Not Eligible OTC Medication

Is Medicines Purchased from Other Countries HSA or FSA eligible?

You can pay for this directly with your HSA or FSA, or reimburse yourself later.

Reviewed against IRS Publication 502 · Updated June 19, 2026

No — Medicines Purchased from Other Countries is not HSA eligible

Medicines purchased from other countries are generally not eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), health reimbursement arrangement (HRA), dependent care flexible spending account (DCFSA), or a limited-purpose flexible spending account (LPFSA). Using HSA funds for Medicines Purchased from Other Countries would be a non-qualified distribution subject to income tax, plus a 20% penalty if you are under 65.

Not a qualified medical expense

Paying with HSA funds results in income tax on the amount and a 20% penalty if you’re under age 65. Keep Medicines Purchased from Other Countries off your HSA unless circumstances change.

How to claim it

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Frequently asked questions

Is Medicines Purchased from Other Countries FSA or HRA eligible too?

No. Because FSAs and HRAs follow the same IRS Publication 502 rules as HSAs, Medicines Purchased from Other Countries is generally not reimbursable through an FSA or HRA either.

Can I use my HSA debit card to pay for Medicines Purchased from Other Countries?

No. Medicines Purchased from Other Countries is not a qualified medical expense. Using your HSA card would be a non-qualified distribution subject to income tax and a 20% penalty if you are under 65.

Do I need to keep a receipt for Medicines Purchased from Other Countries?

Yes — for every HSA withdrawal the IRS requires documentation proving the expense was qualified. Keep itemized receipts for at least 3 years after the tax year.

Can I reimburse myself years later for Medicines Purchased from Other Countries?

Yes — the IRS imposes no time limit on HSA reimbursements. As long as the expense was incurred after your HSA was established and you have documentation, you can reimburse yourself years or even decades later.

Source: IRS Publication 502 — Medical and Dental Expenses. Not tax advice; consult a tax professional for your situation.