HSA-Eligible Diabetes Supplies: What the IRS Says
The IRS names two diabetes items outright in Publication 502: insulin, and a blood sugar test kit. Its Form 8889 instructions add that CGMs for people diagnosed with diabetes are generally treated as preventive care for high-deductible plans. For other items, ask your HSA administrator. This is general tax information, not tax advice.
The rule
HSA qualified medical expenses are, generally, unreimbursed medical expenses that could be deducted on Schedule A. Publication 502 says you can include the cost of devices used in diagnosing and treating illness and disease.
What the IRS says by item
| Item | What the IRS states |
|---|---|
| Insulin | Pub 502: “You can also include amounts you pay for insulin.” It is the exception to the rule that a drug that is not prescribed cannot be included. |
| Blood sugar test kit | Pub 502 (Diagnostic Devices): if you have diabetes and use a blood sugar test kit, you can include its cost in your medical expenses. |
| CGM | Form 8889 instructions (2025): Notice 2024-75 clarifies that continuous glucose monitors for people diagnosed with diabetes are generally treated as preventive care for HDHP purposes. |
| Insulin (HDHP) | Same instructions: the safe harbor for absence of a deductible for certain insulin products applies whether or not the insulin is prescribed to treat diabetes. |
| Strips, lancets, pump supplies, glucose tablets | Not named in the sections of Publication 502 we read. Ask your HSA administrator. |
| Diet food | Pub 502 (weight-loss section): you cannot include the cost of diet food or beverages. |
Checked 2026-10-22 against the IRS pages for the 2025 tax year. Tax rules change.
Makers’ statements
Dexcom’s Stelo page and Abbott’s Lingo page each say their over-the-counter sensors are HSA/FSA eligible. See over-the-counter CGMs. Your HSA or FSA administrator has the final word on what it reimburses, and may ask for receipts.
Add up costs in the supply cost calculator. For Medicare, see test strips.
Frequently asked questions
Is insulin an HSA-eligible expense?
Yes. IRS Publication 502 says you can include amounts you pay for insulin, even though most drugs that are not prescribed cannot be included.
Is a blood sugar test kit HSA-eligible?
Publication 502 gives this exact example: if you have diabetes and use a blood sugar test kit, you can include its cost in your medical expenses.
Are CGMs HSA-eligible?
Both Dexcom (Stelo) and Abbott (Lingo) state their over-the-counter sensors are HSA/FSA eligible. The IRS also says in its Form 8889 instructions that CGMs for people diagnosed with diabetes are generally treated as preventive care for high-deductible health plans.
Where can I check an item Publication 502 does not name?
Ask your HSA administrator, or check IRS Publication 502 and Publication 969. HSA rules follow the medical expenses you could deduct, so an item not named may still qualify if it treats or diagnoses a condition.
Information only, not medical advice. Your care team may set different targets for you, and only a lab test ordered by a clinician can diagnose diabetes or prediabetes. See our medical disclaimer.
Sources
- IRS Publication 502 (2025): Medical and Dental Expenses
- IRS: Instructions for Form 8889 (2025), Health Savings Accounts
- Dexcom: Stelo (checked 2026-10-22)
- Abbott: Lingo (checked 2026-10-22)
Last reviewed: by the Diabetes Blogs editorial team. Information only, not medical advice.
