Health Savings Accounts with Fexingo: HSAs, Medical Expenses, and Triple Tax Advantage

In this episode of Health Savings Accounts with Fexingo, Lucas and Luna explore how HSAs can cover mental health therapy and counseling expenses. They discuss the IRS guidelines that allow HSA funds to be used for psychiatric care, psychologist visits, and even certain online therapy platforms. Specific examples include coverage for cognitive behavioral therapy, marriage counseling when prescribed...

In this episode of Health Savings Accounts with Fexingo, Lucas and Luna dive into a specific and increasingly relevant question: Can your HSA pay for weight loss programs, medications, and even surgery? With the rise of GLP-1 drugs like Ozempic and Wegovy, and new IRS guidance in 2025, the rules have shifted. Lucas breaks down the key distinction between 'medical necessity' and 'general health'—an...

Episode 55 explores a lesser-known HSA-eligible expense: medical alert systems. Lucas and Luna break down the IRS guidelines that allow these devices for individuals with chronic conditions, using the example of a 2026 subscriber base growing 18% year-over-year. They discuss how fall-detection pendants, smartwatch integrations, and emergency response services qualify, the importance of a doctor's...

Episode 54 of Health Savings Accounts with Fexingo explores a surprising eligible expense for your HSA: sunscreen. Lucas and Luna break down the IRS criteria that can make sunscreen a qualified medical expense, including SPF requirements, doctor's notes, and how to maximize your HSA for skin cancer prevention. They walk through real scenarios—like buying broad-spectrum SPF 50 for a family trip—and...

When you lose a tooth, a single dental implant in the US can cost between $3,000 and $6,000. But if you have a Health Savings Account, you can use pre-tax dollars to pay for the entire procedure — the implant, the abutment, the crown, and even bone grafts if needed. In this episode, Lucas and Luna walk through the IRS rules that make dental implants an eligible medical expense under your HSA, incl...

Episode 52 of Health Savings Accounts with Fexingo explores whether you can use your HSA for medical marijuana and CBD products. Lucas and Luna clarify the IRS stance on Schedule I substances, the distinction between FDA-approved cannabinoid drugs versus raw cannabis, and how recent state-level legalization doesn't change federal tax rules. They walk through the one narrow exception: Marinol and s...

Since the CARES Act permanently allowed HSAs to cover over-the-counter drugs without a prescription, millions of account holders have been leaving money on the table. Lucas explains the rule change that took effect in 2020, how to use your HSA card at pharmacies for items like allergy meds and pain relievers, and the surprising list of eligible OTC items—including menstrual products. Luna shares h...

Episode 50 of Health Savings Accounts with Fexingo dives into a frequently overlooked HSA-eligible expense: emergency medical kits and first-aid supplies. Lucas and Luna discuss what qualifies under IRS guidelines—from bandages and antiseptics to CPR manikins and automated external defibrillators (AEDs). They break down the recent IRS clarification in Notice 2024-30 that expanded preventive care d...

Episode 49 of Health Savings Accounts with Fexingo explores how HSAs cover acupuncture and chiropractic care for medical conditions, not general wellness. Lucas and Luna break down IRS guidelines, a real case of a listener using HSAs for chronic back pain treatment, and the key distinction between 'medical necessity' and 'maintenance.' Learn the documentation tips to avoid audit issues and how to...

Lucas and Luna explore how Health Savings Accounts can be used to pay for home office medical equipment—think ergonomic chairs, standing desks, and specialized keyboards—when prescribed for a specific medical condition. They break down IRS Publication 502 rules, the critical distinction between general health and medical necessity, and walk through real examples like a nurse with chronic back pain...

Lucas and Luna break down exactly how Health Savings Accounts interact with your health plan's deductible and out-of-pocket maximum. They use a concrete example: a family with a $6,000 deductible and a $13,000 out-of-pocket max. Lucas explains the triple-tax advantage when you contribute pre-tax, let it grow tax-free, and withdraw tax-free for qualified expenses. Luna notes that many people don't...

Episode 46 of Health Savings Accounts with Fexingo dives into a specific IRS rule change from early 2026 that permanently expanded HSA-qualified high-deductible health plans to cover telehealth visits with zero deductible. Lucas and Luna break down the mechanics, the practical savings for a typical remote worker, and how to stack telemedicine with your HSA investment strategy. They also compare th...

Episode 45 of Health Savings Accounts with Fexingo tackles a question many people face during job transitions: can you use your HSA to pay for COBRA premiums or other health insurance? Lucas and Luna break down the IRS rules on HSA-qualified medical expenses, explain when premiums are eligible (and when they aren't), and walk through real scenarios like losing employer coverage, retiring early, or...

Episode 44 of Health Savings Accounts with Fexingo dives into an often-overlooked HSA expense: travel and lodging for medical care. Lucas and Luna break down the IRS rules — what qualifies, what doesn't, and how to document it. They walk through a real example: a patient traveling from rural Montana to Seattle for a specialized surgery, and how the HSA can cover airfare, hotel nights, and even mil...

On this episode of Health Savings Accounts with Fexingo, Lucas and Luna explore how HSAs cover hearing-related expenses in 2026. With over 30 million Americans experiencing hearing loss, HSAs offer a triple tax-advantaged way to pay for hearing aids, cochlear implants, audiologist visits, hearing tests, and even batteries and maintenance kits. Lucas breaks down the IRS rules, including that hearin...

Episode 42 of Health Savings Accounts with Fexingo dives into a common grey area: when does a cosmetic procedure qualify as a medical expense under HSA rules? Lucas and Luna break down the IRS distinction between purely cosmetic and medically necessary procedures, using concrete examples like rhinoplasty for breathing issues, laser skin resurfacing for precancerous lesions, and eyelid surgery that...

Episode 41 of Health Savings Accounts with Fexingo dives into a common but often overlooked eligible expense: prescription sunglasses and specialty eyewear. Lucas and Luna explain the IRS rules around vision-related HSA spending, including what counts as a qualified medical expense versus a fashion accessory. They walk through specific scenarios—transition lenses, photochromic glasses, prescriptio...

Episode 40 of Health Savings Accounts with Fexingo explores when you can use HSA funds for travel costs related to medical care. Lucas and Luna break down the specific IRS rules, including mileage reimbursement at the 2026 standard rate, lodging limits of $50 per person per night, and what qualifies as a 'primary purpose' trip. They walk through a concrete example of flying from Dallas to Rocheste...

In this episode, Lucas and Luna explore whether Health Savings Account funds can be used for gym memberships, fitness classes, and exercise equipment. They break down the IRS guidelines on what qualifies as medical care versus general health or wellness. Using the case of a 2026 IRS Private Letter Ruling that approved a gym membership for a patient with obesity, they explain when a doctor's note o...

In this episode, Lucas and Luna break down how Health Savings Accounts can be used for breastfeeding supplies and lactation support—a lesser-known but fully IRS-eligible expense. They cover which items qualify (pumps, storage bags, nipple creams, nursing bras in some cases), what documentation you need, and how FSA/HSA rules differ for lactation consultants. Using recent IRS guidance and real-worl...

In this episode of Health Savings Accounts with Fexingo, Lucas and Luna dive into how HSAs can cover vision surgery, including LASIK, PRK, and cataract surgery. They break down the IRS eligibility rules, the difference between elective and medically necessary procedures, and how to use your HSA to pay for pre- and post-op appointments. With LASIK averaging $4,200 per eye and cataract surgery often...

Lucas and Luna dive into the often-overlooked role of Health Savings Accounts in covering fertility treatments, egg freezing, IVF, and other family-building medical expenses. With the average IVF cycle costing over $20,000 in 2026, understanding which costs are HSA-eligible can save families thousands. They break down IRS guidelines, recent clarifications on fertility preservation for medical reas...

Lucas and Luna dive into how Health Savings Accounts can be used to pay for physical therapy, including insurance copays, out-of-network providers, and specialized equipment. They discuss the IRS rules that make PT an eligible expense, how to get a Letter of Medical Necessity if needed, and a real example of someone recovering from ACL surgery using their HSA for sessions, braces, and even a home...

Episode 34 of Health Savings Accounts with Fexingo dives into using your HSA for mental health therapy. Lucas and Luna break down IRS guidelines on qualifying mental health expenses, including talk therapy, psychiatric care, and online platforms like Talkspace. They explore how the 2026 expansion of telehealth coverage makes it easier to pay for sessions with pre-tax dollars, and offer practical t...

Lucas and Luna dive into a surprisingly common and costly healthcare scenario: emergency room and urgent care visits. With ER visits averaging over $2,000 per trip and urgent care around $150-200, knowing how to use your Health Savings Account for these expenses can save you hundreds. Lucas explains the IRS rules for coverage, including what counts as a qualifying medical expense, how to handle co...