What Can I Use HRA Funds For? Care, Premiums, and Equipment

You can use HRA funds for a wide range of tax-free medical costs: doctor and specialist visits, dental and vision care, prescription drugs, many over-the-counter products, medical equipment, travel to appointments, and — with certain HRA types — health insurance premiums. The federal baseline comes from the tax code’s definition of medical care, which covers spending on the diagnosis, treatment, or prevention of disease.¹ Your employer’s plan document can narrow that list, so what your particular HRA reimburses may be a smaller subset of everything federal law allows. Check the summary plan description before assuming a specific expense is covered.

Medical, Dental, Vision, and Hearing Care

Visits to physicians, surgeons, and specialists for the treatment or prevention of a medical condition are core eligible expenses. Mental health care from licensed psychologists or psychiatrists qualifies on the same basis.¹ Diagnostic services such as lab work, X-rays, MRI scans, and CT scans are reimbursable when a healthcare provider orders them to screen for or treat a condition.²

Dental coverage is broad. Routine cleanings, fluoride treatments, fillings, extractions, dentures, and orthodontic work like braces all qualify.² Teeth whitening does not — the IRS treats it as cosmetic.

On the vision side, eye exams, prescription eyeglasses, contact lenses (with supplies like saline solution), and corrective eye surgery such as LASIK are eligible. Hearing aids, including batteries, repairs, and maintenance, also qualify.²

Prescription Drugs and Over-the-Counter Products

Prescription medications are eligible under virtually every HRA. The CARES Act permanently expanded eligibility to include over-the-counter medicines — pain relievers, cold and allergy medications, antacids — without requiring a prescription. That same law made menstrual care products (tampons, pads, liners, cups) qualified medical expenses for the first time.³

Some dual-purpose products qualify only when they meet a specific threshold. Sunscreen with SPF 15 or higher and broad-spectrum protection is generally reimbursable, as is lip balm with SPF 15 or above. Plain bug spray is not eligible, but a combination product that also carries SPF 15+ sun protection may qualify. Keep the original packaging so the SPF rating is visible when you submit your claim.

Medical Equipment and Supplies

Physical supplies used primarily for medical care are reimbursable. Common examples: bandages, first-aid kits, thermometers, and blood-sugar test kits for diabetes management. Mobility aids like crutches, walkers, and wheelchairs qualify, along with the cost of maintaining and operating them.² The item has to be primarily for preventing or treating a medical condition rather than for general convenience or comfort.

Travel and Lodging for Medical Care

Transportation to and from medical appointments is eligible. If you drive your own vehicle, you can claim the IRS medical mileage rate of 20.5 cents per mile for 2026, plus any tolls and parking fees.⁴ Bus, taxi, and rideshare fares for medical trips also count.

Lodging away from home is reimbursable up to $50 per night per person when the trip is primarily for medical care at a licensed hospital or equivalent facility, and the stay does not involve a significant element of recreation or vacation.⁵ Meals during medical travel are not reimbursable.

Insurance Premiums

Whether premiums are eligible depends on the type of HRA your employer offers. A standard group health HRA that sits alongside an employer-sponsored plan typically does not allow premium reimbursement. Three HRA types are designed to reimburse premiums, each with its own rules.

Individual Coverage HRA

An Individual Coverage HRA (ICHRA) reimburses you for individual health insurance you buy on your own or through the Health Insurance Marketplace. Any employer can offer one regardless of size, and there is no federal cap on annual contributions.⁶ ICHRA funds can also reimburse out-of-pocket medical expenses that meet the standard eligibility rules.

Qualified Small Employer HRA

A Qualified Small Employer HRA (QSEHRA) is available only to employers with fewer than 50 full-time employees that do not offer a group health plan.⁷ For plan years beginning in 2026, the maximum reimbursement is $6,450 for self-only coverage and $13,100 for family coverage.⁸ You have to maintain qualifying health coverage to use QSEHRA funds.

Excepted Benefit HRA

An Excepted Benefit HRA (EBHRA) is offered alongside a traditional group health plan and reimburses expenses the primary plan may not cover, such as dental care, vision care, copayments, and coinsurance. It cannot reimburse premiums for individual health insurance, group plan premiums (other than COBRA continuation coverage), or Medicare premiums.⁹ For plan years beginning in 2026, the maximum an employer can make available in an EBHRA is $2,200.⁸

Medicare and Long-Term Care Premiums

Medicare Part B premiums are recognized as eligible medical expenses under federal law.⁵ Other Medicare premiums, including Part D, generally qualify when the HRA plan allows premium reimbursement. Qualified long-term care insurance premiums are also eligible, but the reimbursable amount is capped by age. The 2026 limits:

Age 40 or under: $500
Age 41 to 50: $930
Age 51 to 60: $1,860
Age 61 to 70: $4,960
Age 71 or over: $6,200

These age-based limits are adjusted annually for inflation.⁸

What HRA Funds Cannot Cover

Spending aimed at general health rather than treating or preventing a specific medical condition is not reimbursable. The most common ineligible categories:

Gym memberships and fitness classes are treated as general health expenses. A membership purchased solely to treat a specific disease diagnosed by a physician, such as obesity, hypertension, or heart disease, may qualify.¹⁰
Cosmetic procedures — facelifts, hair transplants, teeth whitening, liposuction — are excluded because they aim at appearance rather than treating disease or restoring function.²
Personal care items such as toothpaste, toothbrushes, deodorant, and standard lotions are personal expenses, not medical care.²
Vitamins and supplements are generally ineligible unless a physician recommends them as treatment for a specific diagnosed condition, such as a documented nutritional deficiency.¹⁰

Where the Line Moves

Cosmetic surgery qualifies when it corrects a deformity from a congenital abnormality, a personal injury from an accident, or a disfiguring disease.¹ Reconstructive breast surgery after a mastectomy is a common example.

Weight-loss programs sit in a similar gray area. A general diet or fitness program is not eligible, but a structured weight-loss program prescribed by a physician to treat a diagnosed condition such as obesity, diabetes, hypertension, or heart disease can be reimbursed.¹⁰ The cost of special diet foods is not reimbursable unless it exceeds the cost of a normal diet and is substantiated by a physician.

For any of these gray-area expenses — supplements, gym memberships, weight-loss programs, nutritional counseling — you will typically need a letter of medical necessity from your doctor identifying the diagnosed condition and confirming that the expense is medically necessary. Without it, the administrator will likely deny the claim.

Getting Reimbursed

Every claim requires documentation showing the expense is a qualified medical cost. At a minimum: the date of service, the name of the provider or pharmacy, a description of the service or product, and the amount you paid after any insurance adjustments. An explanation of benefits (EOB) from your insurance company works as complete documentation on its own, because it confirms the date, the medical nature of the service, and the amount you owe. Your own statement that an expense was medical, without supporting records, is not enough — IRS rules specifically prohibit self-certification as a substitute for proper documentation.¹¹ Keep digital or physical copies of every receipt and EOB throughout the plan year.

Most administrators accept claims through a mobile app or secure online portal where you upload images of your receipts. Some also accept mailed paper claims. Processing typically runs five to ten business days, and approved reimbursement is usually deposited directly to your bank or mailed as a check.

Watch your plan’s run-out period, the window after the plan year ends when you can still submit claims for expenses incurred during that year. Many plans allow 30, 60, or 90 days. Expenses incurred during the plan year but submitted after the run-out period are typically forfeited, so put the deadline on your calendar.

A Note on Unused Balances

An HRA belongs to your employer, not to you, so what happens to money you do not spend depends entirely on the plan’s design. Some plans roll unused balances into the next year in full, some cap the rollover, and others forfeit anything unspent at year-end. Your summary plan description spells out which rule applies, and it is the same document that will tell you whether a specific expense on this list is one your particular HRA actually reimburses.

1
Office of the Law Revision Counsel. 26 USC 213 Medical, Dental, Etc., Expenses
2
Internal Revenue Service. Publication 502, Medical and Dental Expenses
3
Internal Revenue Service. IRS Outlines Changes to Health Care Spending Available Under CARES Act
4
Internal Revenue Service. IRS Sets 2026 Business Standard Mileage Rate at 72.5 Cents Per Mile, Up 2.5 Cents
5
Office of the Law Revision Counsel. 26 USC 213 Medical, Dental, Etc., Expenses
6
HealthCare.gov. Individual Coverage Health Reimbursement Arrangements
7
HealthCare.gov. Health Reimbursement Arrangements for Small Employers
8
Internal Revenue Service. Revenue Procedure 2025-19
9
Centers for Medicare and Medicaid Services. What Is an Excepted Benefit Health Reimbursement Arrangement
10
Internal Revenue Service. Frequently Asked Questions About Medical Expenses Related to Nutrition, Wellness and General Health
11
Internal Revenue Service. Notice 2006-69 Amounts Received Under Accident and Health Plans