Editorial Guidelines
How HSAMaxGuide decides whether something is HSA or FSA eligible, which sources it relies on, and how rulings are kept current.
How we source eligibility rulings
No single IRS publication answers "can my HSA or FSA pay for this?" on its own. Every ruling is built from three layers, and each ruling page lists the ones it relies on, labelled, so you can see which rule does the work.
| Layer | Primary sources | What it decides |
|---|---|---|
| 1. Account rule | IRC §223(d)(2) and IRS Publication 969 | Whether an HSA, FSA or HRA can pay for an expense. This is the governing rule. It defines qualified medical expenses by reference to IRC §213(d), then adds its own exceptions, such as OTC medicine without a prescription, menstrual care products, and limits on paying insurance premiums. |
| 2. Medical-care definition | IRC §213(d) and IRS Publication 502 | Whether something counts as medical care, item by item. Pub. 502 is written for the itemized medical deduction on Schedule A, so we use it for this definition, not as the final word on account eligibility. |
| 3. Changes & guidance | CARES Act §3702 (2020), IRS announcements, annual Revenue Procedures | Later changes and clarifications, such as OTC medicine and menstrual products (CARES Act), PPE (IRS Announcement 2021-7), and each year's contribution limits and HDHP thresholds. |
Where the layers disagree: over-the-counter medicine
Since January 1, 2020, OTC medicine can be paid from an HSA, FSA or HRA without a prescription. CARES Act §3702 removed the prescription requirement from IRC §223 for HSAs, and Pub. 969 states the same rule for FSAs and HRAs. Pub. 502 did not change: it still says that, except for insulin, you can't include a drug that isn't prescribed in your itemized medical deduction. When the account rule and the deduction rule differ, our rulings follow the account rule, and the ruling page says so.
How rulings stay current
- We read the primary source (statute, IRS publication, announcement or Revenue Procedure), not secondary summaries.
- Contribution limits and HDHP thresholds are updated when the IRS publishes each year's Revenue Procedure.
- A ruling is re-reviewed when the IRS issues new guidance on its category.
- Plan administrators can apply stricter rules than the law requires. When in doubt, confirm with yours before you buy.
Independence and corrections
Affiliate relationships never change a ruling: every status is set from the sources above first (see how we make money). Found something that looks wrong? Tell us the page and the source and we'll review it.
This is educational content, not tax advice. For anything with real money at stake, confirm with your plan administrator or a tax professional.