Use this guide to understand which medical services, products, and treatments qualify for reimbursement through your HSA.
Be sure to also review our ineligible expenses guide.
1. Authorized Medical Practitioners
For an expense to be eligible, both of the following must be true:
- The service must be performed by a practitioner recognized by the Canada Revenue Agency for Medical Expense Tax Credit (METC) purposes in the province where the service is performed
- The service must be a medical service, meaning a diagnostic, therapeutic, or rehabilitative service performed by that practitioner acting within the scope of their professional training
Being treated by an authorized practitioner is required, but it does not make everything they do automatically eligible.
Products, wellness services, memberships, lifestyle programs, or general health services do not qualify as medical services.
Practitioner eligibility is province-specific, meaning a practitioner type that qualifies in one province may not qualify in another.
For example, an acupuncturist is recognized in Ontario but not in Manitoba.
The CRA maintains a province-by-province list of authorized medical practitioners. It includes licensed professionals such as:
- Chiropractors
- Dentists
- Medical doctors
- Optometrists
- Psychologists
- Physiotherapists
- Occupational therapists
- Speech-language pathologists
- Registered massage therapists (RMTs)
- Naturopaths
- Acupuncturists
- Audiologists
- Dietitians
- Osteopaths
- Podiatrists
- Social workers
- Dental hygienists
- Respiratory therapists
- Clinical counsellors
- Midwives
See the full list of authorized medical practitioners by province (CRA)
2. Eligible Medical Expenses
In addition to eligible medical services, an HSA can reimburse a broad range of out-of-pocket medical expenses when they qualify under the Medical Expense Tax Credit (METC).
To be eligible, an expense must generally be incurred for medical services, treatments, or supplies that are diagnostic, therapeutic, or rehabilitative in nature, and meet the specific conditions for eligibility outlined on the METC list.
These rules apply uniformly across Canada.
Documentation requirements may vary by expense type.
Below are common examples of medical expenses that may be eligible through a Hiveworks HSA when CRA requirements are met:
- Prescription drugs
- Dental services
- Orthodontics (braces)
- Vision care (glasses, contact lenses, eye exams)
- Laser eye surgery
- Physiotherapy
- Massage therapy
- Mental health counselling
- Fertility treatments
- Ambulance services
- Hearing aids
- Diabetic supplies
- Custom orthotics
- Medical travel costs (conditions apply)
- Incontinence supplies
- CPAP machines
- Oxygen and oxygen equipment
- Hospital services (private or semi-private rooms)
- Speech therapy
- Occupational therapy
- Acupuncture
- Chiropractor treatments
- Smoking cessation programs
- Breast pumps
- Home care services
- Mobility aids (walkers, wheelchairs)
- Diagnostic scans (e.g. MRI, CT)
- Eye surgery
- Nursing services
- Vaccinations
- Compression stockings
- Blood tests
- Premiums paid for other benefits plans
Some of these require extra documentation:
- Prescription: Often applies to medications, some equipment, or therapies
- Certification in writing: For services like private nursing or medical renovations
- Form T2201 Certificate: Required for certain disability-related claims
See the CRA’s full list of eligible medical expenses and documentation requirements
How to think about HSA eligibility in real-world situations
Many questions about HSA eligibility arise from everyday situations where the rules feel unclear.
In practice, eligibility is not determined by whether an expense feels reasonable or medically helpful, but by how the Canada Revenue Agency classifies that expense under the Medical Expense Tax Credit framework.
A useful way to think about HSA eligibility is to separate clinical care from personal or supportive spending.
Medical services that are diagnostic, therapeutic, or rehabilitative in nature, and performed by an authorized practitioner acting within their professional scope, generally qualify.
Expenses that fall outside that definition often do not, even when they are health-related.
This distinction becomes especially important with mixed-use expenses.
For example, many clinics offer both eligible services and ineligible products or programs.
An appointment with a practitioner may qualify, while supplements, wellness products, memberships, or access fees purchased at the same time do not.
How an expense is billed, packaged, or marketed does not change its eligibility.
Timing of Expense
Eligibility is tied to when medical treatment begins or when a service is actually provided, not when payment is made.
This matters for prepaid services, treatment plans, and programs.
Understanding this distinction helps prevent claims that are technically correct in substance but submitted too early to qualify.
Provincial Differences
Practitioner recognition varies by province, meaning the same service may be eligible in one province and ineligible in another.
This is why CRA’s province-specific practitioner list is a critical reference when reviewing HSA claims.
Documentation Plays a Key Role
Even when an expense is eligible in principle, missing prescriptions, incomplete receipts, or required forms can prevent reimbursement.
Reviewing CRA documentation requirements alongside eligible expense categories helps ensure claims are submitted correctly the first time.
Understanding both eligible and ineligible expenses together helps set clear expectations, and keeps your plan compliant over the long term.
Questions around expense eligibility? Email us at support@hiveco.ca or call us at 1-888-661-7786.
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