Spending with your HSA

With an HSA, paying for qualified medical expenses is always free from federal income taxes.

How can you spend from your HSA?

When you, your spouse, or your dependents have qualified medical expenses that aren't covered by your health care plan, you can pay for them tax-free1 with your HSA. There are multiple ways you can spend from your HSA.

Spend now with your Fidelity HSA® debit card

Pay for qualified medical expenses anytime with a swipe of your card.

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Pay your bills with Fidelity Bill Pay

Receive and pay bills for qualified medical expenses.

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Reimburse yourself for expenses

Get money back for medical expenses that you paid out of pocket.

Reimburse yourselfLog In Required

What's considered a qualified medical expense?


  • Office visits
  • Diagnostic testing
  • Surgical procedures
  • Over-the-counter medications
  • Prescriptions


  • Fillings
  • Cleanings
  • Braces
  • Artificial teeth


  • Exams
  • Glasses
  • Contact lenses
  • Corrective surgery


  • Counseling
  • Cessation programs
  • COVID-19 tests
  • Face masks
  • Hand sanitizer and sanitizing wipes

For more information and a complete list of qualified medical expenses, see IRS Publication 502.

At age 65, you can spend your HSA dollars on anything, not just medical expenses, and you won't incur the 20%

penalty. The withdrawal will just count toward your gross annual income.

Frequently asked questions

  • Are my HSA contributions available to spend immediately?

    Direct-deposit contributions from a linked bank account are usually available in your HSA within a few hours. Transfers from other HSAs or an IRA are usually available in your HSA within a few business days, once Fidelity receives the money from a third-party provider. Please see our guide to moving money with Fidelity for more information.

  • What if I need $1,000 tomorrow for a qualified medical expense?

    If you don’t have enough set aside in your core position in your HSA, you can pay for your qualified medical expense out-of-pocket now and reimburse yourself later, once you have enough money in your HSA. If you’re investing your HSA money, you can sell some of your investments any time, and that money will be available to use when the trade settles, usually within a few business days.

  • When can I cash out my HSA?

    You can choose to cash out your HSA any time, but if you're not using the money to pay for qualified medical expenses, your withdrawal will be subject to taxes and may be subject to penalties.

  • When can I withdraw my HSA money without penalty?

    You can withdraw your HSA money penalty-free any time before or during retirement to pay for qualified medical expenses. If you use it for any other expense before retirement, your withdrawal will be subject to taxes and may be subject to penalty. If you use your HSA money for any other expense after age 65, you'll just have to pay the taxes, and you won't be penalized. Please see IRS Publication 502 for a complete and up-to-date list of qualified medical expenses.

  • Can I use my HSA money to reimburse myself for qualified medical expenses from last year or before?

    Yes. As long as you incurred your qualified medical expense after you established your HSA, you can reimburse yourself for those expenses using your HSA money any time.

  • How do I prove that I spent my money on a qualified medical expense?

    Keep all your receipts for your out-of-pocket qualified medical expenses as well as documentation for your claims and your explanations of benefits (EOBs).

  • What happens if I spend my HSA money on something other than a qualified medical expense?

    If you use your HSA money on something other than qualified medical expenses before retirement, your withdrawal will be subject to taxes, and it may be subject to a 20% penalty. If you use it for something other than qualified medical expenses after age 65, your withdrawal will be subject to taxes but not penalized.

  • What if I retire and haven't used all my HSA money?

    Your HSA is always yours, so you can still spend your HSA money on qualified medical expenses with no federal income taxes or penalties in retirement.

    Retirement-related qualified medical expenses, covered by your HSA, could include:

    • COBRA coverage costs
    • Health care coverage while you’re receiving unemployment benefits
    • Medicare premiums other than Medicare Supplemental coverage
    • Qualified long-term care coverage

    If you choose to use your HSA money for something other than qualified medical expenses, you will be responsible for paying federal income taxes on it and may be penalized if you’re under age 65. You’ll also still be eligible to contribute to your HSA in retirement as long as you aren’t enrolled in Medicare5 or covered by an ineligible health plan.

  • What do I do if I accidentally withdraw HSA money by mistake?

    To make a repayment to your Fidelity HSA, submit a completed "Fidelity HSA® Return of Mistaken Distribution" form to Fidelity in accordance with applicable instructions.

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