Who determines if HSA distributions are used exclusively for qualified medical expenses?

The HSA owner is responsible for using the account within the rules. As you are purchasing medical goods and services, you should save your itemized receipts showing date of service, patient name, services rendered and how much insurance paid, if any.

If you are ever personally audited, you will be asked to present receipts for eligible expenses matching the amount you have withdrawn from your HSA. Your HSA custodian is not determining if your purchases are for qualified medical expenses nor are the transactions on your monthly statement enough to prove the purchases are permitted. Save your receipts.

Distributions from your HSA should only be used for qualifying medical, vision, hearing or dental expenses.