Yes, eye drops are HSA eligible when they treat or prevent an eye condition. That covers prescription drops and, since the CARES Act took effect for purchases after December 31, 2019, over-the-counter drops as well, with no prescription or Letter of Medical Necessity required.1Internal Revenue Service. IRS Outlines Changes to Health Care Spending Available Under CARES Act Federal law treats amounts spent on the diagnosis, treatment, or prevention of disease as qualified medical expenses, and therapeutic eye drops fit that definition.2Office of the Law Revision Counsel. 26 U.S. Code 213 – Medical, Dental, Etc., Expenses The CARES Act change is permanent.
Over-the-Counter Drops You Can Buy
Common OTC eye drops that qualify include:
- Artificial tears and lubricating drops for dry eyes, such as Refresh Tears or Systane
- Antihistamine allergy drops such as Zaditor or Pataday
- Redness relievers such as Visine or Clear Eyes
These treat a physical condition affecting the eyes, which is what makes them qualified medical expenses.2Office of the Law Revision Counsel. 26 U.S. Code 213 – Medical, Dental, Etc., Expenses The same rule applies if you pay from a Flexible Spending Account or a Health Reimbursement Arrangement.1Internal Revenue Service. IRS Outlines Changes to Health Care Spending Available Under CARES Act
Contact lens solutions ride along with the same logic. Cleaning solution, saline, and rewetting drops all count, because they support the use of a prescribed medical device.
Prescription Eye Drops
Prescription drops have always been HSA-eligible, and the CARES Act didn’t change that. Your HSA can pay for any prescription drops used to treat a diagnosed condition, including:
- Glaucoma drops such as latanoprost or timolol, which lower eye pressure to protect the optic nerve
- Antibiotic drops for bacterial infections like conjunctivitis
- Steroid drops prescribed after cataract surgery, LASIK, or other procedures
- Stronger prescription antihistamine drops when OTC options aren’t enough
The full cost counts, including any copay, as long as the drops are prescribed to treat, diagnose, or prevent a medical condition.3Cornell Law School. 26 U.S. Code 223(d)(2)(A) – Qualified Medical Expenses
What Doesn’t Qualify
The IRS draws a clear line between medical treatment and cosmetic use. Cosmetic products generally aren’t qualified medical expenses unless they correct a deformity from a congenital abnormality, an accident, or a disfiguring disease.4Internal Revenue Service. Publication 502 (2025), Medical and Dental Expenses Examples that typically fail the test:
- Cosmetic eyelid drops like Upneeq (oxymetazoline) when used purely to lift the eyelids for appearance rather than to treat a diagnosed condition such as acquired ptosis
- Eyelash-growth serums used for longer or thicker lashes rather than to treat a medical condition like hypotrichosis
- Color-enhancing or brightening drops designed to change how your eyes look
Some products sit on the line. A Letter of Medical Necessity from your doctor can establish that a treatment is medically required, which is how the same prescription eyelid drop can qualify when it treats ptosis that interferes with vision but not when it’s used only for looks.
What Happens If You Buy Something That Doesn’t Qualify
A non-qualified purchase has real tax consequences. The amount gets added to your taxable income for the year, and you owe an additional 20 percent tax on top of regular income tax. Spend $50 from your HSA on a cosmetic eye product, and that $50 becomes taxable income plus a $10 penalty, before your marginal rate is applied. The 20 percent penalty doesn’t apply after you turn 65, become disabled, or die, though the distribution is still taxable in those cases.5Internal Revenue Service. Publication 969 (2025), Health Savings Accounts and Other Tax-Favored Health Plans
If you swipe your HSA card on something ineligible by mistake, many administrators let you return the money to your account before you file your taxes, which undoes the problem.
How to Pay and What to Keep
You have two practical options. The first is swiping your HSA debit card at the pharmacy. Large retailers run an approval system that checks each product at checkout and declines items that aren’t HSA-eligible, which helps catch mistakes before they happen. The second is paying out of pocket and submitting a reimbursement claim through your administrator’s website or app by uploading a photo of the receipt. There’s no deadline for reimbursing yourself, as long as the expense occurred after your HSA was opened and you have documentation.5Internal Revenue Service. Publication 969 (2025), Health Savings Accounts and Other Tax-Favored Health Plans
Either way, keep an itemized receipt. The IRS requires records showing that each distribution went to a qualified expense, wasn’t reimbursed elsewhere, and wasn’t also claimed as an itemized deduction.5Internal Revenue Service. Publication 969 (2025), Health Savings Accounts and Other Tax-Favored Health Plans A good receipt shows the specific product name, the date, the amount, and the merchant. If your slip only shows a category code, ask for an itemized version or pull one from the store’s loyalty portal. Digital scans are fine. Hold onto them for at least three years from the date you file the return covering the purchase.6Internal Revenue Service. How Long Should I Keep Records? Sales tax charged on eligible drops is reimbursable too, so the full receipt total is what you can claim.