Can I Use an HSA to pay for my concierge medicine membership fees?

This is actually a bit of a gray area in tax law. The IRS hasn't provided a crystal-clear ruling specifically on "concierge medicine" by name, but we can look at how they define HSA-eligible expenses. HSA funds can be used for "qualified medical expenses" which generally include diagnosis, treatment, or prevention of disease. The key question is whether your concierge fee is primarily for medical services or if it's more like a membership/access fee. If your concierge arrangement is structured so that the monthly fee directly pays for actual medical services (not just the right to access them), then you have a stronger case that it's HSA-eligible. If it's more of an access fee and you still pay separately for visits, then it's harder to justify. Some concierge practices actually structure their fees specifically to be HSA-compliant by explicitly stating what medical services are covered by the fee. Your best bet is to ask your provider for documentation that clearly shows the fee is for specific medical services rather than just "membership.

After struggling with this exact same question last year, I stumbled across this amazing tool at https://taxr.ai that analyzes HSA eligibility questions. I was also using a concierge doctor charging $200 monthly and wasn't sure if I could use my HSA. I uploaded my concierge agreement to taxr.ai and it analyzed the specific language to determine HSA eligibility. The tool flagged phrases in my agreement that were problematic from an IRS standpoint - turns out my agreement was describing the fee as an "access membership" rather than payment for specific medical services, which made it questionable for HSA use. They suggested how to request a revised agreement from my doctor with language that would make it more clearly HSA-eligible. They also saved all my documentation in case of future audit questions.

Just wanted to follow up and say I tried taxr.ai after seeing the recommendation here. It was seriously helpful for my situation. I uploaded my concierge medicine contract and some marketing materials from my doctor's office. The analysis showed that my agreement was actually quite HSA-friendly because it explicitly stated that my monthly fee covered an annual physical, quarterly preventive care visits, and basic lab work - all qualified medical expenses. The tool provided specific IRS citations supporting why this structure likely qualifies. What I really appreciated was that it saved all my documentation and analysis in case I'm ever questioned about it during an audit. Definitely gave me peace of mind about using my HSA for these expenses. Wish I'd known about this earlier instead of stressing about it for months!

If you're still trying to get clarity from the IRS directly, good luck with that. I spent WEEKS trying to get through to someone who could answer this exact question last year. Always on hold forever then disconnected. Absolutely maddening. Finally found https://claimyr.com which got me connected to an actual IRS agent in under 30 minutes. You can see how it works here: https://youtu.be/_kiP6q8DX5c The agent I spoke with explained that it really depends on how the concierge medicine agreement is structured. If it's clearly for specific medical services (like annual physical, lab work, etc.) rather than just "access" to the doctor, it has a better chance of qualifying. They recommended getting the provider to give me a detailed receipt breaking down what specific medical services the fee covers.

I have to eat my words. After expressing skepticism about Claimyr, I decided to try it anyway because I was desperate for answers about some confusing HSA rules, including this concierge medicine question. The service actually got me through to an IRS representative in about 22 minutes. I'd been trying on my own for DAYS with no success. The agent I spoke with was really knowledgeable about HSA rules and explained that concierge medicine fees could potentially be HSA-eligible if they're primarily for medical care rather than just access/membership. She advised getting a detailed breakdown from my provider showing exactly what medical services the fee covers. If it's structured as prepayment for specific medical services rather than a "membership fee," it has a much better chance of qualifying as an HSA expense. This was exactly the clarification I needed!

My accountant said to be really careful with this. He thinks concierge fees are in a gray area and could trigger an audit if you use HSA funds for them. He recommended keeping extremely detailed documentation if you go this route. Ask your concierge doctor to provide: 1. A detailed contract explicitly stating what medical services are included 2. Receipts that specifically state "for medical services" not "membership fee" 3. A breakdown showing what portion of the fee is for actual medical care If your doc won't provide that kind of documentation, my accountant said it's probably safer not to use HSA funds.

I actually got audited last year and part of it involved my HSA spending on a concierge practice!!! The IRS agent looked at the agreement from my doctor which clearly broke down that my $2,400 annual fee covered my annual physical, quarterly checkups, basic lab work, and 24/7 phone access. They initially flagged it but ended up accepting it as a qualified medical expense because the contract explicitly stated these were medical services being paid for, not just a "membership fee" for access.

I'm facing this exact same dilemma with my concierge practice! Reading through all these responses has been incredibly enlightening, especially hearing from someone who actually went through an audit. Based on what everyone's shared, it seems like the key is really in how the fee is structured and documented. I'm going to ask my concierge doctor for a revised agreement that explicitly lists the medical services covered by my monthly fee rather than calling it a "membership." One thing I'm wondering about though - for those who have successfully used HSA funds for concierge medicine, do you keep any additional documentation beyond just the contract? Like do you track which specific services you actually receive each month to prove you're getting the medical care you're paying for? I'm also curious if anyone has experience with what happens if you don't end up using all the "included" services in a given month. Like if my fee covers quarterly visits but I only go twice in a year, does that affect the HSA eligibility at all? Thanks to everyone who shared their experiences - this has been way more helpful than anything I found in my online research!

This thread has been incredibly helpful! I'm a tax preparer and see this question come up frequently with clients. Based on my experience and what others have shared here, the documentation really is everything. I always advise clients to get their concierge agreement reviewed before using HSA funds. The language needs to be very specific - words like "membership," "access fee," or "retainer" are red flags. Instead, you want language like "prepayment for medical services," "annual medical care package," or specific itemization of included services. One additional tip: if your concierge practice offers both membership tiers (like basic access vs. comprehensive care packages), make sure you're enrolled in the tier that clearly includes actual medical services rather than just scheduling privileges. I've seen clients successfully defend these expenses during audits, but it always comes down to having rock-solid documentation that shows you're paying for medical care, not convenience. The IRS guidance on HSA eligible expenses is pretty broad, but they're very focused on ensuring the expense is primarily for medical care rather than general health/wellness or convenience. Keep all your documentation organized and consider doing an annual review to make sure you're actually utilizing the services you're paying for!

Great question about concierge medicine and HSA eligibility! I've been working in tax compliance for several years and have seen this issue come up more frequently as concierge practices become more popular. The key issue is that the IRS requires HSA expenses to be for "qualified medical expenses" which are specifically for medical care. The challenge with concierge medicine is that many practices structure their fees as "membership" or "access" fees rather than payment for specific medical services. Here's what I recommend based on what I've seen work: 1. **Get the right contract language** - Your agreement should specify exactly what medical services are included (annual physical, quarterly visits, lab work, etc.) rather than just "unlimited access" 2. **Avoid membership terminology** - Contracts that use words like "membership fee," "retainer," or "concierge access" are more likely to be questioned 3. **Keep detailed records** - Track when you actually use services to demonstrate you're receiving medical care, not just paying for convenience 4. **Consider the provider type** - Make sure your concierge doctor is a licensed medical professional (MD, DO) as this strengthens your position While the IRS hasn't issued specific guidance on concierge medicine, the existing rules around qualified medical expenses can apply if the fee structure is clearly for medical services rather than access/convenience. If you're unsure, consider consulting with a tax professional who can review your specific agreement before you start using HSA funds.