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NPA Urges IRS to Include Supplements as Qualified Medical Expenses

by Eric Munson | September 2, 2025

The Natural Products Association (NPA) urged the Internal Revenue Service (IRS) to modernize IRS Publication 502 to expand “qualified medical expenses” to include nutritional and dietary supplements that carry U.S. Food and Drug Administration (FDA)-authorized health claims or structure-function claims.

This update would allow consumers to use their Health Savings Accounts (HSAs), Flexible Spending Accounts (FSAs) and Health Reimbursement Arrangements (HRAs) without first obtaining a prescription.

Daniel Fabricant, PhD, president and CEO of NPA, sent a letter to the IRS advocating for a revision to IRS Publication 502.

“Currently, IRS rules prohibit consumers from using HSA, FSA or HRA dollars for supplements unless they first obtain a prescription. The prescription requirement adds no clinical benefit and instead creates costly and unnecessary barriers to supporting Americans’ health, forcing consumers to schedule doctor appointments solely for permission to buy widely available, FDA-regulated products that are used every day to support immune health, heart health, cognitive function and more,” Fabricant wrote.

According to Section 213(d) of the Internal Revenue Code (IRC), “medical care” includes 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.” NPA argues nutritional supplements apply to these parameters.

NPA proposed the following update to Publication 502: “You can include in medical expenses the cost of ‘dietary supplements,’ as defined in 21 U.S.C. 321(ff)(1), provided that such products are labeled with an FDA-authorized health claim, bear statements describing how they are intended to affect the structure or function of the human body, or include statements characterizing the documented mechanism by which the product maintains such structure or function.”

“This modest change would modernize a 20th-century rule to reflect 21st-century science and consumer health behavior, without changing the underlying statute or regulation. Allowing Americans to use their HSA, FSA, or HRA dollars for scientifically substantiated supplements without a prescription would promote preventive care, reduce unnecessary health system burdens, support health equity by improving access and reinforce personal responsibility in managing health,” Fabricant wrote.

For more information, visit www.npanational.org.

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