Page 98 - 2021-2022 New Hire Benefits

Health Savings Accounts (HSAs)

Qualified medical expenses and your HSA

Your Salisbury Bank HSA covers a wide variety of medical expenses. To help you determine whether an expense
qualifies for tax-free reimbursement under your HSA, Internal Revenue Code Section 213(d) states that eligible
expenses must be made for “medical care.” This is defined as amounts paid for the “diagnosis, cure, mitigation,
treatment or prevention of disease, or for the purpose of affecting any structure or function of the body.”
Qualified medical expenses are eligible for reimbursement through your HSA as long as they are not reimbursed
through insurance or other sources. The examples and requirements listed below are subject to change by the IRS.

Examples of qualified medical expenses:
Acupuncture Crutches Nursing home

Alcoholism treatment Dental Treatment (x-rays, fillings, Nursing services
Ambulance services extractions, dentures, braces, etc.) Operations or surgery
Artificial limb or prosthesis Diagnostic devices Physical examination
(such as a blood sugar test kit)
Artificial teeth Pregnancy test kit
Disabled dependent care expenses
Bandages Prescription drugs including insulin
Doctor’s fees
Birth control pills Psychiatric care
Drug addiction treatment
Body scan Psychologist
Eye exam and eyeglasses
Braille books and magazines Sterilization
(part of the costs) Eye surgery (including laser eye surgery) Stop-Smoking Programs
Breast pumps and supplies Fertility enhancement Telephone – Hearing Impaired
(including in-vitro fertilization)
Breast reconstruction surgery Television – Hearing Impaired
following a mastectomy for cancer Guide dog or other service animal
(for visually or hearing-impaired) Therapy or counseling
Car adaptations Transplants
(for a person with a disability) Hearing aids and hearing aid batteries
Chiropractic services Hospital services Transportation for medical care
(including meals and lodging) Wheelchair or Autoette
Christian Science practitioners
Laboratory fees X-rays
Contact lenses
(including saline solutions and cleaner) Lactation assistance supplies
Long-term care services and insurance

You can treat the following insurance premiums as qualified medical expenses:
1. Long-term care insurance (subject to limits based on age and adjusted annually)
2. Health care continuation coverage (such as coverage under COBRA)
3. Health care coverage while receiving unemployment compensation under federal and state law
4. Medicare or other health care coverage if you are 65 or older (other than premiums for a Medicare
supplement policy, such as Medigap)

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