The most commonly overlooked HSA item: your regular grocery bill. How filers can save big on health spending with this tax tip.

Health Savings Accounts (HSAs) offer a powerful way to save on healthcare costs while reducing your tax bill. Yet many account holders miss out on a simple but effective tax strategy: tracking and reimbursing out of pocket HSA items purchased over the counter throughout the year. These everyday purchases, often found in your grocery or drugstore aisles, qualify as HSA eligible items but are frequently overlooked when it comes to tax deductions. For married couples filing jointly (MFJ) with significant medical expenses, this approach can unlock substantial savings on their 2025 US tax return.

This post will guide you through the common HSA eligible items you might have paid for out of pocket, explain how to claim the tax deduction for HSA items, and offer practical tips to document your purchases. By the end, you’ll understand how to maximize your HSA benefits and keep more money in your pocket.

Common HSA Eligible Items You Probably Bought Without Thinking

Many people assume HSAs only cover doctor visits, prescriptions, or hospital bills. While those are important, the IRS also allows reimbursement for a wide range of out of pocket HSA items you can buy without a prescription. These are often found in grocery stores, pharmacies, and big-box retailers.

Here are some of the most common HSA eligible items that people pay for themselves but forget to track:

• Bandages and first aid supplies

Adhesive bandages, gauze pads, medical tape, antiseptic wipes, and antibiotic ointments.

• Over-the-counter pain relievers and fever reducers

Ibuprofen, acetaminophen, aspirin, and naproxen.

• Cold and allergy medications

Decongestants, antihistamines, cough syrups, throat lozenges, and nasal sprays.

• Eye and ear care products

Eye drops, contact lens solutions, earwax removal kits.

• Feminine hygiene products

Menstrual pain relievers, heating pads, and some feminine care items.

• Thermometers and heating/cooling packs

Digital thermometers, ice packs, and reusable heat pads.

• Sunscreen and lip balm with SPF

Products with SPF 15 or higher qualify as HSA eligible items.

• Vitamins and supplements

Only if prescribed by a doctor for a specific medical condition. General daily vitamins do not qualify.

• Smoking cessation products

Nicotine gum, patches, and lozenges.

• Blood pressure monitors and test strips

For monitoring chronic conditions at home.

• Crutches, bandages, and braces

Durable medical equipment like splints and orthopedic supports.

Most of these items are easy to overlook because they blend into your regular shopping routine. Yet, if you pay for them out of pocket, you can reimburse yourself from your HSA and claim a tax deduction for HSA items.

How to Use This Strategy for Tax Savings on Your 2025 Return

The key to unlocking tax savings is to keep track of all your out of pocket HSA items throughout the year and then make an HSA contribution equal to that amount. Afterward, you take a distribution from your HSA to reimburse yourself for those expenses.

Here’s how to do it step-by-step:

1. Track your out of pocket HSA eligible purchases

   Save receipts and keep a running list of qualifying items you buy without using your HSA debit card.

   
   

2. Make an HSA contribution for the total amount of those purchases

   You can contribute to your HSA up to the IRS limit for 2025 ($3,850 for individuals, $7,750 for families, plus $1,000 catch-up if over 55).

   
   

3. Take a distribution from your HSA to reimburse yourself

   Withdraw the same amount you contributed to cover the out of pocket expenses.

   
   

4. Report your HSA contributions and distributions on your 2025 tax return

   Contributions reduce your taxable income, and distributions for qualified medical expenses are tax-free.

   
   

By doing this, you effectively turn your everyday health purchases into tax-advantaged spending. The IRS treats the reimbursement as a qualified medical expense, so you avoid paying taxes on that money twice.

Why Most People Miss These Out of Pocket HSA Items

Many HSA holders only use their accounts to pay large medical bills or prescriptions directly. This means they miss the chance to claim smaller, routine purchases as part of their tax savings strategy.

Common reasons for missing these items include:

• Not saving receipts or tracking OTC purchases

• Assuming only prescriptions or doctor bills qualify

• Forgetting to reimburse themselves from the HSA account

• Not knowing that some grocery store items are eligible

  
  

Focusing on out of pocket HSA items that are easy to overlook can add up to hundreds or even thousands of dollars in tax savings.

Easy Ways to Document and Substantiate Your Purchases

Good record-keeping is essential to claim the tax deduction for HSA items without issues. Here are some simple methods to stay organized:

• Use a dedicated folder or envelope for receipts

Keep all receipts for OTC health products in one place.

• Take photos of receipts with your phone

Use apps like Evernote or Google Drive to store digital copies.

• Maintain a spreadsheet or notebook

Record the date, item, store, and amount spent on each purchase.

• Use HSA account statements

Match your receipts with HSA debit card transactions when possible.

• Keep doctor’s notes or prescriptions if required

For items like vitamins or supplements that need a prescription to qualify.

By documenting purchases carefully, you can confidently reimburse yourself and support your tax return if audited.

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Typical Tax Savings for MFJ Filers with $150,000 AGI

Let’s look at a practical example to understand the impact of this strategy.

• A married couple filing jointly (MFJ) has an adjusted gross income (AGI) of $150,000.

• They spend $1,000 on out of pocket HSA items like OTC medications, bandages, and medical supplies.

• They contribute $1,000 to their HSA and then reimburse themselves for these expenses.

  
  

Assuming they are in the 22% federal tax bracket, the tax savings would be:

• $1,000 contribution reduces taxable income by $1,000.

• Tax savings = $1,000 × 22% = $220 saved in federal income tax.

  
  

If state income tax applies, the savings increase further. Plus, the money withdrawn to reimburse the expenses is tax-free, so they effectively get a double tax benefit.

This example shows how even modest tracking of out of pocket HSA items can lead to meaningful savings.

Final Thoughts on Maximizing Your HSA Benefits

Many HSA holders miss out on a simple tax-saving opportunity by overlooking the everyday HSA eligible items they pay for out of pocket. By tracking these purchases, making a matching HSA contribution, and reimbursing yourself, you can reduce your taxable income and keep more money in your wallet.

Start by reviewing your grocery and pharmacy receipts for qualifying items. Use easy documentation methods to stay organized throughout the year. When tax season arrives, you’ll be ready to claim the tax deduction for HSA items and enjoy the full benefits of your Health Savings Account.

Taking these steps can turn routine health spending into a smart financial move for MFJ filers with significant medical expenses. Don’t let these commonly overlooked expenses slip through the cracks—your tax return will thank you.