Many people rely on their Flexible Spending Accounts (FSA) and Health Savings Accounts (HSA) to cover a wide variety of healthcare expenses, including supplements. However, recent updates to IRS guidelines have significantly changed the rules regarding which supplements are eligible for reimbursement through these accounts. If you’re wondering whether your vitamins, fish oils, or other dietary supplements are still reimbursable, it’s essential to understand the new guidelines.
What Changed?
As of November 2024, the IRS updated its guidance on what qualifies as a medical expense for FSA/HSA reimbursement. The new rules significantly affect supplements—including vitamins, minerals, herbal remedies, and other dietary supplements.
Under the updated IRS guidelines:
- Supplements are no longer eligible for reimbursement unless they are specifically prescribed by a healthcare provider to treat a diagnosed medical condition.
- Supplements for general wellness—such as multivitamins, fish oils, and probiotics—are no longer covered under FSA/HSA accounts unless a prescription is provided.
These changes represent a shift away from reimbursing supplements that were once eligible under broader interpretations of medical necessity.
Why Did This Change Happen?
The IRS defines eligible medical expenses for FSA and HSA reimbursements as those that are necessary for the treatment or prevention of a medical condition. Over-the-counter supplements, such as vitamins or herbal products, typically fall under the category of general wellness rather than the treatment of a specific condition. As a result, they no longer meet the IRS’s criteria for medical expenses unless prescribed by a doctor.
In the past, some people were able to use their FSA/HSA accounts for supplements by arguing they contributed to overall health. However, now the IRS is stricter and requires clear documentation that the supplement is part of a treatment plan for a diagnosed health issue.
What Supplements Are Affected?
Under the new IRS guidelines, supplements that fall under the category of general wellness are no longer eligible for reimbursement unless a prescription is provided. Some of the most common supplements affected by this change include:
- Multivitamins
- Fish oils and omega-3 supplements
- Herbal remedies (e.g., echinacea, ginseng, turmeric, etc.)
- Probiotics
- Mineral supplements (e.g., calcium, magnesium)
- Amino acids and other performance supplements
- Dietary aids (e.g., appetite suppressants, weight loss supplements)
If these supplements are not prescribed by a healthcare provider to treat a specific health condition, they are no longer eligible for reimbursement under FSA/HSA accounts.
When Did This Change Take Effect?
The IRS officially updated the rules regarding supplements in November 2024. The changes were made to IRS Publication 502, which governs the rules around eligible medical expenses for tax-advantaged accounts like FSA and HSA.
Previously, some individuals could submit receipts for non-prescribed supplements and be reimbursed, but under the new guidelines, only prescribed supplements will qualify for reimbursement.
What Should You Do If Your Claim Was Denied?
If you’ve previously been reimbursed for a supplement without a prescription and your recent claim was denied, it’s important to understand the reason behind the denial. Under the new IRS guidelines, claims for supplements without a prescription will be automatically denied. If your claim was denied for this reason:
- Contact Your FSA/HSA Administrator: Reach out to your administrator to confirm the reason for the denial. They will guide you on whether you can resubmit your claim with a prescription.
- Request a Prescription: There is a difference between recommending a supplement and a prescription – in many cases you will not get a prescription for a supplement from your provider. If the supplement is part of a medical treatment plan to treat your condition (ie. vitamin d deficiency after blood work shows low vitamin d), ask your healthcare provider for a prescription so you can resubmit your claim for reimbursement.
What About Supplements You’ve Already Purchased?
If you’ve already purchased supplements in the past using your FSA or HSA without a prescription, it’s unlikely that these will be reimbursed moving forward under the updated guidelines. While you may have been reimbursed for these products before, the new rules have made it clear that only supplements that are part of a doctor-prescribed treatment plan are eligible.
If you’ve already submitted a claim for a non-prescribed supplement and it was reimbursed, you will not be able to claim future purchases of the same supplement without a prescription.
How Can You Stay Informed About These Changes?
For more detailed information on what is and isn’t eligible for reimbursement, refer to IRS Publication 502, which provides a comprehensive list of covered medical expenses under tax-advantaged accounts like FSAs and HSAs. You can find the most up-to-date information on supplements and other medical expenses in the publication.
You can access the full IRS guide here:
IRS Publication 502 – Medical and Dental Expenses
In Conclusion
These changes to the IRS guidelines may be frustrating, especially if you’ve relied on your FSA/HSA for general wellness supplements in the past. However, by working with your healthcare provider to obtain prescriptions for the supplements you need as part of a treatment plan, you can continue to use your FSA or HSA benefits for those specific items. It’s important to stay informed and up to date on the latest IRS guidelines to ensure you’re using your FSA/HSA funds properly.