Marijuana is not eligible for reimbursement with a Flexible Spending Account (FSA) or Health Savings Account (HSA), even when used for medical purposes.
Why Is Marijuana Not FSA/HSA Eligible?
Although marijuana may be legal for medical or recreational use in many states, it remains illegal under federal law. Because FSAs and HSAs are regulated by federal tax law, expenses for marijuana and marijuana-derived products do not qualify as medical care under IRS Code Section 213(d).
According to IRS Publication 502, “You can’t include in medical expenses amounts you pay for controlled substances (such as marijuana, laetrile, etc.) that are illegal under federal law, even if such substances are legal under state law.”
This exclusion applies to all forms of marijuana—including flower, edibles, tinctures, and topical products—regardless of whether they are purchased with a state-issued medical marijuana card.
What’s Not Covered?
Medical or recreational marijuana in any form (flower, edibles, oils, or concentrates)
Marijuana-derived products such as THC tinctures or topicals
Purchases from dispensaries, even with a medical marijuana card
Growing or cultivation equipment for personal or medical use
State registration or medical marijuana card fees
LMN and Exceptions
Marijuana is not eligible under any circumstances. A Letter of Medical Necessity (LMN) cannot make marijuana or marijuana-derived products reimbursable under federal law.
However, some FDA-approved cannabinoid medications that contain specific active ingredients (such as cannabidiol, or CBD) and have a National Drug Code (NDC) may qualify if prescribed by a physician. Examples include Epidiolex, which is approved for certain seizure disorders.
If you are prescribed an FDA-approved medication derived from cannabis:
Confirm that the product has an NDC and is classified as a prescription drug.
Use your FSA/HSA card to purchase it through a pharmacy.
Retain your prescription and receipts in case verification is required.
All non-prescription marijuana or cannabis products remain ineligible for reimbursement.
