Buyer Beware: What's Not Eligible Under Your Canadian HSA (Yet)

You’ve probably seen it before: a product labelled “HSA Eligible” on Instagram or your favourite online store. Maybe it’s a skincare item, a hair vitamin, or that sleek new fitness tracker.  

It almost sounds too good to be true, right? Well, it just might be. Unfortunately, just because something is marketed as HSA-eligible online doesn’t mean it qualifies as such under Canadian guidelines. 

Why There’s Confusion 

Many online stores are based in the U.S., where Health Savings Accounts follow a different set of eligibility guidelines. In Canada, our version of an “HSA” is a Health Spending Account, the guidelines of which are based on the Canada Revenue Agency (CRA)’s Medical Expense

Tax Credit (METC) list, which isn't the same as what’s allowed south of the border. 

That means a lot of popular U.S.-marketed “HSA Eligible” items don’t make the cut here (at least, not yet). 

A Canadian HSA vs an American HSA 

Even though they share the same abbreviation, Canadian and American HSAs aren’t the same thing at all. 

In the United States, a Health Savings Account is a personal savings account that’s tied to a high-deductible health insurance plan. Employees and employers can both contribute pre-tax dollars, and those funds can be used for a wide range of qualified medical expenses, often including over-the-counter medications, menstrual products, vitamins, and wellness tools. 

In Canada, our Health Spending Accounts work differently, and they don’t function as a savings account or bank account. Here, it’s a non-taxable employee benefit funded entirely by the employer. Every eligible expense is determined by the Canada Revenue Agency (CRA) and is tied directly to the Medical Expense Tax Credit (METC) list. 

Common “HSA Eligible” Items Not Covered in Canada 

Here are a few expenses that may be eligible in the U.S. but are not reimbursable under Canadian HSA rules: 

• Menstrual products (pads, tampons, period underwear, cups) 

• Vitamins, supplements, and probiotics 

• Skincare and sunscreen 

• Fitness trackers and smartwatches 

• Over-the-counter (OTC) medicines 

• Massage guns and at-home therapy devices 

• “Wellness” foods and drinks (protein powders, green juices, meal kits) 

While these items may show up under “HSA Eligible” categories on U.S. websites, they don’t meet the CRA’s criteria under the METC. 

How to Spot the Difference 

Before you hit “add to cart,” take a closer look: 

1. Is the shop U.S.-based? If so, they’re likely referencing American HSA rules. 

2. Reference the CRA’s Medical Expense Tax Credit list to be sure. 

3. When in doubt, ask! Your HSA provider (like us) can help you determine whether an expense qualifies before you make a purchase. 

The Bottom Line 

The world of health and wellness spending is evolving. While Canada’s METC list may not include every trending wellness product (yet), staying informed helps you make the most of your HSA. 

If you’re ever unsure, reach out to our team, we can help you figure it out before you check out.