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IRS publication 502 includes a partial list of what expenses are considered qualified medical expenses for health savings account purposes. The list is not exhaustive as there are many shades of gray when it comes to interpreting what constitutes a medical expense. According to federal rules, the expense has to be "primarily for the prevention or alleviation of a physical or mental defect or illness." There is no way to monitor what you spend your HSA money on. You are the one who ultimately decides whether to pay for an expense with funds from your HSA. If you are audited by the IRS at a later date, and the expense cannot be documented and proven to be a qualified medical expense, you will likely be fined. Keep all your receipts for tax purposes to avoid this possibility. You can use the money in your own HSA to pay for medical care not only for yourself but also for your spouse or dependent. You can even use your HSA funds to pay for medical services provided in other countries. However, you cannot use the money in your HSA to pay your insurance premiums unless you are unemployed.