The complete CRA list of Health Spending Account Eligible Expenses
Every expense the Canada Revenue Agency lets a Health Spending Account reimburse, A to Z — with the prescription, certification and Form T2201 flags from the CRA's own eligibility table, the dollar caps, and the provision that disqualifies each item on the other list. Free printable checklist included.
- 18 min read
- For Canadian employees, employers, and accountants
- Updated 2026-08-12
A Health Spending Account has no expense list of its own — it uses the CRA's
TL;DRA Health Spending Account has no expense list of its own. Under CRA Interpretation Bulletin IT-339R2, paragraph 4, an HSA — legally a Private Health Services Plan under subsection 248(1) of the Income Tax Act — may only reimburse expenses that would qualify for the Medical Expense Tax Credit under subsection 118.2(2), which is the same list every Canadian taxpayer uses at filing time.
"Health Spending Account," "Healthcare Spending Account" and "HCSA" are three marketing names for one thing: a Private Health Services Plan, defined in subsection 248(1) of the Income Tax Act. The tax treatment comes from that definition — deductible to the employer, not employment income to the employee — and so does the boundary of what the plan may pay for.
IT-339R2 draws that boundary in one clause, and the wording matters because it sets a ceiling rather than a menu. A plan may choose to cover less than subsection 118.2(2) allows. It can never cover more and stay a private health services plan.
The public reference is the CRA's page for lines 33099 and 33199, "Details of medical expenses," last modified January 20, 2026. It names each expense and flags, item by item, whether a prescription is needed, whether a medical practitioner must certify the need in writing, and whether Form T2201 — the Disability Tax Credit Certificate — must be approved and on file. The A–Z table further down this page reproduces those entries with the conditions and dollar limits folded into each row.
One disambiguation before you read on. This page is about the Canadian Health Spending Account. The American "HSA" is a personal savings account governed by the U.S. Internal Revenue Code with its own list in IRS Publication 502; the two share an acronym and nothing else. Plan setup, carry-forward and audit rules are also out of scope here — those are the subject of the rules guide linked below.
must be in respect of hospital care or expense or medical care or expense which normally would otherwise have qualified as a medical expense under the provisions of subsection 118.2(2)
CRA, IT-339R2, paragraph 4
The five terms that decide every answer on this page
- HSA / HCSA
- Two marketing names for the same product: an employer-funded account that reimburses employees for medical expenses.
- PHSP
- Private Health Services Plan — the legal category in ITA s. 248(1) that an HSA must fit to be tax-free to the employee.
- METC
- Medical Expense Tax Credit — the personal credit in ITA s. 118.2 whose eligible-expense list the HSA borrows in full.
- Form T2201
- Disability Tax Credit Certificate — must be approved and on file before a small number of listed expenses qualify.
- Regulation 5700
- The schedule of prescribed medical devices in the Income Tax Regulations. A device that is not on it is not eligible, however medically necessary.
Which list applies to your plan
| What you have | Which list governs it |
|---|---|
| Canadian HSA or HCSA (a PHSP) | The Income Tax Act s. 118.2(2) list — the CRA's eligibility table for lines 33099 and 33199. |
| Group insurance plan | The insurer's policy booklet, which is narrower. An insured plan pays for what the contract covers, and contracts rarely reach the full statutory list. |
| U.S. Health Savings Account | IRS Publication 502. Different country, different statute; nothing on this page applies to it. |
The printable checklist: every eligible and ineligible expense on one page
TL;DRThe CRA does not publish a one-page checklist of eligible medical expenses. Its official downloadable document is Guide RC4065, Medical Expenses (2025 edition), a full-length guide, and the per-item conditions live on a web page rather than in a printable table — so this page includes a free, ungated, two-page checklist of the same list, dated and cited back to the CRA source.
Start with the CRA's own material if you want the authority in hand: Guide RC4065, Medical Expenses, is free on canada.ca and covers the credit in full, and the "Details of medical expenses" page carries the conditions attached to each entry. Neither is something you can pin above a desk or hand to an employee.
The checklist below is the same list, compressed. Page one groups the eligible expenses by category with P, C and T markers for prescription, written certification and Form T2201, and carries the dollar caps as footnotes. Page two lists what is not eligible with the reason for each, the massage-therapy province matrix, and the Medical Expense Tax Credit threshold. It is dated, it names its source, and it is updated when the CRA changes the list.
The whole list, on one page
Print it, pin it in the lunchroom, or send it to your bookkeeper. No email required.
PDF · 2 pages · updated August 2026
The complete A–Z table of CRA-eligible medical expenses
TL;DRThis is the CRA's eligibility table for lines 33099 and 33199, reproduced in alphabetical order with the agency's own flags — prescription needed, written certification needed, Form T2201 needed — and the dollar limits and conditions from the CRA's "Details of medical expenses" page, which was last modified January 20, 2026. A Health Spending Account reimburses from this table and nothing outside it.
Type a word to filter, or jump to a letter. Where a row reads "Conditional," the expense is eligible only in the circumstances set out in the notes — read the note before you spend, not after.
Showing 133 of 133 expenses.
| Expense | HSA-eligible? | Prescription / certification | Conditions and limits |
|---|---|---|---|
| Acoustic coupler | Eligible | Prescription | Modem coupler that lets a person with a hearing impairment use a telephone. |
| Air conditioner | Eligible | Prescription | For a person with a severe chronic ailment, disease or disorder. Claim the lesser of $1,000 and 50% of the amount paid. |
| Air filter, cleaner or purifier | Eligible | Prescription | For a person with a severe chronic respiratory ailment or immune system disorder, to cope with or overcome that ailment. |
| Altered auditory feedback devices | Eligible | Prescription | For a person with a speech impairment. |
| Ambulance service | Eligible | None required | To or from a public or licensed private hospital. |
| Artificial eye | Eligible | None required | |
| Artificial limb | Eligible | None required | |
| Assisted breathing devices | Eligible | Prescription | Devices that give air to the lungs under pressure, including CPAP machines and mechanical ventilators. |
| Athletic or fitness club fees | Not eligible | Not applicable | Membership and program fees are not a medical service under ITA s. 118.2(2). |
| Attendant care and care in a facility | Eligible | None required | Amounts paid for attendant care at home, in a group home, or in a nursing home or other facility. How much is claimable depends on the type of care and on whether the Disability Tax Credit is also being claimed. |
| Audible signal devices | Eligible | Prescription | Large bells, loud-ringing bells, visible signals and vibrating signals, for a person with a hearing impairment. |
| Baby breathing monitor | Eligible | Prescription · Written certification | For a child at risk of sudden infant death syndrome. A medical practitioner must certify in writing that the child is at risk. |
| Bathroom aids | Eligible | Prescription | To help a person get in or out of a bathtub or shower, or on or off a toilet. |
| Birth control devices | Not eligible | Not applicable | Non-prescription devices are not eligible. Prescription contraceptives dispensed by a pharmacist are eligible as prescription drugs. |
| Bliss symbol boards | Eligible | Prescription | Or similar devices used by a person with a speech impairment to communicate by selecting symbols or spelling out words. |
| Blood coagulation monitors | Eligible | Prescription | For a person who needs anticoagulation therapy, including disposable peripherals. |
| Blood pressure monitors | Not eligible | Not applicable | Not eligible, even on medical advice. |
| Bone conduction receiver | Eligible | None required | |
| Bone marrow transplant | Eligible | None required | Reasonable amounts paid to find a compatible donor and arrange the transplant, including legal fees and insurance premiums, plus reasonable travel, board and lodging for the patient, the donor, and their attendants. |
| Braces for a limb | Eligible | None required | Includes a woven or elasticized stocking where it is a substitute for a brace. |
| Braille note-taker devices | Eligible | Prescription | So a person who is blind can take notes with a device that reads them back or prints them in braille. |
| Braille printers, synthetic speech systems and large print-on-screen devices | Eligible | Prescription | Designed to let a person who is blind operate a computer. |
| Breast prosthesis | Eligible | Prescription | Because of a mastectomy. |
| Cancer treatment | Eligible | None required | In or outside Canada, provided by a medical practitioner or a public or licensed private hospital. |
| Catheters, catheter trays and tubing | Eligible | None required | Or other products needed for incontinence caused by illness, injury or affliction. |
| Certificates | Eligible | None required | The fee paid to a medical practitioner for completing and providing information on Form T2201 or another required certificate. |
| Chair (power-operated guided chair for a stairway) | Eligible | Prescription | Including installation. |
| Cochlear implant | Eligible | None required | |
| Computer peripherals | Eligible | Prescription | |
| Cosmetic surgery | Conditional | None required | Eligible where the procedure is necessary for medical or reconstructive purposes — surgery to address a deformity related to a congenital abnormality, a personal injury resulting from an accident or trauma, or a disfiguring disease. Procedures undertaken purely for cosmetic reasons are excluded by ITA s. 118.2(2.1). |
| Cosmetic surgery solely for cosmetic procedures | Not eligible | Not applicable | Liposuction, hair replacement procedures, filler injections to remove wrinkles and teeth whitening are excluded by ITA s. 118.2(2.1), whatever the amount paid. |
| Crutches | Eligible | None required | |
| Deaf-blind intervening services | Eligible | None required | Paid to someone in the business of providing these services. |
| Dental services | Eligible | None required | Paid to a medical practitioner or a dentist. Purely cosmetic dental work is excluded by ITA s. 118.2(2.1). |
| Dentures and dental implants | Eligible | None required | |
| Devices or software for reading print | Eligible | Prescription | Designed to be used by a person who is blind or who has a severe learning disability. |
| Diaper services | Not eligible | Not applicable | The service is not eligible, although the diapers themselves are. |
| Diapers and disposable briefs | Eligible | None required | For a person who is incontinent because of illness, injury or affliction. |
| Driveway alteration | Eligible | None required | Reasonable amounts paid to alter the driveway of the main residence of a person with a severe and prolonged mobility impairment, to ease access to a bus. |
| Drugs and medical devices bought under Health Canada's Special Access Programs | Eligible | None required | |
| Egg and sperm freezing and storage | Eligible | None required | To preserve ova (eggs) or sperm for the purpose of conceiving a child in the future. |
| Elastic support hose | Eligible | Prescription | Designed only to relieve swelling caused by chronic lymphedema. |
| Electrolysis | Eligible | None required | Only amounts paid to a medical practitioner qualify. Purely cosmetic procedures are not eligible. |
| Electronic bone healing device | Eligible | Prescription | |
| Electronic speech synthesizers | Eligible | Prescription | So a person who cannot speak can communicate using a portable keyboard. |
| Electrotherapy devices | Eligible | Prescription | For a person with a chronic ailment or a severe mobility impairment. |
| Environment control system | Eligible | Prescription | Computerized or electronic, for a person with a severe and prolonged mobility impairment. |
| Extremity pump | Eligible | Prescription | For a person with chronic lymphedema. |
| Fertility-related procedures | Eligible | None required | Amounts paid to a medical practitioner or a public or licensed private hospital to conceive a child. Since 2022, certain amounts paid to a fertility clinic or donor bank in Canada for donor sperm, ova or embryos also qualify. |
| Furnace | Eligible | Prescription | For a person with a severe chronic respiratory ailment or immune system disorder. |
| Gluten-free food products | Eligible | Written certification | Only the incremental cost of gluten-free products over comparable non-gluten-free products, for a person with celiac disease certified in writing by a medical practitioner. |
| Health plan premiums paid by an employer and not included in your income | Not eligible | Not applicable | You cannot claim an amount you never paid and were never taxed on. |
| Hearing aids | Eligible | None required | Including repairs and batteries. |
| Heart monitoring devices | Eligible | Prescription | Including repairs and batteries. |
| Hospital bed | Eligible | Prescription | Including attachments. |
| Hospital services | Eligible | None required | Public or licensed private hospital services. |
| Hot tub installed in a home | Not eligible | Not applicable | Drawn from the CRA's whirlpool bath treatments entry rather than a line item of its own on the CRA's table. The tub is not eligible even when prescribed; treatments given by a medical practitioner are. |
| Ileostomy and colostomy pads | Eligible | None required | Including pouches and adhesives. |
| In vitro fertility program | Eligible | None required | |
| Infusion pump | Eligible | Prescription | Including disposable peripherals, to treat diabetes; also a device that lets a person with diabetes measure their blood sugar level. |
| Injection pens | Eligible | Prescription | To give injections, such as an insulin pen. |
| Insulin or substitutes | Eligible | Prescription | |
| Kidney machine (dialyzer) | Eligible | None required | Including repairs, maintenance, installation, related supplies and electricity, and additions or alterations to a home needed to install it. |
| Laboratory procedures and services | Eligible | Prescription | Including the required interpretation. COVID-19 tests need a prescription to qualify, even where the test was required for travel. |
| Laryngeal speaking aids | Eligible | None required | |
| Laser eye surgery | Eligible | None required | No prescription required. |
| Lift or transportation equipment | Eligible | Prescription | Power-operated, designed only to help a person with a disability move between levels of a building, or into or out of a vehicle or a wheelchair. |
| Liver extract injectable | Eligible | Prescription | For a person with pernicious anaemia. |
| Lodging | Conditional | None required | Drawn from the accommodation clause inside the CRA's travel expenses entries rather than a line item of its own on the CRA's table. Eligible only as part of travel for medical services unavailable locally, and only where the person travelled at least 80 km one way. See Travel expenses. |
| Medical cannabis | Eligible | None required | Cannabis, cannabis oil, plants or seeds bought for a patient who holds a medical document, from a holder of a licence for sale under the Cannabis Regulations. The cost of growing cannabis at home is not eligible. |
| Medical services by medical practitioners | Eligible | None required | Amounts paid to a medical practitioner, dentist or nurse, or to a public or licensed private hospital. Which professions count as a medical practitioner is decided province by province. |
| Medical services provided outside of Canada | Eligible | None required | Paid to a licensed medical practitioner or a licensed hospital outside Canada. |
| Mobile application | Not eligible | Not applicable | An app that tracks health information and sends it to a doctor is not eligible. A device that measures blood glucose is. |
| Moving expenses | Conditional | None required | Reasonable moving expenses, to a limit of $2,000 ($3,525 for residents of Ontario), to move to housing that is more accessible for a person with a severe and prolonged mobility impairment. |
| Needles and syringes | Eligible | Prescription | |
| Note-taking services | Eligible | Written certification | For a person with an impairment in physical or mental functions certified in writing by a medical practitioner, paid to someone in the business of providing these services. |
| Nurse | Eligible | None required | Full-time or part-time nursing care in a self-contained domestic establishment or in a hospital. |
| Nursing home | Conditional | None required | Drawn from the CRA's attendant care and care in a facility entry rather than a line item of its own on the CRA's table. Full-time care in a nursing home; how much is claimable depends on the care provided and on whether the Disability Tax Credit is also claimed. |
| Optical scanners | Eligible | Prescription | Or similar devices designed to help a person who is blind read print. |
| Organ transplant | Eligible | None required | Reasonable amounts paid to find a compatible donor and arrange the transplant, including legal fees and insurance premiums, plus reasonable travel, board and lodging for the patient, the donor, and their attendants. |
| Organic food | Not eligible | Not applicable | Not eligible. The narrow food exception is the incremental cost of gluten-free products for certified celiac disease. |
| Orthodontic work | Eligible | None required | For medical reasons. Purely cosmetic orthodontics are excluded by ITA s. 118.2(2.1). |
| Orthopaedic shoes, boots and inserts | Eligible | Prescription | Custom made, on the written order of a medical practitioner. |
| Osteogenesis stimulator | Eligible | Prescription | Inductive coupling, for treating non-union of fractures or aiding bone fusion. |
| Over-the-counter medications | Not eligible | Not applicable | The CRA states these cannot be claimed even if prescribed by a medical practitioner. |
| Oxygen and oxygen tent | Eligible | Prescription | Including other equipment needed to administer oxygen, and the electricity to run it. |
| Oxygen concentrator | Eligible | None required | Amounts paid to buy, use and maintain an oxygen concentrator, including the electricity to run it. |
| Pacemakers | Eligible | Prescription | |
| Page-turner devices | Eligible | Prescription | To help a person turn the pages of a book when a severe and prolonged impairment markedly restricts the use of their arms or hands. |
| Personal response systems | Not eligible | Not applicable | Systems such as Lifeline and Health Line Services are not eligible. |
| Personalized therapy plan | Eligible | Prescription · Form T2201 | For a person eligible for the Disability Tax Credit, where the plan is needed to access public funding for specialized therapy and is designed by a qualifying professional. |
| Phototherapy equipment | Eligible | None required | For treating psoriasis or other skin disorders, including the cost of electricity. |
| Pre-natal and post-natal treatments | Eligible | None required | Paid to a medical practitioner or a public or licensed private hospital. |
| Premiums paid to private health services plans | Conditional | None required | Medical, dental and hospitalization plan premiums you paid yourself qualify where the plan is a private health services plan and 90% or more of its premiums relate to eligible medical expenses. Employer-paid premiums that were not included in your income do not qualify. |
| Prescription drugs and medications | Eligible | Prescription | Prescribed by a medical practitioner and recorded by a pharmacist. Products available without a prescription are not eligible even when recommended. |
| Pressure pulse therapy devices | Eligible | Prescription | For treating a balance disorder. |
| Provincial and territorial health plan premiums | Not eligible | Not applicable | Premiums and contributions to a provincial or territorial health insurance plan are not eligible in any jurisdiction. The table further down names all thirteen plans. |
| Radon testing | Not eligible | Not applicable | Not eligible, whatever the reading. |
| Reading services | Eligible | Written certification | For a person who is blind or has a severe learning disability certified in writing by a medical practitioner, paid to someone in the business of providing these services. |
| Real-time captioning | Eligible | None required | For a person with a speech or hearing impairment, paid to someone in the business of providing these services. |
| Rehabilitative therapy | Eligible | None required | Including lip reading and sign language training, to adjust to a loss of hearing or speech. |
| Renovation or construction expenses | Conditional | None required | Reasonable amounts for changes that give a person with a severe and prolonged mobility impairment access to, or greater mobility or functioning within, their home. The work must not be expected to increase the home's value and must not be something people with normal physical development would typically incur. |
| School for persons with an impairment in physical or mental functions | Eligible | Written certification | An appropriately qualified person must certify in writing that the equipment, facilities or personnel the school specially provides are needed because of the person's impairment. |
| Scooter | Eligible | None required | Bought to replace a wheelchair. |
| Service animals | Conditional | None required | For a person who is blind, profoundly deaf, has a severe and prolonged impairment that markedly restricts the use of arms or legs, is severely affected by autism or epilepsy, or — for expenses incurred after 2017 — has a severe mental impairment. The animal must be specially trained to perform specific tasks; animals that provide emotional support only do not qualify. |
| Sign-language interpretation services | Eligible | None required | For a person with a speech or hearing impairment, paid to someone in the business of providing these services. |
| Spinal brace | Eligible | None required | |
| Standing devices | Eligible | Prescription | For standing therapy, for a person with a severe mobility impairment. |
| Supplements and vitamins | Not eligible | Not applicable | Not claimable even if prescribed. The one exception is vitamin B12 therapy for pernicious anaemia, which is a separate eligible entry. |
| Talking textbooks | Eligible | Written certification | Related to enrolment at a secondary school in Canada or a designated educational institution, for a person with a perceptual disability. |
| Teletypewriters | Eligible | Prescription | Or similar devices that let a person who is deaf or unable to speak make and receive telephone calls. |
| Television closed caption decoders | Eligible | Prescription | For a person with a hearing impairment. |
| Tests | Eligible | Prescription | Medical tests such as electrocardiographs, electrocardiograms, metabolism tests, radiological services or procedures, spinal fluid tests, stool examinations, sugar content tests, urine analysis and x-ray services, including any related interpretation or diagnosis. |
| Therapy | Eligible | Prescription · Form T2201 | Therapy a person eligible for the Disability Tax Credit needs, prescribed and supervised by a medical doctor or nurse practitioner, and by a psychologist for a mental impairment or an occupational therapist for a physical impairment. Amounts paid to a family member are not eligible. |
| Training | Eligible | None required | Reasonable amounts paid to train a person who cares for a relative with an impairment and who lives with, or is dependent on, that person. |
| Travel expenses (40 km or more one way) | Conditional | None required | Reasonable travel expenses to obtain medical services not available locally. Vehicle expenses qualify from 40 km one way; meals, accommodation, parking and an attendant's costs qualify from 80 km one way. |
| Travel expenses (less than 40 km one way) | Not eligible | Not applicable | Below the CRA's distance threshold, travel to obtain medical care is not eligible. |
| Treatment centre | Eligible | Written certification | For a person addicted to drugs, alcohol or gambling. A medical practitioner must certify that the person needs the centre's specialized equipment, facilities or staff. |
| Truss for hernia | Eligible | None required | |
| Tutoring services | Eligible | Written certification | Supplementary to the primary education of a person with a learning disability or an impairment in mental functions, paid to someone in the business of providing these services who is not related to the student. A medical practitioner must certify in writing that the services are needed. |
| Vaccines | Eligible | Prescription | |
| Van | Conditional | None required | A van previously adapted, or bought to be adapted, to transport a person who needs a wheelchair: 20% of the amount paid, to a maximum of $5,000 ($8,813 for residents of Ontario). |
| Vehicle device | Eligible | Prescription | Designed only to help a person with a mobility impairment get into or out of a vehicle. |
| Vision devices | Eligible | Prescription | Eyeglasses, contact lenses and prescription swimming goggles to correct vision, on the written order of a medical practitioner or optometrist. |
| Visual or vibratory signalling device | Eligible | Prescription | Used by a person with a hearing impairment. |
| Vitamin B12 | Eligible | Prescription | For a person with pernicious anaemia. The only vitamin on the CRA's eligible list. |
| Voice recognition software | Eligible | Written certification | Used by a person with a physical impairment certified in writing by a medical practitioner. |
| Volume control feature | Eligible | Prescription | Added to a telephone for a person with a hearing impairment. |
| Walking aids | Eligible | Prescription | Devices designed only to help a person with a mobility impairment walk. |
| Water filter, cleaner or purifier | Eligible | Prescription | For a person with a severe chronic respiratory ailment or immune system disorder. |
| Wheelchairs and wheelchair carriers | Eligible | None required | |
| Whirlpool bath treatments | Eligible | None required | The amount paid to a medical practitioner. A hot tub installed in a home is not eligible, even if prescribed. |
| Wigs | Eligible | Prescription | Custom made for a person who has suffered abnormal hair loss because of disease, medical treatment or an accident. |
Source: Canada Revenue Agency, "Details of medical expenses" and the eligibility table for lines 33099 and 33199 (canada.ca; page last modified January 20, 2026). Every eligibility status and every prescription, written certification and Form T2201 flag below is the CRA's own. Three entries — hot tub installed in a home, lodging, and nursing home — are drawn from clauses inside other CRA entries rather than being line items of their own, and their notes say so. Where an entry sets a dollar limit, the limit is the federal figure, with the Ontario figure noted alongside it.
Reimbursed at 100%
Every expense on this list, reimbursed at 100%
A Health Spending Account pays the full eligible amount, tax-free to the employee and deductible to the business. The ceiling is the allocation you set — not a coinsurance percentage, and not a per-category cap.
What is not eligible — and the provision that disqualifies each item
TL;DRThe CRA's table names a set of expenses as expressly not eligible — among them athletic and fitness club fees, over-the-counter medications even when prescribed, vitamins and supplements other than vitamin B12, blood pressure monitors, organic food, radon testing, and premiums for all thirteen provincial and territorial health plans — and subsection 118.2(2.1) of the Income Tax Act separately excludes procedures undertaken purely for cosmetic reasons.
An expense that fails the Medical Expense Tax Credit test fails Health Spending Account reimbursement too, and no administrator has discretion to add to the list. Each exclusion below names the provision or the CRA wording that disqualifies it.
Over-the-counter medications – cannot be claimed as medical expenses, even if prescribed by a medical practitioner.
CRA, Details of medical expenses
Athletic or fitness club fees
Listed as not eligible on the CRA's table: club membership and program fees are not a medical service under ITA s. 118.2(2). Employers who want to fund fitness use a taxable Lifestyle Spending Account instead.
Over-the-counter medications
The CRA states these cannot be claimed even if prescribed by a medical practitioner. Paragraph 118.2(2)(n) requires the drug to be prescribed and recorded by a pharmacist, and an over-the-counter purchase never is.
Vitamins and supplements
Same rule, same page: not claimable even when prescribed. The single exception is vitamin B12 therapy for pernicious anaemia, which is eligible with a prescription.
Procedures undertaken purely for cosmetic reasons
Excluded by ITA s. 118.2(2.1), which removes cosmetic expenses from the s. 118.2(2) list. Surgery to correct a congenital abnormality, or needed because of an accident, trauma or a disfiguring disease, remains eligible.
Provincial and territorial health plan premiums
Not eligible in any of the thirteen jurisdictions; the table below names each plan. Premiums you paid yourself to a private health services plan are a different entry, and those are eligible.
Health plan premiums paid by an employer and not included in your income
You cannot claim a credit for money you never paid and were never taxed on. This is the entry most often confused with the eligible one above it.
Blood pressure monitors
Listed as not eligible. Blood coagulation monitors and blood glucose measuring devices are eligible with a prescription, so the distinction is the device, not the fact of taking a reading.
Non-prescription birth control devices
Not eligible as a device. Prescription contraceptives dispensed and recorded by a pharmacist are eligible as prescription drugs.
Diaper services
The laundering service is not eligible. The diapers and disposable briefs themselves are eligible for a person who is incontinent because of illness, injury or affliction.
Mobile applications that track health information
Not eligible. A device that actually measures blood glucose is eligible with a prescription; an app that records the reading and forwards it to a doctor is not.
Organic food
Not eligible. The one food exception on the CRA's list is the incremental cost of gluten-free products for a person with certified celiac disease.
Personal response systems such as Lifeline and Health Line Services
Listed as not eligible on the CRA's table, regardless of the subscriber's health.
Radon testing
Listed as not eligible. Home testing and remediation are treated as property costs, not medical care.
Travel of less than 40 km one way
Below the CRA's distance threshold. Vehicle expenses become eligible at 40 km one way to services not available locally; meals, accommodation, parking and an attendant's costs become eligible at 80 km.
A hot tub installed in a home
Not eligible even when a physician prescribes it. Whirlpool bath treatments given by a medical practitioner are eligible; the tub in the backyard is not.
Animals that provide emotional support only
The service-animal entry requires an animal specially trained to perform specific tasks for a person with one of the listed impairments. Comfort and companionship alone do not meet the test.
The premium line most people get backwards
The thirteen health plans whose premiums are never eligible
| Province or territory | Plan |
|---|---|
| Alberta | Alberta Health Care Insurance Plan (AHCIP) |
| British Columbia | Medical Services Plan (MSP) |
| Manitoba | Manitoba Health |
| New Brunswick | New Brunswick Medicare |
| Newfoundland and Labrador | Medical Care Plan (MCP) |
| Northwest Territories | NWT Health Care Plan |
| Nova Scotia | Medical Services Insurance (MSI) |
| Nunavut | Nunavut Health Care Plan |
| Ontario | OHIP and the Ontario Health Premium |
| Prince Edward Island | Hospital and Medical Services Plan |
| Quebec | RAMQ prescription drug insurance contributions |
| Saskatchewan | Saskatchewan Health |
| Yukon | Yukon Health Care Insurance Plan |
The honest limit of the design
A Health Spending Account also cannot replace everything a group policy's premium bought. Life, disability and critical-illness premiums are never eligible medical expenses. Out-of-country emergency medical coverage is an insured product, not a reimbursement, and no HSA balance substitutes for it. And a fixed annual allocation cannot absorb a catastrophic claim the way a pooled insured plan can. That is the real boundary of the tool, and it is why many Canadian employers run an HSA alongside a small insured layer rather than instead of one.
Which expenses need a prescription, a written certification, or Form T2201
TL;DRThree different documents gate three different sets of expenses. A prescription from an authorized practitioner covers the largest group, including insulin, needles and syringes, vaccines, laboratory tests and custom orthopaedic footwear. A short list instead needs a medical practitioner to certify the need in writing. And two entries — therapy and a personalized therapy plan — require an approved Form T2201, the Disability Tax Credit Certificate, on file. Medical devices carry a further condition: they must appear on the schedule in section 5700 of the Income Tax Regulations.
The A–Z table flags these per row. This section is the summary an employee needs before spending money, because every one of these documents has to exist before the purchase, not after the claim is declined.
Prescription needed
A written order from an authorized medical practitioner, dated before the purchase. This is the largest group on the CRA's table, and several entries in it surprise people:
- Insulin and its substitutes, and needles and syringes
- Vaccines
- Laboratory procedures and services, including COVID-19 tests required for travel
- Custom orthopaedic shoes, boots and inserts
- Vision devices: eyeglasses, contact lenses, and prescription swimming goggles
- Elastic support hose, but only where it relieves swelling from chronic lymphedema
- Walking aids, scooters bought to replace a wheelchair, and power-operated lifts
- Air conditioners, air filters, furnaces and water purifiers, for a severe chronic respiratory ailment or immune system disorder
- Wigs, after abnormal hair loss caused by disease, medical treatment or an accident
- Pacemakers and heart monitoring devices
Written certification needed
A prescription is not enough here. A medical practitioner, or in one case an appropriately qualified person, must certify in writing that the individual needs what is being paid for:
- Baby breathing monitor, for a child at risk of sudden infant death syndrome
- Gluten-free food products, for certified celiac disease (the incremental cost only)
- Note-taking services
- Reading services
- School for persons with an impairment in physical or mental functions
- Talking textbooks
- Treatment centre, for addiction to drugs, alcohol or gambling
- Tutoring services, for a learning disability or an impairment in mental functions
- Voice recognition software
Form T2201 needed
Two entries require the Disability Tax Credit Certificate to be approved and on file, and both also require a prescription:
- Therapy — prescribed and supervised by a medical doctor or nurse practitioner, and by a psychologist for a mental impairment or an occupational therapist for a physical impairment. Amounts paid to a family member are not eligible.
- Personalized therapy plan — designed by a qualifying professional and required in order to access public funding for specialized therapy.
Devices have to be on the Regulation 5700 schedule
Paragraph 118.2(2)(m) of the Income Tax Act does not describe medical devices in general terms. It reaches a device or equipment of a prescribed kind, and "prescribed" here means named in section 5700 of the Income Tax Regulations. That schedule runs from artificial limbs and hospital beds to bone-conduction receivers and blood-coagulation monitors, each entry carrying its own qualifying words — which is why the CRA's descriptions are so specific about who the device is for.
a wig made to order for an individual who has suffered abnormal hair loss owing to disease, medical treatment or accident
Income Tax Regulations, s. 5700(a)
What the receipt has to show
Keep the prescription or certification with the receipt. A Health Spending Account claim is reviewed against the criteria the CRA itself applies: the receipt should name the practitioner, name their regulatory body, and show the date of service and the amount paid. Prescriptions and certifications should be dated before the purchase — a document written afterwards to rescue a claim carries very little weight.
Paramedical services are eligible only where the profession is regulated in your province
TL;DRParagraph 118.2(2)(a) of the Income Tax Act requires payment to a medical practitioner, dentist or nurse, or to a public or licensed private hospital — and which professions count as a medical practitioner is decided province by province. Massage therapy, for example, is eligible in British Columbia, New Brunswick, Newfoundland and Labrador, Ontario and Prince Edward Island, and not in Alberta, Manitoba, Quebec, Saskatchewan or Nova Scotia as of 2026.
Eligibility follows the province where the service is delivered, not the province where the employer is incorporated or where payroll is run. An Ontario company with an employee in Calgary applies Alberta's answer to that employee's massage receipt.
The CRA maintains the list — "Authorized medical practitioners for the purposes of the medical expense tax credit" — and updates it as provinces regulate new professions. It is the source of truth, it does change, and it is worth checking against rather than trusting a plan booklet or a clinic's assurance.
In practice there are two groups: professions regulated nearly everywhere, where a receipt is normally enough, and professions whose status varies, where the province decides the answer.
Regulated in all or nearly all provinces
- Physiotherapists
- Chiropractors
- Psychologists
- Optometrists
- Dentists
- Registered nurses
Check your province first
- Massage therapists
- Naturopaths
- Acupuncturists
- Osteopaths
- Counselling therapists
- Registered psychotherapists
Massage therapy, province by province
| Province | Massage therapy |
|---|---|
| British Columbia | Eligible |
| Alberta | Not eligible |
| Saskatchewan | Not eligible |
| Manitoba | Not eligible |
| Ontario | Eligible |
| Quebec | Not eligible |
| New Brunswick | Eligible |
| Nova Scotia | Not eligible |
| Prince Edward Island | Eligible |
| Newfoundland and Labrador | Eligible |
Status as of 2026, from the CRA's authorized-medical-practitioners page. Provinces add regulated professions over time; confirm against that page before relying on this row. The territories are not shown because the CRA's list does not currently authorize the profession there. Provincial tax treatment of the plan itself differs from provincial eligibility of the practitioner — see the Ontario guide for the retail sales tax and premium tax that apply there.
Same list, very different money: HSA reimbursement vs the Medical Expense Tax Credit
TL;DRA Health Spending Account reimburses 100% of an eligible expense, tax-free. The Medical Expense Tax Credit gives a 15% federal non-refundable credit — but only on what is left after subtracting the lesser of 3% of net income or $2,890 for the 2026 tax year. At a $70,000 net income, a $2,000 dental crown produces no federal credit at all, and $2,000 through an HSA.
The credit works like this. Total the eligible medical expenses paid in any 12-month period ending in the tax year — line 33099 for yourself, your spouse or common-law partner and your children under 18, line 33199 for other dependants. Subtract the lesser of 3% of your net income (line 23600) or $2,890, the threshold for the 2026 tax year. What remains generates a 15% federal non-refundable credit, plus a provincial credit on line 58689 of your Form 428. For the 2025 tax year the threshold was $2,834.
The threshold is the part people miss. It is not a deductible you clear once and forget; it scales with income, and for most working Canadians 3% of net income comes in below $2,890, so the credit only ever touches the portion of a bill above that line. A modest year of dental and vision spending can produce no credit whatsoever.
The two never apply to the same dollar. The credit is available only for amounts you have not been and will not be reimbursed for, so an expense an HSA has paid is out of the credit entirely. They do stack in sequence: spend the allocation first, then claim the genuinely unreimbursed remainder at tax time. On the employer's side the reimbursement has its own bookkeeping life: how HSA reimbursements are recorded walks through the journal entries, the T2 deduction and the T4 treatment.
The same expense, run through both routes
| Feature | Health Spending Account | Medical Expense Tax Credit |
|---|---|---|
| Recovery rate | 100% of the eligible expense, reimbursed in full | About 15% federally on the amount above the threshold, plus a provincial credit on Form 428 |
| Income threshold | None. The ceiling is the allocation the employer sets, not a percentage of income | The lesser of 3% of net income (line 23600) or $2,890 for the 2026 tax year |
| Who ends up better off | The employee: a PHSP reimbursement is not employment income | The taxpayer, and only on the portion of the bill above the threshold |
| Where it is reported | Nowhere on the T4. PHSP reimbursements do not appear in box 14 | T1 lines 33099 (self, spouse, children under 18) and 33199 (other dependants) |
| Timing | When the claim is processed, during the plan year | At tax filing, on expenses paid in any 12-month period ending in the tax year |
| Can the same expense go in both? | No. Once reimbursed, the expense is out of the credit | No. The credit is only for amounts you have not been and will not be reimbursed for |
Worked example
One employee, $70,000 net income for the 2026 tax year, no provincial credit assumed. Two scenarios, the same eligible expenses, run through both routes.
- 3% of $70,000 net income
- $2,100
- METC threshold: the lesser of 3% of net income or $2,890
- $2,100
- Scenario A — $2,000 dental crown, credit base after the threshold
- $0
- Scenario A — federal credit at 15%
- $0
- Scenario A — reimbursed through a Health Spending Account
- $2,000
- Scenario B — $3,500 of eligible expenses, credit base after the threshold
- $1,400
- Scenario B — federal credit at 15%
- $210
- Scenario B — reimbursed through a Health Spending Account
- $3,500
- Scenario B: what the HSA returns and the credit does not
- $3,290
Federal credit only; a provincial credit on Form 428 would add to the METC side. Threshold from the CRA's lines 33099 and 33199 page: the lesser of 3% of net income (line 23600) or $2,890 for the 2026 tax year. Figures are illustrative and rounded to whole dollars.
How to check whether a specific expense qualifies before you claim it
Seven checks, in order. Most claims that get declined fail one of the first four.
TL;DRFind the expense by the CRA's own name, confirm the practitioner's profession is authorized in the province where the service happens, obtain any prescription or written certification before you buy, check section 5700 of the Income Tax Regulations for devices, rule out the cosmetic and over-the-counter exclusions, keep an itemized receipt naming the practitioner and their regulatory body, and submit it to your plan administrator.
- 01
Find the expense by name
Search the A–Z table above for the CRA's own wording, or open the CRA's "Details of medical expenses" page. The wording is the rule: "whirlpool bath treatments" is on the list, "hot tub" is on it as an exclusion.
- 02
Check the practitioner, and the province
For a service, confirm the profession appears on the CRA's authorized-medical-practitioners list for the province where the service will be delivered — not the province where the employer is incorporated.
- 03
Get the prescription or certification before you buy
If the row is flagged for a prescription or a written certification, obtain it from an authorized practitioner first. A document written afterwards to support a claim is the weakest evidence you can offer.
- 04
For devices, check Regulation 5700
Paragraph 118.2(2)(m) of the Income Tax Act only reaches devices of a prescribed kind. Confirm the device appears on the schedule in section 5700 of the Income Tax Regulations.
- 05
Rule out the exclusions
Purely cosmetic purposes are excluded by subsection 118.2(2.1). Over-the-counter medications are excluded even when prescribed, and so are vitamins and supplements other than vitamin B12 for pernicious anaemia.
- 06
Keep an itemized receipt
The receipt should show the practitioner's name, their regulatory body, the date of service, and the amount paid. Keep it: the CRA can ask for it years later.
- 07
Submit it to your plan administrator
Your administrator reviews the claim against these same criteria. NuvioLife members have a Friendly Coverage Lookup built in, and approved claims are reimbursed in hours by EFT or Interac e-Transfer.
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Eligible expenses, answered plainly
Authoritative references
Every rule, flag and dollar limit on this page traces back to one of these primary sources: canada.ca, the Income Tax Act and Regulations on justice.gc.ca, or a published CRA interpretation bulletin. Open any link to read the underlying authority.
- Lines 33099 and 33199 - Eligible medical expenses you can claim on your tax return (CRA; carries the eligibility table and the $2,834 threshold)
- Details of medical expenses (CRA; per-item conditions and dollar limits, page modified 2026-01-20)
- Authorized medical practitioners for the purposes of the medical expense tax credit (CRA, by province)
- Income Tax Act s. 118.2 - Medical expense credit (Justice Canada)
- Income Tax Regulations s. 5700 - Prescribed medical devices and equipment (Justice Canada)
- IT-339R2 - Meaning of "Private Health Services Plan" (CRA)
- Income Tax Act s. 248(1) - PHSP definition (Justice Canada)
- Income Tax Folio S1-F1-C1 - Medical Expense Tax Credit (CRA)
- RC4065 Medical Expenses guide, 2025 edition (CRA; the official downloadable companion)
- CRA payroll - Medical expenses, including PHSP payments (employer treatment)