Most Canadians know that a Health Spending Account (HSA) can reimburse common medical expenses like dental cleanings, eyeglasses, and prescriptions. But far fewer realize just how broad the list really is – and how many specialized, high-value, or alternative expenses are fully eligible under CRA rules.
If you own an incorporated business or operate as an incorporated professional, a Health Spending Account is one of the most effective ways to turn personal medical costs into corporate deductions while receiving reimbursements tax-free. The key is understanding exactly what you can claim.
Below are 20 eligible HSA expenses most Canadians don't know about, all of which qualify under CRA's Medical Expense Tax Credit (METC) guidelines and can be legally reimbursed through a properly structured Health Spending Account.
1. Fertility Treatments & IVF Expenses
Fertility drugs, IVF procedures, embryo storage, and related medical services are all eligible under a Health Spending Account. These costs can easily reach tens of thousands of dollars, making HSA reimbursement extremely valuable.
2. Laser Eye Surgery (LASIK & PRK)
Corrective eye surgery is fully eligible, including consultations, surgery fees, and follow-up treatment.
3. Orthodontics for Adults and Children
Braces, Invisalign, retainers, and orthodontic evaluations are covered under a Health Spending Account, even for adults.
4. Psychology & Mental Health Counselling
Registered psychologists, psychotherapists, counsellors, and social workers are all eligible providers.
5. Massage Therapy (Registered Massage Therapists)
As long as the practitioner is registered in your province, massage therapy is HSA-eligible.
6. Acupuncture
A recognized medical service, acupuncture sessions can be reimbursed in full.
7. Custom Orthotics & Prescription Footwear
HSA coverage includes orthotic inserts, prescription orthopedic shoes, and podiatrist assessments.
8. Physiotherapy & Athletic Therapy
Everything from injury rehab to sports therapy sessions qualifies under a Health Spending Account.
9. Speech Therapy
Sessions with a licensed speech therapist for children or adults are eligible.
10. Dietitian & Nutrition Counselling
Dietitian appointments, including meal planning for chronic conditions, are HSA-eligible.
11. Hearing Aids & Assistive Listening Devices
Hearing tests, hearing aids, batteries, and auditory equipment are all eligible.
12. Medical Cannabis (When Prescribed)
Prescribed medical cannabis is eligible under a Health Spending Account. The prescription must come from an authorized medical practitioner.
13. Breast Pumps & Lactation Consultations
Breast pumps, equipment, and certified lactation consultant services are eligible expenses.
14. CPAP Machines & Sleep Therapy Equipment
Sleep apnea testing, CPAP machines, masks, tubing, and filters qualify.
15. Diagnostic & Lab Testing
Private bloodwork, ultrasounds, specialized testing, and lab services can be reimbursed through an HSA.
16. Botox for Medical Conditions
Botox used to treat migraines, TMJ, or other medical conditions (not cosmetic) is eligible.
17. Travel Costs for Medical Treatment
If medical treatment requires travel over 40 km (one way), travel costs may be claimed. Over 80 km may include meals and accommodation. A Health Spending Account can reimburse these costs when they meet CRA rules.
18. Home Accessibility Renovations
Certain renovations qualify, including ramps, widened doorways, and bathroom modifications for mobility.
19. Medical Devices & Supplies
Eligible items include:
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Glucose monitors
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Blood pressure monitors
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TENS machines
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Breast prostheses
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Incontinence supplies
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Mobility aids
If prescribed or medically necessary, these can all be reimbursed through your Health Spending Account.
20. Private Health Practitioners
Many Canadians don't realize HSAs cover services outside traditional medical offices, such as:
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Naturopaths
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Osteopaths
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Chiropractors
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Chiropodists
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Registered kinesiologists
As long as the practitioner is regulated in your province, their services can be processed through a Health Spending Account.
Why Most Canadians Don't Know About These Eligible Expenses
The CRA's list of eligible medical expenses is long – and not widely advertised. Traditional employee health plans often restrict coverage, impose limits, or exclude certain treatments entirely.
A Health Spending Account, on the other hand, is governed by CRA's Medical Expense Tax Credit rules. This makes the list of eligible expenses much broader than most people realize.
With a properly structured HSA, your corporation pays for these expenses as a tax-deductible benefit, while you and your family receive the reimbursements 100% tax-free.
How to Maximize Your Health Spending Account
To get the most value out of your HSA:
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Use a compliant platform that adjudicates claims properly.
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Keep receipts and medical documentation organized.
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Understand the CRA's eligibility rules.
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Work with a broker who specializes in Health Spending Account planning.
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Set a reasonable annual limit for yourself and any employees.
The more you understand what qualifies, the more tax savings your HSA can generate.
More to Consider…
A Health Spending Account is one of the most powerful tax tools available to incorporated Canadians, but only if you know how to use it to its full potential. These 20 often-overlooked eligible expenses can help you save thousands of dollars per year, reduce your personal out-of-pocket health costs, and protect your family's well-being with tax-free benefits.