IRS posts medical expenses FAQ

The Internal Revenue Service has posted frequently asked questions that address whether certain costs related to nutrition, wellness and general health are medical expenses that may be paid or reimbursed under a health savings account, flexible spending arrangement, Archer medical savings account or health reimbursement arrangement.

Generally, deductions are allowed for expenses paid during the taxable year for medical care if certain requirements are met. Alternatively, medical expenses are eligible to be paid or reimbursed under an HSA, FSA, Archer MSA or HRA.

The FAQs address issues such as whether the cost of nutritional counseling, weight-loss programs, gym memberships and treatment for substance use disorders are considered medical expenses that may be paid or reimbursed under these accounts.

They also offer short explanations of what might make an expense eligible for payment through a FSA, HSA, Archer MSA or an HRA; for instance:

• If the expense provides a diagnosis of whether a disease or illness is present (like dental, eye and physical exams); or,
• If the expense treats a diagnosed disease or illness (like programs for substance abuse or alcohol use disorders, or smoking cessation programs).

On the other hand, some expenses may only be deductible if they're prescribed by a doctor to treat a specific disease, but otherwise deductible. A gym membership purchased as a result of a diagnosis for obesity or high blood pressure, for instance, would be deductible, while a membership bought for the individual's general health would not be. 

These FAQs are part of the National Strategy on Hunger, Nutrition and Health, an initiative undertaken by the federal government to end hunger and reduce diet-related diseases by 2030.