Back-to-School Shopping? 8 Expenses an HSA May Help Cover

Quick look: Back-to-school shopping doesn’t end with backpacks and school supplies. From annual physicals and new glasses to orthodontic care and college healthcare expenses, families can face a long list of health-related costs throughout the school year. A health savings account (HSA) can help employees use pre-tax dollars to pay for many of these qualified expenses, making it a valuable benefit for families at every stage.

When students head back to the classroom each fall, that transition brings a wave of costs: physicals, new glasses, or perhaps a first round of braces. But the expenses don’t stop as the school year ramps up, and for many families, healthcare spending is one of the biggest items in their household budget.

A health savings account (HSA) is a particularly useful tool during these seasonal spending spikes. Available to participants enrolled in a high-deductible health plan (HDHP), HSAs allow employees to set aside pre-tax dollars to pay for qualified medical expenses. These contributions can grow and come out tax-free, and unlike a flexible spending account (FSA), balances roll over each year. In 2026, the contribution limit for an HSA for family coverage is $8,750, and those aged 55 and up can contribute an extra $1,000.

For small and mid-sized businesses (SMBs), HSAs can also be a key part of a benefits strategy. They give employees another way to make their healthcare dollars go further while helping employers offer benefits that support employees and their families.

8 ways to save on school-year expenses with an HSA

There’s almost certainly a way for parents to put an HSA to use, no matter their child’s age, grade level, extracurriculars, or health needs.

1. Sports and back-to-school physicals

Many schools and youth sports leagues require an annual physical before students can step onto the field or into the classroom. Sports physicals are typically not covered by insurance unless they’re combined with an annual well-child visit, which means families must pay out of pocket for a separate appointment. HSA funds can cover the cost of the appointment if it is standalone, helping avoid an unexpected expense.

2. Eye exams, glasses, and contacts

According to the Centers for Disease Control and Prevention (CDC), 25% of kids between ages 2 and 17 wear glasses or contact lenses, and that number tends to climb as children move through school. HSAs help parents save on vision care by covering eye exams, prescription glasses, contact lenses, and even blue-light lenses for students who study and spend long hours in front of screens.

3. Orthodontic care

Each year, 3.5 million children undergo orthodontic treatment, and it often comes with a substantial price tag. Standard metal braces typically cost between $3,000 and $7,500, and aligners and palate expanders also can reach into the thousands, making orthodontics one of the most expensive back-to-school-adjacent costs families face.

Dental insurance plans often limit lifetime orthodontic coverage to $1,000 to $2,000, leaving a sizable gap. However, employees can avoid high-interest financing or tapping their savings by covering the difference with their HSA.

4. HSA cards for college students

Teens can still benefit from their parents’ HSA even when they go off to college. As long as the student is still claimed as a tax dependent, parents can request an additional HSA debit card in the student’s name, linked to the same account. This gives students an easy way to pay for eligible prescriptions, doctor visits, and other qualified expenses on campus without waiting for a parent to send money or reimburse a receipt.

5. Over-the-counter healthcare essentials

A back-to-school shopping list might include pencils, notebooks, and backpacks, but families may want to stock up on healthcare essentials, too. Depending on the item, HSA funds can be used for a variety of eligible over-the-counter (OTC) items, including:

• Bandages and first aid supplies for sports practice scrapes
• Pain relievers and cold medicine
• Thermometers
• Menstrual products
• Sunscreen for sports and recess
• Medicated acne treatments
• Lice treatment kits

And thanks to changes made under the CARES Act, many OTC medications can be purchased with HSA funds without a prescription.

6. Telehealth visits

Busy school days, extracurricular activities, and packed work schedules can make it tricky to find the time for an in-person doctor’s visit. The convenience of telehealth has become a go-to option for busy families and students alike. In fact, one study found 71% of college students report using a telehealth service, compared to just 54% of the general population.

HSA funds can be put toward virtual visits, giving whole families a flexible way to get care for a minor illness, follow-up, or other appropriate medical concern without having to sit in a waiting room.

7. Mental health support

The return to school can bring academic demands, social pressures, and major changes in routine. For some students, that transition can also affect their mental well-being. CDC data shows 40% of high school students report persistent feelings of sadness or hopelessness, and approximately 70% of college students say they’ve experienced a mental or behavioral health concern in the last year.

HSAs can generally be used for therapy sessions, counseling, and other mental health services, helping open the door to support without adding financial stress to the mix.

8. Allergy testing

Fall allergies tend to flare up right as the school year kicks off, and for kids heading off to college or a new city, an unfamiliar environment can expose new allergens. HSA funds can cover allergy testing and treatment, helping families pinpoint triggers and get ahead of symptoms.

The extra perks of an HSA

Beyond helping working parents save on their families’ needs throughout the school year, HSAs add even more value in a handful of ways:

• Investment potential: Account holders can invest their HSA funds once their balance reaches the HSA provider’s required minimum threshold.
• Triple tax savings: HSAs offer three layers of tax advantages:
  • Contributions are tax-deductible (or pre-tax via payroll)
  • Any interest, dividends, or investment earnings grow tax-free
  • Withdrawals are also tax-free when used for qualified medical expenses
• Funds stay with the employee: Unlike FSAs, with an HSA, there are no “use it or lose it” rules. HSAs are bank accounts, and the money that is contributed isn’t recouped if an employee switches employers.
• Elections can be changed at any time: If a participant wants to increase or lower their contribution, they can do so at any time. Adjusting along the way can be helpful for those who know they have a large upcoming expense, or simply want to build a rainy-day medical fund.

Making valuable benefits more accessible for SMBs

An HSA-eligible health plan can be a valuable way for SMBs to give employees more flexibility when managing healthcare costs. But building and administering a competitive benefits package can be a lot for a lean HR team to take on.

This is when some SMBs choose to partner with an HR outsourcing provider, like a professional employer organization (PEO). PEOs give SMBs access to Fortune 500-level benefits, including HSA-eligible plans, at competitive rates and without having to manage everything in-house.

Beyond benefits, a PEO also provides support with the everyday HR work that comes with managing a growing workforce, like risk and compliance, recruiting, payroll, and employee management.

With ExtensisHR, employees get more from their benefits and employers get more support:

• Flexible benefits that suit your team’s specific needs
• Complimentary recruiting, from creating job ads to onboarding coordination
• A three-layer dedicated team, featuring an Account Manager, HR Business Partner, and Payroll Specialist
• An Employee Solution Center that provides ultra-responsive support for employee questions about enrollment, plan definitions, qualifying life events, and more

Employees want benefits that work for their lives, not just benefits they can check off a list. An HSA can help families stretch their healthcare dollars while preparing for the expenses that come with the start of a new school year.