An HSA purchases list for Canada includes qualifying drugs, prescription eyewear, dental treatment, recognized practitioner services, medical devices and certain travel expenses. Eligibility depends on the specific expense, covered person, records and employer plan; general wellness purchases do not qualify merely because they support health.
Check common expense categories
- Medical and hospital care: check the actual service, provider and unreimbursed amount. Laboratory tests, diagnostic procedures and X-rays generally require a prescription under CRA’s listed requirements.
- Dental care: eligible examinations, fillings, crowns, dentures and orthodontics may qualify. Purely cosmetic procedures, including tooth whitening, are generally excluded; medical or reconstructive exceptions have their own conditions.
- Vision care: prescription glasses and contact lenses must correct eyesight. Eye examinations and laser eye surgery have their own eligible-service requirements.
- Practitioner and mental-health services: confirm the profession’s recognition in the service jurisdiction. A licensed-provider label or a counselling description alone is insufficient.
- Fertility and specialized care: check the exact procedure, provider, drug and any applicable donor or surrogate conditions.
Apply the drug and supplement rules
Under the ordinary drug rule, the medicine must legally require a prescription and its purchase must be recorded by a pharmacist. Over-the-counter medicines generally do not qualify even if prescribed. The narrow exception in Income Tax Regulations section 5701 has separate conditions, including legally required medical-practitioner intervention where the drug is acquired.
Insulin and other specifically listed categories follow their own requirements. Medical cannabis requires the appropriate medical document, client registration and purchase from the registered licensed seller.
Vitamins and supplements do not qualify merely because prescribed or recommended. The exception is vitamin B12 therapy prescribed by a medical practitioner for pernicious anaemia.
Check each device or supply
CPAP machines, orthopaedic shoes or inserts, and oxygen equipment require a prescription under their listed categories. Wheelchairs and crutches do not require one under theirs. Hearing aids, prosthetics, diabetic supplies and other items need their own category check.
Review medical travel conditions
Qualifying transportation generally requires at least 40 km one way; meals and accommodation generally require at least 80 km. Substantially equivalent services must be unavailable near home, the route reasonably direct and the trip reasonable.
Vehicle expenses have further conditions when public transportation is not readily available. An attendant’s travel requires written certification that the patient cannot travel alone.
Keep general wellness separate
Gym membership fees are not eligible medical expenses even when recommended or prescribed by a doctor. General fitness, spa services and cosmetic purchases are not automatically eligible. A separate WSA may cover employer-permitted lifestyle categories, generally as taxable benefits.
Sources
Prepare the claim
- Confirm the covered person, allowance and actual plan deadline.
- Keep an itemized receipt identifying the provider, patient where applicable, service or item, date and amount.
- Supply required prescriptions, certification and other-plan reimbursement details.
- Submit only the eligible unreimbursed amount through the accepted process.
- Retain the decision and payment record.
Payment depends on review, available benefits, employer funding and processing. Qualifying employee benefits under a Private Health Services Plan (PHSP) are generally non-taxable federally; Québec applies separate provincial rules.
Request an HSA cost estimate
Use the form below to request an estimate for your organization. A comparison needs actual eligible reimbursements, administration, taxes and any insurance protection; it does not establish a guaranteed saving or eligibility decision.
