Can I Use My HSA for Long COVID Treatments in the USA? (2025 Guide)

Introduction

Long-COVID, often called post-COVID syndrome, is one of the most pressing health challenges in the United States today. Millions of Americans are still struggling with lingering symptoms months—or even years—after their initial infection. Fatigue, brain fog, breathing problems, anxiety, and ongoing medical needs can result in high out-of-pocket healthcare expenses.

If you have a Health Savings Account (HSA), you might be wondering:

👉 Can I use my HSA to pay for long-COVID treatments in 2025?

The short answer is yes—many long-COVID related expenses are HSA-eligible, but there are important rules and documentation requirements you should know. This guide breaks everything down in simple terms, so you can make the most of your HSA while managing long-COVID care.

What Is Long-COVID?

According to the CDC, long-COVID (also called post-acute sequelae of SARS-CoV-2, or PASC) refers to symptoms that continue for 4 weeks or longer after the initial infection. Common issues include:

Chronic fatigue and brain fog
Shortness of breath or chest pain
Sleep disorders
Depression and anxiety
Organ damage or neurological complications

Because symptoms vary widely, treatment often involves multiple specialists—from primary care physicians to mental health providers, rehabilitation centers, and alternative therapies.

Quick Refresher: How HSAs Work

A Health Savings Account (HSA) is a tax-advantaged account available to people enrolled in a high-deductible health plan (HDHP). Here’s why it’s valuable:

Tax-free contributions: You don’t pay income tax on money you put in.
Tax-free growth: Your balance grows without being taxed.
Tax-free withdrawals: As long as funds are used for qualified medical expenses, you won’t pay taxes.

The IRS updates the list of qualified expenses every year. In 2025, many long-COVID treatments fall under these rules.

Can I use my HSA for Long COVID Treatments USA in 2025?

✅ Covered HSA-Eligible Long-COVID Expenses

Most long-COVID treatments are considered medical care and therefore eligible, including:

Doctor visits (primary care, specialists, pulmonologists, cardiologists, etc.)
Diagnostic tests (lung function tests, MRI, blood work)
Prescription medications (for managing symptoms like pain, anxiety, or sleep issues)
Mental health therapy and counseling
Physical therapy and rehabilitation sessions
Hospital bills and outpatient treatments

👉 If your doctor prescribes or recommends it for medical necessity, it usually qualifies.

⚠️ Expenses That May Require Documentation

Some treatments may require a Letter of Medical Necessity (LMN) from your doctor for HSA reimbursement:

Alternative therapies (acupuncture, chiropractic, massage therapy for chronic pain)
Nutritional supplements or vitamins
Sleep studies or specialized equipment

Having written documentation ensures that, if the IRS ever audits your HSA usage, you’re covered.

❌ Non-Eligible Expenses

The following are typically not HSA-eligible, unless specifically prescribed for medical necessity:

Over-the-counter vitamins or supplements
General wellness treatments (spa visits, gym memberships, meditation apps)
Experimental or unapproved treatments without medical documentation

IRS Updates: COVID-19 and HSA Coverage

During the COVID-19 Public Health Emergency (2020–2023), the IRS expanded flexibility for HSAs:

Testing and vaccines were automatically HSA-eligible.
Telehealth visits were covered pre-deductible.

⚠️ However, as of 2024–2025, some temporary flexibilities ended. That means:

COVID-related care is still HSA-eligible if it qualifies as medical treatment.
Telehealth coverage depends on your insurance plan, though HSAs still cover telehealth expenses as long as you’re paying out of pocket.

Practical Examples

Example 1:

Sarah suffers from long-COVID fatigue and depression. Her doctor prescribes antidepressants and weekly therapy sessions.
✅ Both her prescriptions and therapy bills are HSA-eligible.

Example 2:

John has lingering breathing issues after COVID. His pulmonologist recommends pulmonary rehab and a CPAP machine.
✅ Both the rehab sessions and medical equipment are HSA-eligible.

Example 3:

Priya wants to try herbal supplements to improve her energy levels. Unless her doctor provides a Letter of Medical Necessity,
❌ these are not HSA-eligible.

Benefits of Using an HSA for Long-COVID

Lower out-of-pocket costs: You’re using pre-tax money, which can save you 20–30% instantly.
Covers ongoing care: Since long-COVID is often chronic, having a dedicated tax-free account helps manage recurring costs.
Flexibility: You can pay for a wide range of services, including mental health, physical therapy, and prescriptions.
Rollover advantage: Unlike FSAs, your HSA balance rolls over year to year—so unused funds remain available for future treatments.

Tips for Maximizing HSA Use in 2025

Get documentation: Always keep receipts and, if needed, a Letter of Medical Necessity.
Use HSA debit cards when possible: Makes record-keeping easier.
Leverage telehealth: Many long-COVID patients rely on virtual care, which is still HSA-eligible.
Plan contributions: The 2025 HSA contribution limits are:
- $4,300 for individuals
- $8,550 for families
- +$1,000 catch-up if age 55+
Track IRS updates: Rules on eligible expenses may expand or change each year.

FAQs About HSA and Long-COVID

Q1: Can I use my HSA for long-COVID rehab programs?
Yes, if prescribed by a doctor, rehab and physical therapy are considered eligible expenses.

Q2: Are over-the-counter supplements covered?
Not usually, unless prescribed with medical documentation.

Q3: Can I pay for long-COVID related mental health therapy with HSA?
Absolutely. Therapy, psychiatry, and counseling are all qualified HSA expenses.

Q4: What if my insurance denies coverage for a long-COVID treatment?
You can still use HSA funds as long as it meets IRS eligibility requirements.

Final Thoughts

Managing long-COVID can be overwhelming, both physically and financially. The good news is that in 2025, many long-COVID treatments are HSA-eligible, giving patients in the USA a way to reduce financial stress while focusing on recovery.

Always remember:

Keep documentation for all medical expenses.
Consult your doctor about eligibility for alternative therapies.
Review IRS guidelines annually to stay compliant.

Using your HSA strategically can make a real difference in managing the costs of long-COVID care—helping you protect both your health and your wallet.

👉 IRS – Medical and Dental Expenses (Publication 502)
https://www.irs.gov/publications/p502

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