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List of Health Care Spending Accounts (HCSA) Eligible Expenses

By: Benefits by Design | Tuesday June 25, 2019

Updated : Friday December 30, 2022

Health Care Spending Accounts (HCSA)s, sometimes known as Health Spending Accounts (HSA), are an increasingly popular alternative or top-up to traditional health and dental solutions. HCSAs give employees flexibility and enable an element of self-service in choosing how to spend their dollars.

Having access to an HCSA is also a determinant in how highly plan members think of their employee benefits plan. According to the 2020 Sanofi Canada Healthcare Survey, 78% of plan members who have an HCSA rate their benefits plan as “excellent.”

Spending Account Claims Submissions Deadlines and Carry-Forward Rules and Options

List of HCSA Eligible Expenses

The Canada Revenue Agency (CRA) regulates all HCSA eligible expenses. They determine what is eligible and what isn’t. As a result, this list is not complete.

However, it does include some of the most commonly inquired about eligible expenses, such as:

Cancer Treatments

Cancer treatments in or outside Canada, given by a medical practitioner or a public of licensed private hospital.

Cochlear Implants

Cochlear implants for the hearing impaired can be claimed without any certification of prescription.

Dental Services

Dental Services, including orthodontic work (such as braces) paid to a medical practitioner or a dentist. However, expenses for purely cosmetic procedures may not be eligible.

Diagnostic Tests

A variety of diagnostic tests are available as an HCSA eligible expense. For example:

  • electrocardiographs
  • electrocardiograms
  • metabolism tests
  • radiological services or procedures
  • spinal fluid tests
  • stool examinations
  • sugar content tests
  • urine analysis
  • x-ray services.

In addition, you can claim the cost of any related interpretation or diagnosis or prescription needed.


Prescription drugs and medications that can lawfully be obtained for use by the person only if prescribed by a medical practitioner. Furthermore, the drugs or medications must be recorded by a pharmacist. You cannot claim over-the-counter medications, vitamins, or supplements, even if prescribed by a medical practitioner (except Vitamin B12).

Laser Eye Surgery

The amount paid to a medical practitioner or a public or licensed private hospital.

Premiums to Private Health Services Plans

For instance, this could include medical, dental, and hospitalization plans. They can be claimed as a medical expense, as long as 90% or more of the premiums paid under the plan are for eligible medical expenses.


Coverage could include eyeglasses and contact lenses to correct eyesight, for example.

For a complete list, you can check out the CRA website.

Go to the CRA Website

Is a Health Care Spending Account (HCSA) an add-on to a health insurance plan or a plan itself?

HCSAs can be a top-up to an existing plan or a standalone benefits solution.

For example, on a traditional fully-insured plan, an HCSA could act as a top-up to provide more choices to employees. 

On the flip side, our fully digital Standalone® HCSA product is often used as a benefits solution in its own right (hence the name) and gives employees the power to choose how to spend their benefits dollars. Used this way, an HCSA is a flexible employee benefits plan.

The State of Health Care Spending Accounts