Disclosure: this article contains affiliate links. If you buy through them, we may earn a commission at no extra cost to you. Prices were checked in September 2026.
Quick answer: You can buy prescription glasses (Zenni, from $6.95), menstrual cups and period underwear (Saalt, from $32), incontinence and wound care supplies (Carewell), and a continuous blood pressure band (Hilo, $89.99 plus a $149.99 annual fee) straight from your HSA. Air purifiers and humidifiers only qualify with a Letter of Medical Necessity from a doctor. If you do not have an account yet, open a free one at Lively before you buy any of this, because none of it works without a card to swipe.
What This Article Covers (and What It Doesn’t)
This is a shopping list, not a legal explainer. We already broke down the full IRS definition of a qualified medical expense, the CARES Act change, and the 20% penalty for spending HSA money on the wrong thing in our guide to HSA qualified expenses. Read that one first if you are still asking “am I even allowed to do this.” This piece assumes you already know the answer is yes and picks up exactly where that one stops: real products, real 2026 prices, and which ones need a Letter of Medical Necessity (LMN) before your card gets declined at checkout.
Prescription Glasses and Sunglasses: No Letter Needed
Prescription eyewear is one of the cleanest HSA purchases there is because IRS Publication 502 names it directly: eyeglasses and contact lenses needed for medical reasons are deductible medical expenses, no extra paperwork required. Zenni Optical prices single-vision frames from $6.95, with most shoppers landing between $15 and $25 for a complete pair once you add anti-scratch coating and a case. Zenni runs a dedicated FSA/HSA page that walks through both payment paths.
Here is the actual checkout flow: 1) pick your frames and add your prescription at checkout, 2) if you have an HSA debit card, enter it exactly like a Visa card, no special code needed, 3) if you do not carry a physical card yet, pay another way and download the itemized receipt from your order confirmation to submit for reimbursement later. Prescription sunglasses work the same way. Non-prescription sunglasses, even from the same cart, do not qualify, which trips up more people than you would think when they bundle a $9.95 pair of shades into an eyewear order and assume the whole cart is covered.
Period Products Have Been HSA Eligible Since 2020, and Most People Still Don’t Buy Them This Way
Menstrual cups, discs, period underwear, tampons, and pads all became HSA and FSA eligible the moment the CARES Act removed the old “prescription only” rule for OTC and menstrual items, a change we cover in more depth in the eligibility guide linked above. What that means at checkout: you can run these purchases through your HSA card the same way you would a copay.
Saalt sells the reusable side of this category: the Saalt Cup and Saalt Soft Cup run $32, the Saalt Disc is $35, and its leakproof period underwear ranges from $15 for a seamless thong to $49 for a cotton sleep short. LOLA covers the disposable side with organic cotton tampons starting at $9.50 and pads with wings from $8.50. Buy either brand directly through their sites and keep the order confirmation email; that is your proof of purchase if your HSA administrator ever asks for one, since neither retailer flags HSA eligibility at checkout the way an optical or medical-supply site does. Pricing and current styles for Saalt are in the product table below.
Air Purifiers and Humidifiers: This Is Where Most “HSA Eligible” Lists Get It Wrong
An air purifier is not automatically HSA eligible just because you own an HSA and the box says “clean air.” It is what HSA administrators call a dual-use item, something a healthy person would also want, so the IRS standard for capital-type medical equipment kicks in: you need a documented medical reason, in writing, before the purchase counts. In practice that means a Letter of Medical Necessity from a physician stating the specific condition, such as asthma, allergies, or COPD, and confirming the device is needed to treat it. Skip that step and the purchase is a normal retail transaction, not a medical one, even if you paid with your HSA card.
Levoit’s current lineup ranges from the $49.99 Core Mini-P for a bedroom up to the $299.99 Core 600S-P Smart for a larger room, with humidifiers like the Classic 300S at $79.99. None of these are pre-flagged as HSA eligible on Levoit’s own site, so the paperwork is entirely on you. The three-step version: 1) ask your doctor for a written LMN that names your diagnosis and states an air purifier or humidifier is medically necessary for it, 2) buy the unit and save the receipt with the model number visible, 3) staple the LMN to that receipt and keep both indefinitely, the same way you would with any other capital medical expense. Some HSA administrators will let the card go through at the point of sale anyway and only ask for the LMN if the account is audited later, which is exactly how people end up owing back taxes plus a 20% penalty on a $250 air purifier they bought on a whim.
Home Care and Caregiving Supplies Are Already Pre-Approved, No Letter Required
Unlike air purifiers, incontinence supplies, wound dressings, and mobility aids sit on the IRS medical-supply list without any extra documentation, because they only exist to treat or manage a diagnosed condition. Carewell built its entire catalog around this: qualifying products carry a blue “FSA & HSA Eligible” checkmark, and the site keeps a standing collection at its FSA/HSA hub covering pull-ups, briefs, underpads, catheters, and first-aid and wound-care items like gauze and antiseptic.
To buy: 1) open Carewell’s FSA/HSA eligible collection, 2) filter by category (incontinence, wound care, mobility), 3) pay with your HSA debit card at checkout the same as any other card, no receipt-chasing afterward. This is the single most underused corner of an HSA for anyone managing care for an aging parent or a family member with a mobility condition; the spending adds up fast in a way that a single doctor’s copay never does. Carewell’s link is in the product table below.
Continuous Blood Pressure Monitoring: A Real Device, With a Real Catch
Blood pressure monitors sit on the same pre-approved medical-device list as crutches and wheelchairs, which we cover in the eligibility guide, so a standard arm cuff needs no letter at all. Hilo Core complicates that slightly. It is a wearable band with optical sensors plus an FDA-cleared reference cuff, and the company’s own site says plainly that you can use HSA or FSA funds to join. Third-party pricing trackers put the hardware at $89.99 with a required $149.99 annual subscription, for roughly $240 in year one and about $12.45 a month after that, since the band will not function without an active subscription tied to it.
That bundle is the catch: you are not just buying a device, you are buying a device plus a mandatory software subscription, and some HSA administrators treat those as two separate line items. Ask for an itemized receipt that breaks out hardware from subscription before you submit anything, so you are not stuck arguing about a $150 recurring charge a year from now. Current Hilo Core pricing is in the table below.
Dental Night Guards Are an HSA Purchase Almost Nobody Thinks to Make
A custom night guard for teeth grinding is a dental appliance treating a diagnosed condition, bruxism or TMJ, which puts it in the same eligible category as orthodontics rather than the “general dental hygiene” bucket that gets rejected. Remi makes custom guards to order without a dental office visit, priced at roughly $100, using a dentist-quality mold-and-mail process. The distinction that matters for your HSA: a guard bought for teeth grinding or jaw clenching qualifies, a boil-and-bite mouthguard bought for a rec-league basketball game does not, because the second one is treating an activity, not a condition. Remi’s current pricing is in the table below.
Where to Buy It: Full Product List
| Category | Product | Price | Letter of Medical Necessity? | Where to buy |
|---|---|---|---|---|
| Eyewear | Zenni Optical prescription glasses | From $6.95 | No | Shop Zenni |
| Period care | Saalt cups, discs, period underwear | $15 to $49 | No | Shop Saalt |
| Air quality | Levoit air purifiers and humidifiers | $49.99 to $299.99 | Yes | Shop Levoit |
| Home care | Carewell incontinence, wound care, mobility | Varies by item | No | Shop Carewell |
| Blood pressure | Hilo Core wearable + cuff | ~$240 year one | No, but verify itemization | Shop Hilo |
| Dental | Remi custom night guard | ~$100 | No, if for grinding/TMJ | Shop Remi |
Things People Assume Are HSA Eligible But Aren’t
- Non-prescription sunglasses, including ones bought in the same order as prescription glasses. Only the corrective pair counts.
- An air purifier bought without a Letter of Medical Necessity on file. The purchase itself does not become ineligible retroactively; you just cannot prove it was ever eligible if you get audited.
- Teeth whitening trays, even from the same lab that makes eligible night guards. Whitening is cosmetic, grinding protection is not.
- “Shapewear” period underwear marketed primarily for a flatter silhouette rather than leak protection. The medical purpose has to be the primary purpose.
- Fitness smartwatches bought for general health tracking. A device has to be marketed and used for a specific diagnosis, the way Hilo is built around blood pressure, not general wellness.
How to Open an HSA If You Don’t Have One Yet
None of the products above are purchasable with HSA funds if you do not have an HSA to fund. You need an HDHP (high-deductible health plan) to open one, and for 2026 the IRS caps contributions at $4,400 for self-only coverage and $8,750 for family coverage, with an extra $1,000 catch-up allowed if you are 55 or older, according to IRS Publication 969.
Lively is worth opening specifically because it charges no monthly fee, ever, holds your cash balance FDIC-insured, and lets you invest the balance above a small cash cushion once you want to. Steps: 1) go to Lively’s site and start the application, 2) confirm you are enrolled in a qualifying HDHP, 3) link a bank account to fund the HSA, 4) order the Lively Benefit Access Visa card, which is what you will actually swipe at Zenni, Carewell, or anywhere else on this list. If you want to compare it against other providers first, our best HSA accounts breakdown and our full Lively review both go deeper on fees and investment options. Open a Lively HSA here.
FAQ
Do I have to buy from these specific brands to use my HSA?
No. Any menstrual product, prescription eyewear, or medical supply that meets the IRS definition qualifies regardless of where you buy it, including Target, Amazon, or your local pharmacy. The brands here are ones we verified directly for pricing and HSA handling at checkout, not the only options.
What actually happens if I use my HSA card for something that turns out not to be eligible?
The IRS treats it as a non-qualified distribution. Before age 65 that means ordinary income tax on the amount plus a 20% penalty on top, a rule we walk through with real numbers in our HSA qualified expenses guide.
Is the Hilo subscription itself HSA eligible, or just the hardware?
Hilo markets the whole bundle, band, cuff, and subscription, as something you can join using HSA or FSA funds. Ask for an itemized receipt anyway so hardware and subscription are broken out separately in your records.
Can I use HSA money I contributed last year for something I buy today?
Yes. HSA balances never expire and never reset, unlike an FSA, so funds from any prior year are just as spendable today as funds you deposited this morning.
Does a Letter of Medical Necessity expire?
Most administrators treat an LMN as valid for one year from the date it is signed, then want a renewed letter for ongoing purchases like replacement air purifier filters. Check with your specific HSA administrator, since this is set by the plan, not the IRS.
Can I use HSA funds for my spouse’s or kid’s glasses, night guard, or period products?
Yes, as long as you can claim them as a tax dependent, even if they are on a different insurance plan than you. That rule and its exceptions are covered in the eligibility guide linked throughout this piece.
This article is for informational purposes only and is not medical or tax advice. Confirm eligibility rules with your HSA administrator or a tax professional before making a purchase, especially anything requiring a Letter of Medical Necessity.
