Will HSA Cover Vitamins and Supplements? The Definitive Guide

January 11, 2026 •

3 min read

According to IRS regulations, expenses considered “merely beneficial to general health” are not eligible for tax-free spending. So, will HSA cover vitamins and supplements, or do you need a specific medical justification? For the most part, eligibility is determined by your medical need, not general wellness.

Quick Summary

HSA coverage for vitamins and supplements is possible, but not guaranteed. Eligibility hinges on a healthcare provider's recommendation to treat or prevent a specific medical condition. Proper documentation, like a Letter of Medical Necessity, is crucial for reimbursement and avoiding tax penalties.

Key Points

General Rule: Vitamins and supplements are only HSA-eligible if recommended by a healthcare provider for a specific medical condition, not general health.
Medical Necessity: You will likely need a Letter of Medical Necessity (LMN) from a licensed professional to prove the supplement is for a diagnosed condition.
Prenatal Exception: Prenatal vitamins are a key exception and are generally eligible over-the-counter without an LMN.
Critical Documentation: Keep detailed records, including the LMN, receipts, and diagnosis information, for your records and potential audits.
Ineligible Items: General wellness products like daily multivitamins, protein powders, and herbal remedies are not typically covered unless medically prescribed.
Verify Eligibility: Always check with your HSA administrator for specific plan rules and eligibility requirements before making a purchase.

The General Rule: Medical Necessity, Not General Wellness

For a vitamin or supplement to be an eligible HSA expense, it must be used primarily to alleviate or prevent a physical or mental disability or illness. In most cases, this means it cannot be for general health or wellness, such as a daily multivitamin taken 'just in case'. The expense must be substantiated as medically necessary by a qualified healthcare professional, such as a doctor, chiropractor, or other licensed practitioner.

The Critical Role of a Letter of Medical Necessity (LMN)

For most non-prescription supplements, a Letter of Medical Necessity (LMN) is the key to eligibility. This is a formal document from your healthcare provider that explains why the specific supplement is necessary to treat your diagnosed medical condition. The LMN must contain several key pieces of information:

Your specific diagnosis or condition.
The name of the recommended vitamin or supplement.
The specific dosage and duration of treatment.
The provider's name, credentials, and signature.

Documenting Your Expenses

Keeping meticulous records is vital, especially in the event of an IRS audit. While a written prescription may not always be legally required, it is strongly recommended for documentation. You should save the following for your records:

The Letter of Medical Necessity from your healthcare provider.
Detailed receipts that clearly identify the product purchased, date, and cost.
Documentation of your diagnosis from your medical records.
Communication with your HSA administrator regarding eligibility confirmation.

Important Exceptions to the Rule

There are a few notable exceptions where a supplement may be eligible without a specific prescription or LMN for a diagnosed condition:

Prenatal Vitamins: Due to their direct relationship with pregnancy, prenatal vitamins are generally considered an eligible HSA expense and can be purchased over-the-counter without an LMN.
Over-the-Counter (OTC) Medications: The CARES Act of 2020 expanded eligibility to include certain OTC medications without a prescription, but this change did not extend to most general wellness vitamins and supplements.

HSA vs. FSA Eligibility for Vitamins and Supplements

Eligibility rules for vitamins and supplements are similar for both Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs), as both adhere to IRS guidelines for qualified medical expenses.


Feature	HSA	FSA
General Vitamins	Requires a Letter of Medical Necessity (LMN) for a specific medical condition.	Requires a Letter of Medical Necessity (LMN) for a specific medical condition.
Prenatal Vitamins	Eligible without a prescription or LMN.	Eligible without a prescription or LMN.
Funds Rollover	Funds can roll over indefinitely year-to-year.	Rollover is limited or non-existent (use-it-or-lose-it rule).
Account Ownership	The account belongs to you, even if you change employers.	The account is typically employer-owned.
Contribution Changes	You can adjust your contributions at any time.	Changes are generally limited to open enrollment or qualifying life events.

Practical Steps to Use Your HSA for Supplements

Consult Your Doctor: Discuss your health needs with a healthcare provider and ask if any supplements are medically necessary for a specific condition.
Obtain Documentation: If a supplement is recommended, request a Letter of Medical Necessity or a written prescription. Ensure it includes all necessary details to justify the expense.
Check with Your Administrator: Review the specific rules with your HSA administrator, as they may have their own procedures or a list of approved items.
Keep Records: Save the LMN, receipts, and any other relevant medical documentation in case your eligibility is ever questioned.

Conclusion

While a common perception is that HSA funds cannot be used for vitamins and supplements, this is only half the story. The key distinction lies between general wellness and specific medical necessity. If a healthcare provider recommends a supplement to treat a specific diagnosed condition, it becomes an eligible expense with the proper documentation, usually a Letter of Medical Necessity. For common exceptions like prenatal vitamins, the process is often more straightforward. By understanding the specific IRS guidelines and maintaining thorough records, you can confidently use your HSA to cover these medically necessary purchases and maximize your tax-advantaged savings. For more information, the IRS website and your HSA provider's resources are the best places to start, as specific policies can vary.

An excellent external resource for official guidance is IRS Publication 502, which details qualified medical and dental expenses.

Frequently Asked Questions

While a formal prescription is not always legally required, you do need a recommendation from a licensed healthcare provider for a specific medical condition. A Letter of Medical Necessity (LMN) serves this purpose and is highly recommended for documentation.

No, standard multivitamins are generally not HSA-eligible. They are considered a general health expense and require a Letter of Medical Necessity from a healthcare provider to treat a specific medical condition.

Yes, prenatal vitamins are a special exception and are HSA-eligible without a prescription. They are recognized as a necessary part of prenatal care.

No, you cannot use your HSA for vitamins or supplements taken for general well-being or preventative health. The expense must be tied to the diagnosis, treatment, or prevention of a specific medical condition.

An LMN should include your name, the diagnosed medical condition, the specific vitamin or supplement needed, the duration of treatment, and the provider's name and signature.

Using HSA funds for an ineligible expense can result in a 20% tax penalty on the withdrawn amount, in addition to regular income taxes. It is essential to ensure eligibility and keep proper documentation.

Similar to adult vitamins, children's vitamins generally require a Letter of Medical Necessity from a healthcare provider to be HSA-eligible, unless they are a prescribed part of treatment for a specific condition.