Receipts — what the IRS requires and how long to keep them

The IRS doesn't audit your HSA every year — it picks at random and looks at multi-year patterns. The rule of thumb is: if you ever pull tax-free money out of an HSA for a reimbursement, you should be able to produce the receipt for that expense, however old.

What a valid receipt needs

The IRS wants enough info to confirm the expense was for qualified medical care:

• Provider name — who you paid
• Date of service or purchase
• Amount you paid out-of-pocket
• Description — what was the service or product (so it's clear it was medical)

Cleanest sources:

• Pharmacy receipts with the prescription name and amount
• Doctor's office receipts with the visit type
• Itemized invoices for procedures
• EOBs (Explanation of Benefits) for insurance-covered services

What's not enough on its own

• A credit card statement — shows you paid $50 to "CVS," but doesn't prove what you bought
• A bank transfer record — same issue
• A photo of just the credit card terminal screen — no provider info

Pair these with the actual itemized receipt to make a complete record.

How long to keep them

The IRS statute of limitations on a tax return is generally 3 years, but for HSA reimbursements it's effectively as long as you might want to claim it. If you pay for an expense in 2025 and don't reimburse yourself until 2040, you need the 2025 receipt in 2040 to defend that reimbursement if audited.

Practical advice: keep every HSA-related receipt for the entire life of the HSA, plus 7 years after you've used the last reimbursement.

How Reimbursable helps

• We store every receipt you upload indefinitely as long as your account is active.
• The Tax Documents export includes a ZIP of every receipt for the year — useful as an offline backup.
• The audit-ready PDF in the export ties expenses, receipts, and reimbursements together in one document.

Lost receipts

If you can't find a receipt:

• Pharmacies can usually reprint receipts going back several years.
• Medical offices can reprint or email statements.
• Insurance EOBs can be re-downloaded from your insurer's website.

If you genuinely can't recover a receipt, you have a choice: leave the expense unclaimed, or claim it and accept the audit risk. Most tax pros suggest erring on the side of leaving it unclaimed.

Updated on: 05/06/2026