head over to the Stridekick HSA/FSA Shop to explore eligible products and find ways to make your pre-tax health dollars work harder.