Can You Use FSA or HSA Money on a DNA Test?

Why this comes up at year-end

Health flexible spending accounts (FSAs) are generally "use-it-or-lose-it" plans, in the IRS's own words. Money you don't spend by the end of the plan year is usually forfeited, unless your plan offers one of two options:

• A grace period of up to 2½ months after the plan year ends, during which new expenses can still be paid from last year's balance.
• A carryover of a limited amount of unused money into the next plan year. Anything above the limit is forfeited. In its 2026 inflation adjustments (Revenue Procedure 2025-32), the IRS set the maximum carryover at $680 for plans that allow one.

A health FSA can offer one of these or neither, but not both. That's a plan design choice, so check your plan documents or benefits portal. If your plan year follows the calendar, December is when this gets urgent, and it's when a lot of people start wondering whether a DNA test could soak up the balance.

Health savings accounts (HSAs) work differently. The IRS says amounts left in an HSA at the end of the year generally carry over, so there's no year-end deadline pushing you to spend.

One timing detail matters for mail-in kits. An FSA reimburses qualified expenses you incurred during the period of coverage. If you order a kit in late December but collect and mail it in January, ask your administrator which plan year they'll count it in before you rely on this year's money.

What the IRS counts as medical care

FSAs and HSAs pay for qualified medical expenses, which follow the tax code's definition of medical care. IRS Publication 502 puts it this way: medical expenses are "the costs of diagnosis, cure, mitigation, treatment, or prevention of disease." The expense has to be primarily to alleviate or prevent a physical or mental disability or illness, and expenses that are "merely beneficial to general health" don't count.

Publication 502 has no entry for consumer DNA tests. It does include laboratory fees that are part of medical care, and diagnostic tests by a physician as part of a physical exam. The IRS's separate FAQ on nutrition, wellness and general health adds a line worth remembering: "A generalized desire to monitor or improve health is not sufficient."

So the question isn't really "is this product eligible?" It's "is this purchase medical care for me?" The same kit can land differently depending on why you're buying it and what your plan requires.

Where DNA tests tend to land

Applied to genetic testing, that definition sorts tests into rough groups. These are general patterns, not guarantees:

The combined-kit row reflects an IRS private letter ruling dated May 2019 and released that August (PLR 201933005). A taxpayer with a health FSA asked whether a DNA kit bundling ancestry and health reports could count as medical care. The IRS concluded that the kit's price had to be allocated between the ancestry services and the health services, and that only the part attributable to medical care could qualify. A private letter ruling applies only to the taxpayer who requested it and can't be cited as precedent, but it shows how the IRS approached the question.

If you have a real medical reason to test, such as a strong family history, unexplained symptoms or a medication question, start with your clinician or a genetic counselor. A clinical test may be partly covered by insurance, and any out-of-pocket share is the most straightforward use of FSA or HSA money. Our guides to consumer vs clinical-grade genetic testing and whether you need a genetic counselor explain the difference.

Letters of medical necessity

For items that aren't automatically eligible, some plans ask for a letter of medical necessity (LMN): a form or letter from your clinician that names the medical condition and explains why the item or service is needed for it. The federal employees' program, FSAFEDS, is one example. Its LMN form is for expenses that aren't automatically eligible, and the practitioner fills in the medical condition and how long treatment will last, then attests that it isn't for general health or cosmetic purposes.

An LMN has to reflect a real medical reason. In March 2024 the IRS warned (IR-2024-65) that some companies were misrepresenting when nutrition and wellness expenses can be paid from these accounts, including claims that notes from doctors based merely on self-reported health information could make personal expenses qualify. The IRS said that documentation doesn't work. It also said a plan that reimburses non-medical expenses isn't a qualified plan, which can make all of its payments taxable, including reimbursements for genuine medical expenses. That alert was about food and wellness products, but the logic is worth keeping in mind for any purchase.

What "HSA/FSA eligible" on a product page means

Some sellers label their tests as eligible. When we checked on October 25, 2026, Dante Labs' homepage described its whole genome kit as "HSA/FSA eligible." That's the seller's statement. It isn't an IRS ruling, and it doesn't bind your plan.

• With an FSA, your plan administrator reviews the claim against the plan's rules. The IRS requires you to give the FSA a written statement from an independent third party showing that the expense was incurred and its amount. The administrator makes the final call.
• With an HSA, the IRS puts the burden on you to keep records showing your distributions paid for qualified medical expenses. Money taken out for anything else is taxable, and the IRS adds a 20% tax on top unless the distribution comes after you're disabled, reach 65, or die.

Whichever account you use, check with your administrator before you buy if you can, keep an itemized receipt, and keep any LMN with your tax records.

A sensible checklist before you spend

1. Be honest about why you want the test. If there's a medical reason, talk to your clinician first. Our guide to bringing DNA results to your doctor can help frame that conversation.
2. Check your plan's rules. Look for an eligible-expense list or call your administrator. Ask specifically about genetic tests and whether an LMN would be required.
3. Check your deadline. Grace period, carryover or neither? And how does your plan date an expense for a mail-in test?
4. Keep the paperwork. Save the itemized receipt, any LMN, and any claim approval.
5. Buy a test you'd want anyway. Spending to avoid forfeiting money is understandable, but the test should still be worth having. Our questions to ask before buying whole genome sequencing make a good gut check, and our genome sequencing cost guide explains what drives price.

Common questions

Medical disclaimer. GenomeTesting.org publishes educational content about genetics and consumer genomic testing. Nothing here is medical advice, a diagnosis, or a substitute for care from a qualified clinician or genetic counsellor. Decisions about testing, treatment, or interpreting your own results should be made with a healthcare professional who can see your full history.

Affiliate disclosure. Some links on this page are affiliate links. If you buy through them we may earn a commission at no extra cost to you. This never changes which products we recommend or what we say about them.