No — St John's Wort is not HSA eligible
St. John's Wort is not eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), a health reimbursement arrangement (HRA), a dependent care flexible spending account (DCFSA) or a limited-purpose flexible spending account (LPFSA). Using HSA funds for St John's Wort would be a non-qualified distribution subject to income tax, plus a 20% penalty if you are under 65.
Paying with HSA funds results in income tax on the amount and a 20% penalty if you’re under age 65. Keep St John's Wort off your HSA unless circumstances change.
How to claim it
- Pay with a regular card, not your HSA debit card.
- If a physician prescribes it for a diagnosed condition, some otherwise-ineligible items may qualify with a Letter of Medical Necessity — ask your provider.
Frequently asked questions
Can I use my HSA debit card to pay for St John's Wort?
No. St John's Wort 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 St John's Wort?
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 St John's Wort?
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.