Is over-the-counter medicine HSA eligible?
Yes, since 2020. The CARES Act lets an HSA pay for over-the-counter medicine with no prescription, even though the itemized medical deduction still can’t count it.
The rule
Before 2020 an HSA could pay for a drug sold over the counter only with a prescription. The CARES Act dropped that for anything paid after December 31, 2019, so pain relievers, allergy pills and cold medicine can come out of the HSA as they are.
This is one place the HSA is more generous than the medical expense deduction. On Schedule A, a drug that isn’t prescribed still doesn’t count, except insulin.
Paid yourself, it waits in the HSA until you take the money out, this year or decades from now.
- What to keep
- The store receipt showing the item, the date and what you paid.
- Watch for
- Vitamins and supplements aren’t medicine for this rule. They need a diagnosis and a practitioner’s recommendation.
- Things in the same aisle that aren’t medicine, like toothpaste, are personal items.
Checked on October 2, 2026 against IR-2020-122, the CARES Act and health spending accounts, IRS FAQs on nutrition, wellness and general health and Publication 502, Medical and Dental Expenses. An estimate for your records, not tax advice.
Keep the receipt. Take the money out later.
Pay a medical bill yourself and Reimburse keeps the receipt, with who it was for, until you take the money out of your HSA tax-free.