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Who Decides What is Eligible Under an HSA?

We are often asked why we have to adhere so closely to the list of eligible items, and why we are unable to stray from it. A common misconception is that we at myHSA decide what is eligible on an employees Health Spending Account, but that's not the case!

We do have adjudicators that assess the claims, but they must adhere to guidelines. In Canada, the ultimate arbiter of HSA eligibility is the Canada Revenue Agency (CRA). In this article, I'll delve into the role of the CRA in deciding what expenses are eligible under an HSA. 

When it comes to Health Spending Accounts, the CRA plays a pivotal role in determining which medical expenses are considered eligible for reimbursement. They decide what is eligible because a Health Spending Account is non-taxable, and therefore, they require some level of medical necessity to be present for the items. This means that for an expense to be eligible, it must be incurred primarily for the prevention or treatment of a medical condition. The CRA considers whether the product or service is essential for maintaining or improving an individual's health.

For this reason, our adjudicators uphold the rules and cannot deviate from them to make exceptions on the HSA, as much as we sometimes want to. You are always welcome to reach out to us and gain an understanding of what the criteria is, and in some cases the claim can be supplemented to get it to the point of eligibility. If you are curious about what is eligible, you can check your List of Covered Items on the dashboard of your account!

Questions? Reach out to, we are happy to help!

Danielle Constantine

CX Manager


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