Can I use HSA to pay for vitamins and supplements? Navigating IRS Rules

December 3, 2025 •

3 min read

According to IRS guidelines, expenses that are merely beneficial to general health, such as most vitamins, are not considered qualified medical expenses. Navigating these rules is crucial to understand if you can use your HSA to pay for vitamins and supplements legally and without penalty.

Quick Summary

This guide explains the specific conditions under which vitamins and supplements can be paid for with HSA funds, outlining the necessity of a doctor's recommendation and proper documentation.

Key Points

Medical Necessity is Key: Vitamins and supplements are only HSA-eligible if used to treat a specific medical condition, not for general wellness.
Letter of Medical Necessity (LMN): A formal letter from a healthcare provider is required to prove a vitamin or supplement is medically necessary.
Prenatal Exception: Prenatal vitamins are an exception and are typically HSA-eligible without an LMN due to their role in preventative care during pregnancy.
Required Documentation: Proper record-keeping, including the LMN (if applicable) and purchase receipts, is essential for proving eligibility in an audit.
CARES Act Clarification: The CARES Act change for over-the-counter items does not apply to general vitamins and supplements; the LMN requirement remains.
Verify Before Purchasing: To avoid penalties, confirm with your HSA administrator and your healthcare provider about the eligibility of a specific product.

The General Rule: General Health vs. Medical Condition

The fundamental principle of HSA-eligible expenses is that the item or service must be used to treat, cure, mitigate, or prevent a specific medical condition or disease. The IRS explicitly states that expenses that are merely beneficial for general health do not qualify. For this reason, standard vitamins and supplements taken for overall wellness, such as a daily multivitamin or generic Vitamin C, are typically not HSA-eligible. This distinction is critical for account holders to understand to avoid tax penalties on ineligible withdrawals.

The Role of a Letter of Medical Necessity (LMN)

An exception to the general rule is when a vitamin or supplement is recommended by a healthcare provider to treat a specific, diagnosed medical condition. To prove this medical necessity to your HSA administrator and the IRS, you must obtain a Letter of Medical Necessity (LMN). An LMN is a formal document from a licensed healthcare professional, such as a doctor or physician's assistant, detailing the following:

The specific diagnosed condition: The letter must clearly state the medical issue that the vitamin or supplement is intended to treat.
The medical necessity: It must explain why the particular supplement is required for the treatment, cure, or prevention of that condition.
Dosage and duration: The letter should specify the recommended dosage and the length of the treatment.

Examples of supplements that might qualify with an LMN include:

Iron supplements for a diagnosed case of anemia.
High-dose Vitamin D for a documented Vitamin D deficiency.
Probiotics prescribed by a gastroenterologist for a digestive condition like Irritable Bowel Syndrome (IBS).

The Prenatal Exception

One significant and common exception to the LMN requirement applies to prenatal vitamins. Because pregnancy is considered a medical condition, prenatal vitamins are almost universally recognized as an HSA-eligible expense, even without a prescription or LMN. This is due to their preventive role in maternal and fetal health, and their widespread acceptance in the medical community. HSA funds can be used for both over-the-counter and prescription prenatal vitamins, including various formulations like gummies and tablets.

Documentation and Record Keeping

Accurate and detailed record-keeping is essential when using your HSA funds for supplements, especially for those requiring an LMN. In case of an IRS audit, you are responsible for proving the eligibility of your purchases.

For prenatal vitamins: Keep a clear receipt that identifies the item as 'prenatal vitamins'.

For all other eligible vitamins/supplements: You should retain a copy of the LMN from your healthcare provider, copies of your medical records proving the diagnosis, and the purchase receipts. Digital copies stored securely are recommended for easy access.

Comparison: HSA/FSA Eligibility for Supplements


Feature	General Vitamins/Supplements	Prenatal Vitamins
Eligibility Status	Generally Ineligible	Generally Eligible
Requirement for LMN	Yes, required for eligibility	No, generally not required
Eligible Purpose	Treatment or prevention of a diagnosed medical condition	Prevention of health issues during pregnancy
Common Examples	Iron for anemia, Vitamin D for deficiency	Standard prenatal multivitamins
Documentation Needed	LMN and receipts	Receipts clearly identifying the product
HSA Fund Usage	With specific, required documentation	Can be purchased directly with HSA card

The CARES Act and OTC Status

The Coronavirus Aid, Relief, and Economic Security (CARES) Act of 2020 changed the rules for many over-the-counter (OTC) medications, allowing them to be purchased with HSA funds without a prescription. However, this expansion did not change the eligibility status of most vitamins and supplements, which continue to require an LMN for most situations. The Act only relaxed the prescription requirement for medications, not for general wellness supplements.

Conclusion: Strategic Use of Your HSA

While the answer to "can I use HSA to pay for vitamins and supplements?" is not a simple yes or no, it is a matter of understanding the specific circumstances. For everyday wellness, the answer is generally no, and you should use personal funds. However, when a vitamin or supplement is a necessary component of a treatment plan for a diagnosed medical condition, it becomes eligible with the proper documentation, such as a Letter of Medical Necessity. Prenatal vitamins are a notable exception and are a straightforward, eligible expense. For any gray areas, always consult with your healthcare provider and your HSA administrator, and maintain thorough records. Understanding these rules ensures you can maximize the tax advantages of your HSA while staying compliant with IRS regulations. For more detail on HSA guidelines, consult IRS Publication 502, “Medical and Dental Expenses”.

Frequently Asked Questions

No, you cannot use your HSA card for daily multivitamins intended for general health. The IRS classifies these as beneficial for general wellness, not as a treatment for a specific medical condition.

An LMN is a document from a licensed healthcare provider confirming that a specific vitamin or supplement is medically necessary to treat a diagnosed medical condition. It's required for most non-prenatal vitamins to be HSA-eligible.

Yes, prenatal vitamins are a key exception. They are considered HSA-eligible without a prescription or LMN because pregnancy is considered a medical condition, and they serve a preventive purpose.

You need the Letter of Medical Necessity from your provider (if required) and a receipt clearly showing the purchase. Keeping these records is vital in case of an IRS audit.

Yes, if a licensed chiropractor recommends a supplement to treat a specific condition and provides an LMN, it can be an HSA-eligible expense.

The CARES Act expanded HSA eligibility for over-the-counter medications without a prescription but did not change the rules for most vitamins and supplements. An LMN is still required for non-prenatal items.

If you use HSA funds for an ineligible expense, the withdrawal is taxable, and you may face a 20% tax penalty if you are under age 65.